Intensity-modulated radiotherapy, not 3 dimensional conformal, is the preferred technique for treating locally advanced disease with high-dose radiotherapy: the argument against

Seminars in Radiation Oncology
Allan Price

Abstract

Intensity-modulated radiotherapy (IMRT) allows the delivery of high-dose radiotherapy to target volumes, while sparing adjacent normal tissues. This has been mooted as a method of treating larger and otherwise untreatable lung cancers or of escalating radiotherapy doses. The possibility of achieving these aims has been confirmed in many planning studies, but there is little supporting clinical data. No randomized trial has compared conformal and IMRT, few studies have reported the late outcomes of IMRT, and there is no evidence for improved control of lung cancer with increased radiation dose. Currently IMRT should be regarded as a promising but unproven experimental therapy in locally advanced non-small cell lung cancer. Searches of PubMed were performed looking for the terms "lung cancer and radiotherapy" and "lung cancer and intensity-modulated radiotherapy." The former was carried out for the period 2007, when the author last reviewed this topic, until 2014 and the latter from the first reference to this topic to the present. The first search produced 8000 and the second 929 hits. A standard hierarchy of evidence exists for interventions in medicine, ranging from systematic reviews of randomized trials to case-control studi...Continue Reading

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Citations

Feb 6, 2016·Journal of Thoracic Oncology : Official Publication of the International Association for the Study of Lung Cancer·Andrew T WongDavid Schreiber
Jun 10, 2016·Journal of Medical Imaging and Radiation Oncology·Syed Muntasser IslamJeremy D Ruben
Mar 4, 2017·Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine·Pierre VeraBernard Dubray

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