RADIOTHERAPY FOR THE TREATMENT OF LOCALLY ADVANCED NON SMALL CELL LUNG CANCER

Abstract

In this literature review we analyze the effectiveness of radiotherapy (as an independent method and in combination with surgery and chemotherapy) in the treatment of locally advanced non-small cell lung cancer. The postoperative adjuvant radiotherapy can increase overall survival and reduce the frequency of local recurrences in IIIA / N2 stage of NSCLC, however, its positive effect can be offset by the damage to surrounding structures. Modern high-tech equipment, improved planning systems, methods radiation doses delivery, and the fractionation regimen can improve the outcomes of radiation therapy. No bimodal treatment has shown advantages over other combinations. Some improvement in survival was noted in a number of studies using three-modal treatment, but it was also associated with an increase in the proportion of postoperative complications, especially after pneumonectomies. The heterogeneity of the IIIA / N2 NSCLC group and criteria for their operability present certain difficulties for a correct comparison of the treatment results, which requires further discussion. In most studies, insufficient attention has been paid to the influence of multimodal treatment on the quality of life of patients, which, taking into account comparable results of treatment, can be crucial in determining indications and contraindications.