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dc.contributor.authorHudson, A
dc.contributor.authorChan, C
dc.contributor.authorWoolf, D
dc.contributor.authorMcWilliam, A
dc.contributor.authorHiley, C
dc.contributor.authorO'Connor, J
dc.contributor.authorBayman, N
dc.contributor.authorBlackhall, F
dc.contributor.authorFaivre-Finn, C
dc.date.accessioned2020-08-12T14:47:22Z
dc.date.issued2018-04
dc.identifier.citationLung cancer (Amsterdam, Netherlands), 2018, 118 pp. 139 - 147
dc.identifier.issn0169-5002
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/3943
dc.identifier.eissn1872-8332
dc.identifier.doi10.1016/j.lungcan.2018.02.006
dc.description.abstractThe current standard of care for the management of inoperable stage 3 non-small cell lung cancer (NSCLC) is concurrent chemoradiotherapy (cCRT) using radiotherapy dose-fractionation and chemotherapy regimens that were established 3 decades ago. In an attempt to improve the chances of long-term control from cCRT, dose-escalation of the radiotherapy dose was assessed in the RTOG 0617 randomised control study comparing the standard 60 Gy in 30 fractions with a high-dose arm receiving 74 Gy in 37 fractions. Following the publication of this trial the thoracic oncology community were surprised to learn that there was worse survival in the dose-escalated arm and that for now the standard of care must remain with the lower dose. In this article we review the RTOG 0617 paper with subsequent analyses and studies to explore why the use of dose-escalated cCRT in stage 3 NSCLC has not shown the benefits that were expected. The overarching theme of this opinion piece is how heterogeneity between stage 3 NSCLC cases in terms of patient, tumour, and clinical factors may obscure the potential benefits of dose-escalation by causing imbalances in the arms of studies such as RTOG 0617. We also examine recent advances in the staging, management, and technological delivery of radiotherapy in NSCLC and how these may be employed to optimise cCRT trials in the future and ensure that any potential benefits of dose-escalation can be detected.
dc.formatPrint-Electronic
dc.format.extent139 - 147
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
dc.subjectHumans
dc.subjectCarcinoma, Non-Small-Cell Lung
dc.subjectLung Neoplasms
dc.subjectAntineoplastic Combined Chemotherapy Protocols
dc.subjectNeoplasm Staging
dc.subjectRadiotherapy Dosage
dc.subjectRisk Assessment
dc.subjectClinical Trials as Topic
dc.subjectChemoradiotherapy
dc.subjectDose Fractionation, Radiation
dc.titleIs heterogeneity in stage 3 non-small cell lung cancer obscuring the potential benefits of dose-escalated concurrent chemo-radiotherapy in clinical trials?
dc.typeJournal Article
dcterms.dateAccepted2018-02-05
rioxxterms.versionofrecord10.1016/j.lungcan.2018.02.006
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-nd/4.0
rioxxterms.licenseref.startdate2018-04
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfLung cancer (Amsterdam, Netherlands)
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Quantitative Biomedical Imaging
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Quantitative Biomedical Imaging
pubs.publication-statusPublished
pubs.volume118
pubs.embargo.termsNot known
icr.researchteamQuantitative Biomedical Imagingen_US
dc.contributor.icrauthorO'Connor, James Patricken


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Except where otherwise noted, this item's license is described as https://creativecommons.org/licenses/by-nc-nd/4.0