Andrea Bezjak1, Sarah Temin1, Gregg Franklin1, Giuseppe Giaccone1, Ramaswamy Govindan1, Melissa L Johnson1, Andreas Rimner1, Bryan J Schneider1, John Strawn1, Christopher G Azzoli1. 1. Andrea Bezjak, Princess Margaret Cancer Center, Toronto, Ontario, Canada; Sarah Temin, American Society of Clinical Oncology, Alexandria, VA; Gregg Franklin, New Mexico Cancer Center, Albuquerque, NM; Giuseppe Giaccone, Lombardi Cancer Center, Washington, DC; Ramaswamy Govindan, Washington University, St Louis, MO; Melissa L. Johnson, Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL; Andreas Rimner, Memorial Sloan Kettering Cancer Center; Bryan J. Schneider, Weill Cornell Medical College, New York, NY; John Strawn, Patient Representative, Houston, TX; and Christopher G. Azzoli, Massachusetts General, Boston, MA.
Abstract
PURPOSE: The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on external-beam radiotherapy for patients with locally advanced non-small-cell lung cancer (NSCLC). Because of its relevance to the American Society of Clinical Oncology (ASCO) membership, ASCO endorsed the guideline after applying a set of procedures and a policy that are used to critically examine and endorse guidelines developed by other guideline development organizations. METHODS: The ASTRO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO expert panel was convened and endorsed the guideline. The ASCO guideline approval body, the Clinical Practice Guideline Committee, approved the final endorsement. RESULTS: The recommendations from the ASTRO guideline, published in Practical Radiation Oncology, are clear, thorough, and based on the most relevant scientific evidence. The ASCO Endorsement Panel endorsed the guideline and added qualifying statements. RECOMMENDATIONS: For curative-intent treatment of locally advanced NSCLC, concurrent chemoradiotherapy improves local control and overall survival compared with sequential chemotherapy followed by radiation. The standard dose-fractionation of radiation is 60 Gy given in 2-Gy once-daily fractions over 6 weeks. There is no role for the routine use of induction therapy before chemoradiotherapy. Current data fail to support a clear role for consolidation therapy after chemoradiotherapy; however, consolidation therapy remains an option for patients who did not receive full systemic chemotherapy doses during radiotherapy. Important questions remain about the ideal concurrent chemotherapy regimen and optimal management of patients with resectable stage III disease.
PURPOSE: The American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on external-beam radiotherapy for patients with locally advanced non-small-cell lung cancer (NSCLC). Because of its relevance to the American Society of Clinical Oncology (ASCO) membership, ASCO endorsed the guideline after applying a set of procedures and a policy that are used to critically examine and endorse guidelines developed by other guideline development organizations. METHODS: The ASTRO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO expert panel was convened and endorsed the guideline. The ASCO guideline approval body, the Clinical Practice Guideline Committee, approved the final endorsement. RESULTS: The recommendations from the ASTRO guideline, published in Practical Radiation Oncology, are clear, thorough, and based on the most relevant scientific evidence. The ASCO Endorsement Panel endorsed the guideline and added qualifying statements. RECOMMENDATIONS: For curative-intent treatment of locally advanced NSCLC, concurrent chemoradiotherapy improves local control and overall survival compared with sequential chemotherapy followed by radiation. The standard dose-fractionation of radiation is 60 Gy given in 2-Gy once-daily fractions over 6 weeks. There is no role for the routine use of induction therapy before chemoradiotherapy. Current data fail to support a clear role for consolidation therapy after chemoradiotherapy; however, consolidation therapy remains an option for patients who did not receive full systemic chemotherapy doses during radiotherapy. Important questions remain about the ideal concurrent chemotherapy regimen and optimal management of patients with resectable stage III disease.
Authors: Martin J Edelman; Chen Hu; Quynh-Thu Le; Jessica S Donington; Warren D D'Souza; Adam P Dicker; Billy W Loo; Elizabeth M Gore; Gregory M M Videtic; Nathaniel R Evans; Joseph W Leach; Maximilian Diehn; Steven J Feigenberg; Yuhchyau Chen; Rebecca Paulus; Jeffrey D Bradley Journal: J Thorac Oncol Date: 2017-06-16 Impact factor: 15.609
Authors: Kellie J Ryan; Karen E Skinner; Ancilla W Fernandes; Rajeshwari S Punekar; Melissa Pavilack; Mark S Walker; Noam A VanderWalde Journal: Med Oncol Date: 2019-01-31 Impact factor: 3.064
Authors: James J Urbanic; Xiaofei Wang; Jeffrey A Bogart; Thomas E Stinchcombe; Lydia Hodgson; Steven E Schild; Lyudmila Bazhenova; Olwen Hahn; Ravi Salgia; Everett E Vokes Journal: Int J Radiat Oncol Biol Phys Date: 2018-01-31 Impact factor: 7.038