Implementation of hypoxia measurement into lung cancer therapy.

Tumor hypoxia has been found to be a characteristic feature in lung cancer. It has been shown to decrease the therapeutic efficacy of radiotherapy and some forms of chemotherapy. New methods for qualitative and quantitative assessment of tumor oxygenation have made it possible to establish the prognostic significance of tumor hypoxia. The ability to determine the degree and extent of hypoxia in lung cancer is not only important prognostically, but also in the selection of patients for hypoxia-modifying treatments. To provide the best attainable quality of life for individual patients it is of increasing importance that tools be developed that allow a better selection of patients for these intensified treatment strategies. Although some markers and combinations have shown potential benefit and are associated with treatment outcome, their clinical usefulness needs to be validated in prospective trials. A review of published studies was carried out, focusing on the assessment of tumor hypoxia and the possibilities to overcome hypoxia during treatment in lung cancer.