Avoiding Toxicity With Lung Radiation Therapy: An IASLC Perspective

International Association for the Study of Lung Cancer Advanced Radiation Technology Committee

doi:10.1016/j.jtho.2022.05.003

Avoiding Toxicity With Lung Radiation Therapy: An IASLC Perspective

International Association for the Study of Lung Cancer Advanced Radiation Technology Committee

Research output: Contribution to journal › Review article › peer-review

15 Citations (Scopus)

40 Downloads (Pure)

Abstract

Toxicity concerns from thoracic radiation therapy in the treatment of lung cancers have changed substantially over the past few decades. Survival in the treatment of lung cancer has markedly improved and the introduction of advanced radiation and imaging techniques to treatment planning and delivery has made reducing toxicity possible. Phase 3 dose-escalation trials have revealed that excess dose to critical organs within the thorax can negatively impact overall survival. We summarize the existing literature on the known toxicities of thoracic radiation therapy, summarize the technological advances that have made toxicity reduction possible, and provide an overview of emerging technologies and biomarkers that are being evaluated to assess future toxicity reductions.

Original language	English
Pages (from-to)	961-973
Number of pages	13
Journal	Journal of Thoracic Oncology
Volume	17
Issue number	8
Early online date	02 Aug 2022
DOIs	https://doi.org/10.1016/j.jtho.2022.05.003
Publication status	Early online date - 02 Aug 2022

Bibliographical note

Funding Information:
Disclosures: Dr. Bucknell receives an Australian Government Scholarship, Australia and a research grant from the Royal Australian and New Zealand College of Radiologists, Australia. Drs. Louie, McDonald, and Hanna report receiving honoraria from AstraZeneca, United Kingdom. Dr. Iyengar reports participating in an advisory board from AstraZeneca. Dr. Faivre-Finn reports receiving grants from Elekta and AstraZeneca; consulting fees from AstraZeneca and Merck Sharp & Dohme, United Kingdom; honoraria from AstraZeneca; and payment from participating in an advisory board from AstraZeneca (all payments are made to the institution). Dr. Gomez reports receiving grants from Varian and AstraZeneca; consulting fees from GRAIL, Olympus, and AstraZeneca; honoraria from Varian and MedLearning group; and meeting support from GRAIL. Dr. Chua reports receiving grants from the National Medical Research Council and the Duke–National University of Singapore Medical School; honoraria from AstraZeneca, Peer Voice, University of Hong Kong, and Hong Kong Stereotactic Body Radiation Therapy Study Group; and payment from participating in an advisory board from AstraZeneca. Dr. Chua reports having leadership roles including in the Advanced Radiation Technology Committee, Scientific Committee, Lung Cancer Consortium Singapore, and British Journal of Radiology. Dr. Siva reports receiving grants from Varian, Merck Sharp & Dohme, and Bayer; consulting fees from AstraZeneca and Reflexion; honoraria from AstraZeneca and Reflexion; and meeting support from AstraZeneca. The remaining authors declare no conflict of interest.

Funding Information:
Disclosures: Dr. Bucknell receives an Australian Government Scholarship, Australia and a research grant from the Royal Australian and New Zealand College of Radiologists, Australia. Drs. Louie, McDonald, and Hanna report receiving honoraria from AstraZeneca, United Kingdom. Dr. Iyengar reports participating in an advisory board from AstraZeneca. Dr. Faivre-Finn reports receiving grants from Elekta and AstraZeneca; consulting fees from AstraZeneca and Merck Sharp & Dohme, United Kingdom; honoraria from AstraZeneca; and payment from participating in an advisory board from AstraZeneca (all payments are made to the institution). Dr. Gomez reports receiving grants from Varian and AstraZeneca ; consulting fees from GRAIL, Olympus, and AstraZeneca; honoraria from Varian and MedLearning group; and meeting support from GRAIL. Dr. Chua reports receiving grants from the National Medical Research Council and the Duke–National University of Singapore Medical School; honoraria from AstraZeneca, Peer Voice, University of Hong Kong, and Hong Kong Stereotactic Body Radiation Therapy Study Group; and payment from participating in an advisory board from AstraZeneca. Dr. Chua reports having leadership roles including in the Advanced Radiation Technology Committee, Scientific Committee, Lung Cancer Consortium Singapore, and British Journal of Radiology. Dr. Siva reports receiving grants from Varian, Merck Sharp & Dohme , and Bayer; consulting fees from AstraZeneca and Reflexion; honoraria from AstraZeneca and Reflexion; and meeting support from AstraZeneca. The remaining authors declare no conflict of interest.

