Non small cell lung cancer radiation therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]

Radiation therapy regimens

Shown below is a list of the different regimens radiation therapy for patients with non-small cell lung cancer. The list of regimens has been adapted from the 2014 NCCN Non-Small Cell Lung Cancer guidelines.

Usual Dosages for Definitive Radiation Therapy

Administer fractions of 2 Gy over a period of 6 to 7.5 weeks to a total dose of 60 to 74 Gy.

Neoadjuvant Radiation Therapy Regimen

Administer fractions of 1.8 to 2 Gy over a period of 5 weeks to a total dose of 45 to 50 Gy.

Adjuvant Radiation Therapy Regimens

• Negative surgical piece margins: Administer fractions of 1.8 to 2 Gy over a period of 5 to 6 weeks to a total dose of 40 to 54 Gy.
• Positive surgical piece margins: Administer fractions of 1.8 to 2 Gy over a period of 6 weeks to a total dose of 54 to 60 Gy.
• Extracapsular nodal extension: Administer fractions of 1.8 to 2 Gy over a period of 6 weeks to a total dose of 60 to 70 Gy.
• Residual tumor: Administer fractions of 2 Gy over a period of 6 to 7 weeks to a total dose of 54 to 60 Gy.

Stereotactic Ablative Radiotherapy Usual Dosage

• Peripheral small tumors: 25 to 34 Gy not fractioned.
• Peripheral tumors and chest wall tumors larger than 1 cm: 45 to 60 Gy administered in 3 fractions.
• Central or peripheral tumors smaller than 5 cm: 48 to 60 Gy administered in 4 fractions.
• Central or peripheral tumors principally chest wall tumors smaller that 1 cm: 50 to 55 Gy administered in 5 fractions.
• Central tumors: 60 to 70 Gy administered in 8 to 10 fractions.