Radiosurgery can be successfully used in Stage 1 and Stage 2 non-small cell lung cancer. Lung cancer therapy in elderly patients. Preventive radiation therapy for the potential brain and spine metastatic disease in lung cancer.
Lung cancer radiotherapy advances. Radiation oncology practice is at the forefront of new combined treatment of lung cancer. Leading Swiss radiation oncologist discusses radiation therapy use in lung cancer. preoperative or neoadjuvant radiation therapy for lung cancer. biggest progress in lung cancer treatment will come from radiosurgery. Radiosurgery is especially well suited to treat frail elderly patients with Stage 1 non-small cell lung cancer. Stage 1 lung cancer treatment by radiosurgery is an excellent alternative treatment. Radiosurgery for advanced Stage 2 lung cancer. Radiosurgery for Stage 3 lung cancer specifically. For some selected patients with Stage 4 lung cancer radiation therapy works well. Preventive treatment for patients with Stage III disease. Preventive brain radiotherapy in advanced non-metastatic Stage III non small cell lung cancer. Radiation therapy treatment options in lung cancer. Advanced lung cancer treatment by targeted radiation therapy. Medical second opinion confirms radiotherapy lung cancer treatment plan. Medical second opinion helps to include best radiotherapy and combination lung cancer therapy into comprehensive personalized treatment plan. Best precision medicine radiation therapy treatment for advanced stage lung cancer with metastatic lesions. Get second opinion on advanced lung cancer diagnosis and be confident that your precision medicine treatment is the best. Video interview with top oncologist in radiation therapy treatment from Zurich, Switzerland. Lung cancer radiotherapy advances. Radiosurgery for Stage 1 non-small cell lung cancer. Dr. Anton Titov, MD. Let's talk about the lung cancer. Lung cancer remains a very deadly disease. Over 80% of all lung cancer patients have non-small cell lung cancer histology. There are many advances in lung cancer treatment. But cure is still rare for lung cancer patients. Your radiation oncology practice is at the forefront of new combined treatment of lung cancer. You have recently published a review on advanced radiation therapy for lung cancer. Can you summarize current advances in radical primary radiotherapy for lung cancer? Please review preoperative or neoadjuvant radiation therapy for lung cancer. Dr. Stephan Bodis, MD (Professor of Radiation Oncology, Zurich, Switzerland). Here I'm very careful. Because radiation therapy in lung cancer is a fast-pacing field. Radiotherapy of lung cancer is a very complex field. There are numerous excellent recommendations about radiation therapy in lung cancer. They are published in international journals. So I will summarize a few aspects of radiotherapy in lung cancer. I would like to start with guidelines from medical societies that compile treatment protocols for lung cancer. I think the European Thoracic Oncology Platform, ETOP, is a very good platform. Use it to learn about the current progress in lung cancer treatment. They have good annual reports. They have very good summaries of their activities. I'm not a member, so I don't do PR for this society. Then again, I think NCCN guidelines on lung cancer therapy are useful. ESMO minimal guidelines for lung cancer therapy are useful. Some select national guidelines can also be of help in understanding current lung cancer treatment. There are also updates at the annual meetings like ASCO, ASTRO, ESMO, and ESTRO. From the radiation oncology perspective of view, the biggest progress in lung cancer treatment will come from radiosurgery. Radiosurgery in lung cancer therapy is adopted now in a few countries, in the Netherlands. Radiosurgery is especially well suited to treat frail elderly patients with Stage 1 non-small cell lung cancer. Sometimes lung cancer histology has not been proven. But sometimes lung cancer lesions progress on repeated CT or MRI scans. These Stage 1 lung cancer patients can be offered an option of radiosurgery in a few sessions instead of open thoracic surgery. The results of Stage 1 lung cancer treatment by radiosurgery are good. Maybe they are even excellent. Followup is probably too short to make a definitive conclusion about efficacy of radiosurgery in Stage 1 lung cancer therapy. But followup is now beyond five years. Dr. Stephan Bodis, MD (Professor of Radiation Oncology, Zurich, Switzerland). These results of radiosurgery in Stage 1 lung cancer have now been intensively discussed at various platforms. It is very controversial, of course. But I think the main consensus is this. Stage 1 lung cancer treatment by radiosurgery is at least an excellent alternative treatment to open thoracic surgery. So radiosurgery will make its impact for localized Stage 1 and Stage 2 non-small cell lung cancer. It is effective in elderly, frail patients. Radiosurgery will probably also be useful to treat lung cancer patients. They are at excellent general health. But they would like to avoid major surgery. For the combined modality treatments, chemotherapy, radiation therapy, surgery, it's very hard to pick a particular protocol. Because for advanced Stage 2 lung cancer, for Stage 3 lung cancer specifically, and for some selected patient with Stage 4 lung cancer there have been so many clinical trials. Advanced lung cancer clinical trials have been looking at the best cancer treatment sequence. We looked at the best modality of lung cancer therapy. So it's hard to pick out the best treatment protocol for more advanced lung cancer patients. But the trend in lung cancer treatment is now not to add more and more. The trend in lung cancer treatment is to use only the therapy that has been proven to be efficient. So the trend in radiotherapy to treat lung cancer is to use radiotherapy only if radiotherapy needed as a neoadjuvant or adjuvant treatment. Current trend is to use radiotherapy in lung cancer treatment. You can give it at the least toxicity. Dr. Stephan Bodis, MD (Professor of Radiation Oncology, Zurich, Switzerland). So radiotherapy that irradiated big three dimensional fields for all Stage IIIA or Stage IIIB lung cancer is not used anymore before radiosurgery. That's out. Then we have another aspect of lung cancer therapy. I think there is a trend in preventive treatment for patients with Stage III disease and in good general condition. Preventive treatment of potential CNS brain microscopic metastatic disease in lung cancer will also be used widely today. Now I think preventive radiotherapy in lung cancer uses 20 to 24 grays. This radiation dose is given after a definitive local treatment of lung cancer. Sometimes the patient tolerated this preventive radiotherapy well and is still in complete remission and in good general condition. Then such preventive brain radiation therapy could be offered for many patients with advanced non-metastatic Stage III non small cell lung cancer. Dr. Anton Titov, MD. That's essentially a preventative therapy for the potential brain and spine metastatic disease in lung cancer. Dr. Stephan Bodis, MD (Professor of Radiation Oncology, Zurich, Switzerland). This is a good point. Brain radiation therapy can be preventive. It also delays symptomatic progression of lung cancer metastatic disease. I think this is what I would like to say. For small cell lung cancer we are still a little bit behind on the treatment that could be done. Radiotherapy in small cell lung cancer has little role in extensive disease. For the limited small cell lung cancer the treatment is still chemotherapy. Then involved field radiotherapy could be offered for patients with small cell lung cancer. They are in good general condition with a carefully staged lung cancer tumor. This is my contribution at the moment. Lung cancer radiotherapy advances. Stage 1 non-small cell lung cancer radiosurgery treatment in elderly frail patients. Preventive brain metastases radiotherapy.