Skip Navigation

This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Trott, K.-R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Trott, K.-R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Annals of Oncology 10:S77-S81, 1999
© 1999 European Society for Medical Oncology

Reviews

Chemoradiotherapy interactions and lung toxicity

K.-R. Trott

Department of Radiation Biology, St. Bartholomew's and the Royal London School of Medicine and Dentistry London, UK

Correspondence to: K.-R. Trott, Department of Radiation Biology, St. Bartholomew's and The Royal London School of Medicine and Dentistry, Charterhouse Square, London EC1M6BQ UK

Background: The combination of high-dose radiotherapy with intensive chemotherapy may improve the prognosis of patients with inoperable, locally advanced non-small-cell lung cancer. In the design of suitable clinical protocols, potential interactions of drugs and radiation in the tumour, the lung and other critical normal tissues have to be considered.

Methods: From experimental data on chemotherapy radiotherapy interactions and based on knowledge about the biology of non-small cell lung cancer and the pathogenesis of radiation pneumopathy, the principles which should be considered in the design of treatment schedules are developed.

Results: For the increase in local tumour control, further escalation of radiation dose should be considered first. The most critical issue for lung toxicity may be the volume of the 30 Gy isodose. Yet, the most critical normal tissue which may limit the further increase in dose and dose intensity appears to be the oesophagus.

Conclusions: Since the main cause of treatment failure remains local recurrence, further increase in locoregional cyto-toxicity is the first priority in locally advanced non-small-cell lung cancer. This can best be achieved by increasing radiation dose and dose intensity further. Yet, there may also be a role for simultaneous radiochemotherapy, even if this would increase the lung volume which develops radiation pneumopathy and thus the severity of symptoms. This problem should be dealt with by reducing the irradiated lung volume by use of conformal treatment planning. The most critical side effects will then be due to increased severity of acute oesophagitis.

drug radiation interactions, lung damage, non-small-cell lung cancer, radiochemotherapy


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.