ASCO Endorses ASTRO Guideline on External-Beam Radiotherapy for Patients With Locally Advanced NSCLC
ASCO issued an endorsement of the American Society for Radiation Oncology (ASTRO) evidence-based guideline on external-beam radiotherapy for patients with locally advanced non–small cell lung cancer (NSCLC). The ASCO endorsement was published by Bezjak et al in the Journal of Clinical Oncology.
The ASCO guideline endorsement panel summarized the key ASTRO recommendations as follows:
- For curative-intent treatment of locally advanced NSCLC, concurrent chemoradiotherapy is recommended, because it improves local tumor control and overall survival compared with sequential chemotherapy followed by radiation or radiation therapy alone.
- For patients who cannot tolerate concurrent chemoradiotherapy, sequential chemotherapy followed by radical (definitive) radiation is recommended, because it improves overall survival when compared with radiotherapy alone. Radiotherapy alone may be used for patients who are ineligible for combined-modality treatments; it may offer better tolerability but poorer survival.
- There is no role for the routine use of induction chemotherapy before chemoradiotherapy.
- There is no role for the routine use of consolidation chemotherapy after chemoradiotherapy. However, this treatment remains an option for patients who did not receive full systemic chemotherapy doses during radiotherapy.
- The ideal concurrent chemotherapy regimen has not been determined; the two most common regimens are cisplatin/etoposide and carboplatin/paclitaxel.
An ASCO guideline endorsement panel determined that the ASTRO guideline recommendations are clear, thorough, and based on the most relevant scientific evidence.
Information for patients about NSCLC is available at www.cancer.net/cancer-types/lung-cancer. The guideline endorsement is available at www.instituteforquality.org/practice-guidelines.
ASCO encourages feedback on its guidelines from oncologists, practitioners, and patients through the ASCO Guidelines Wiki at www.asco.org/guidelineswiki.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
