Definitive and Adjuvant Radiotherapy in Locally Advanced Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation Oncology Evidence-Based Clinical Practice Guideline
Definitive and Adjuvant Radiotherapy in Locally Advanced Non-Small-Cell Lung Cancer: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Society for Radiation Oncology Evidence-Based Clinical Practice Guideline
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DOI：
10.1200/jco.2014.59.2360
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发表时间：
2015-06-20
影响因子：
45.3
通讯作者：
Azzoli, Christopher G.
中科院分区：
文献类型：
--
作者：
Bezjak, Andrea;Temin, Sarah;Azzoli, Christopher G.
目的美国放射肿瘤学会（ASTRO）制定了一个关于局部晚期非小细胞肺癌（NSCLC）患者外照射放射治疗的循证指南。由于它的相关性，美国临床肿瘤学会（ASCO）的成员，ASCO认可的指导方针后，应用一套程序和政策，用于严格审查和认可的其他指南开发organizations.MethodsThe ASTRO指南制定的指导原则进行了审查ASCO内容专家的临床准确性和ASCO方法学家的发展严谨性。在有利的审查，ASCO专家小组召开并批准了该指南。ASCO的指南批准机构，临床实践指南委员会，批准了最终的administration.ResultsThe建议从ASTRO指南，发表在实用放射肿瘤学，是明确的，彻底的，并根据最相关的科学证据。ASCO认可小组认可了该指南，并增加了qualifying statements. Recommendations对于局部晚期NSCLC的治愈性治疗，与序贯化疗后放疗相比，同步放化疗可改善局部控制和总生存率。放射的标准剂量分次是60戈伊，每天分次给予2-戈伊，持续6周。在放化疗前常规使用诱导治疗没有作用。目前的数据无法支持放化疗后巩固治疗的明确作用;然而，巩固治疗仍然是放疗期间未接受全身化疗剂量的患者的一种选择。关于理想的同步化疗方案和可切除的III期疾病患者的最佳管理仍存在重要问题。(C)2015年美国临床肿瘤学会
PurposeThe American Society for Radiation Oncology (ASTRO) produced an evidence-based guideline on external-beam radiotherapy for patients with locally advanced non-small-cell lung cancer (NSCLC). Because of its relevance to the American Society of Clinical Oncology (ASCO) membership, ASCO endorsed the guideline after applying a set of procedures and a policy that are used to critically examine and endorse guidelines developed by other guideline development organizations.MethodsThe ASTRO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO expert panel was convened and endorsed the guideline. The ASCO guideline approval body, the Clinical Practice Guideline Committee, approved the final endorsement.ResultsThe recommendations from the ASTRO guideline, published in Practical Radiation Oncology, are clear, thorough, and based on the most relevant scientific evidence. The ASCO Endorsement Panel endorsed the guideline and added qualifying statements.RecommendationsFor curative-intent treatment of locally advanced NSCLC, concurrent chemoradiotherapy improves local control and overall survival compared with sequential chemotherapy followed by radiation. The standard dose-fractionation of radiation is 60 Gy given in 2-Gy once-daily fractions over 6 weeks. There is no role for the routine use of induction therapy before chemoradiotherapy. Current data fail to support a clear role for consolidation therapy after chemoradiotherapy; however, consolidation therapy remains an option for patients who did not receive full systemic chemotherapy doses during radiotherapy. Important questions remain about the ideal concurrent chemotherapy regimen and optimal management of patients with resectable stage III disease. (C) 2015 by American Society of Clinical Oncology