Cancers bronchiques : la radiothérapie prophylactique des aires ganglionnaires a-t-elle encore une place ?

Translated title of the contribution: Lung cancer: is there a place for elective nodal irradiation?

C. Le Péchoux, I. Ferreira, A. Bruna, E. Roberti, B. Besse, J. J. Bretel

    Research output: Contribution to journalShort surveypeer-review

    4 Citations (Scopus)

    Abstract

    The use of conformal radiotherapy in lung cancer has considerably evolved with the advent of improved staging technologies and methods of radiation delivery. Patients with limited disease, inoperable for medical reasons, may be treated with conformal radiotherapy alone; patients with more advanced disease are treated with combined chemo-radiotherapy. If local control may be improved by radiotherapy dose escalation according to several studies, toxicity and more particularly pulmonary toxicity seems to be related to radiation volume. Thus the use of elective nodal irradiation is being questioned. Data for early stage (stage I) non-small-cell lung cancer treated with conformal radiotherapy or stereotactic hypofractionated radiotherapy strongly supports the use of smaller fields that do not incorporate elective nodal regions; local control and survival rates approach those of surgical series. In locally advanced non-small cell lung cancer, eliminating elective nodal irradiation allows to maximize tumor dose and minimize normal tissue toxicity in combined modality treatments; results are encouraging. The use of staging modalities such as positron emission tomography and eventually oesophageal ultrasonography is increasing, allowing to encompass the tumor volume with more accuracy. Several studies have confirmed that involved-field irradiation results into a regional nodal rate of less than 10%. Further larger-scale studies would be needed to definitely establish "no elective nodal irradiation" as a standard in non-small cell lung cancer. There are very few data concerning small cell lung cancer.

    Translated title of the contributionLung cancer: is there a place for elective nodal irradiation?
    Original languageFrench
    Pages (from-to)354-360
    Number of pages7
    JournalCancer/Radiotherapie
    Volume10
    Issue number6-7
    DOIs
    Publication statusPublished - 1 Nov 2006

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