Abstract
Purpose: In stage III non-small cell lung cancer (NSCLC), both local failure and distant metastases are common after sequential chemo-radiotherapy. Elective mediastinal nodal irradiation is commonly performed in these patients, resulting in substantial radiation doses to the esophagus and the normal lung. Both radiation dose escalation and/or concurrent chemo-radiotherapy are limited by the high incidence of pulmonary and esophageal toxicity, leading to calls for the omission of elective nodal irradiation. However, concerns about recurrences in the nodal regions which are not included in the gross target volume (GTV) have limited the willingness to use “involved-field” radiotherapy (IFRT). A study was performed in order to study the recurrence patterns after IFRT using 3-dimensional (3D) treatment planning.
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