Lung cancer

Abstract

In spite of recent advances in both biology and technology of diagnosis and treatment of lung cancer, the overall results remain dismal. After initial treatment, irrespective of stage and histology of the disease, local/regional recurrence is a frequent type of failure. While it is virtually unknown which proportion of patients initially treated with chest radiotherapy undergo reirradiation during the natural course of the disease, there are more reports documenting outcome of reirradiation in recent years. The majority of available studies are retrospective in nature and of limited size. External beam radiation therapy has been used to treat local/regional intrathoracic recurrences after previous radiation therapy for lung cancer, mostly non-small cell histology. In most cases, the aim of the treatment was palliation of symptoms. However, the increasing availability of new technology such as intensity-modulated and stereotactic radiotherapy has resulted in promising outcome after these more aggressive regimens. While endobronchial brachytherapy remains useful in palliating symptomatic recurrences, it is used less frequently in recent years. Although no guideline exists, likely due to considerable variety in first-line radiation therapy parameters, different planning and retreatment characteristics, and lack of validated prognostic factors, current wisdom calls for setting up objectives upfront and making prudent use of available technology.