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Definitive Radiotherapy for Stage I Non-small Cell Lung Cancer: Ain’t Nothing Like the Real Thing?

Definitive Radiotherapy for Stage I Non-small Cell Lung Cancer: Ain’t Nothing Like... EDITORIAL Definitive Radiotherapy for Stage I Non-small Cell Lung Cancer: Ain’t Nothing Like the Real Thing? Jeffrey A. Bogart, MD n contrast to the guarded outlook for the majority of patients diagnosed with non-small Icell lung cancer (NSCLC), the prospect for a cure is excellent after anatomic resection for pathologic stage I disease. Nevertheless, a substantial number of patients with early-stage NSCLC suffer from cardiopulmonary disease and/or other medical comor- bidities, rendering them unsuitable for lobectomy. Treatment philosophies vary widely for the “medically inoperable” population. Although still frequently encountered in clinical practice, a nihilistic approach is not justified because the majority of patients with untreated stage I NSCLC die from lung cancer, not from comorbid illnesses. Moreover, recent observations suggest poorer outcomes for the cohort of patients that do not receive 3,4 any therapy. Fractionated external-beam radiotherapy has been the most frequently employed treatment option by far, with outcomes contingent on patient selection, tumor burden, and, 5,6 perhaps, radiotherapy dose. As the importance of this patient population has become apparent, several alternatives have emerged, including (thorascopic) wedge resection with or without permanent brachytherapy, heavy-particle therapy (proton and carbon ion), 7–12 stereotactic radiosurgery, and radiofrequency ablation. Particularly encouraging is the http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Thoracic Oncology Wolters Kluwer Health

Definitive Radiotherapy for Stage I Non-small Cell Lung Cancer: Ain’t Nothing Like the Real Thing?

Bogart, Jeffrey A.
Journal of Thoracic Oncology , Volume 1 (8) – Oct 1, 2006
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ISSN
1556-0864

Abstract

EDITORIAL Definitive Radiotherapy for Stage I Non-small Cell Lung Cancer: Ain’t Nothing Like the Real Thing? Jeffrey A. Bogart, MD n contrast to the guarded outlook for the majority of patients diagnosed with non-small Icell lung cancer (NSCLC), the prospect for a cure is excellent after anatomic resection for pathologic stage I disease. Nevertheless, a substantial number of patients with early-stage NSCLC suffer from cardiopulmonary disease and/or other medical comor- bidities, rendering them unsuitable for lobectomy. Treatment philosophies vary widely for the “medically inoperable” population. Although still frequently encountered in clinical practice, a nihilistic approach is not justified because the majority of patients with untreated stage I NSCLC die from lung cancer, not from comorbid illnesses. Moreover, recent observations suggest poorer outcomes for the cohort of patients that do not receive 3,4 any therapy. Fractionated external-beam radiotherapy has been the most frequently employed treatment option by far, with outcomes contingent on patient selection, tumor burden, and, 5,6 perhaps, radiotherapy dose. As the importance of this patient population has become apparent, several alternatives have emerged, including (thorascopic) wedge resection with or without permanent brachytherapy, heavy-particle therapy (proton and carbon ion), 7–12 stereotactic radiosurgery, and radiofrequency ablation. Particularly encouraging is the

Journal

Journal of Thoracic Oncology – Wolters Kluwer Health

Published: Oct 1, 2006

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