Publisher Copyright:
© 2022

Keywords

Early-stage lung cancer
Locally advanced lung cancer
Non–small cell lung cancer
Radiation toxicity
Small cell lung cancer
Stereotactic body radiation therapy

ASJC Scopus subject areas

Oncology
Pulmonary and Respiratory Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Avoiding Toxicity With Lung Radiation Therapy: An IASLC Perspective
Copyright 2022 Elsevier. This manuscript is distributed under a Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits distribution and reproduction for non-commercial purposes, provided the author and source are cited.
Accepted author manuscript, 1.6 MBLicence: CC BY-NC-ND

Cite this

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title = "Avoiding Toxicity With Lung Radiation Therapy: An IASLC Perspective",

abstract = "Toxicity concerns from thoracic radiation therapy in the treatment of lung cancers have changed substantially over the past few decades. Survival in the treatment of lung cancer has markedly improved and the introduction of advanced radiation and imaging techniques to treatment planning and delivery has made reducing toxicity possible. Phase 3 dose-escalation trials have revealed that excess dose to critical organs within the thorax can negatively impact overall survival. We summarize the existing literature on the known toxicities of thoracic radiation therapy, summarize the technological advances that have made toxicity reduction possible, and provide an overview of emerging technologies and biomarkers that are being evaluated to assess future toxicity reductions.",

keywords = "Early-stage lung cancer, Locally advanced lung cancer, Non–small cell lung cancer, Radiation toxicity, Small cell lung cancer, Stereotactic body radiation therapy",

author = "Bucknell, {Nicholas W.} and Jos{\'e} Belderbos and Palma, {David A.} and Puneeth Iyengar and Pamela Samson and Kevin Chua and Daniel Gomez and Fiona McDonald and Louie, {Alexander V.} and Corinne Faivre-Finn and Hanna, {Gerard G.} and Shankar Siva and {International Association for the Study of Lung Cancer Advanced Radiation Technology Committee}",

note = "Funding Information: Disclosures: Dr. Bucknell receives an Australian Government Scholarship, Australia and a research grant from the Royal Australian and New Zealand College of Radiologists, Australia. Drs. Louie, McDonald, and Hanna report receiving honoraria from AstraZeneca, United Kingdom. Dr. Iyengar reports participating in an advisory board from AstraZeneca. Dr. Faivre-Finn reports receiving grants from Elekta and AstraZeneca; consulting fees from AstraZeneca and Merck Sharp & Dohme, United Kingdom; honoraria from AstraZeneca; and payment from participating in an advisory board from AstraZeneca (all payments are made to the institution). Dr. Gomez reports receiving grants from Varian and AstraZeneca; consulting fees from GRAIL, Olympus, and AstraZeneca; honoraria from Varian and MedLearning group; and meeting support from GRAIL. Dr. Chua reports receiving grants from the National Medical Research Council and the Duke–National University of Singapore Medical School; honoraria from AstraZeneca, Peer Voice, University of Hong Kong, and Hong Kong Stereotactic Body Radiation Therapy Study Group; and payment from participating in an advisory board from AstraZeneca. Dr. Chua reports having leadership roles including in the Advanced Radiation Technology Committee, Scientific Committee, Lung Cancer Consortium Singapore, and British Journal of Radiology. Dr. Siva reports receiving grants from Varian, Merck Sharp & Dohme, and Bayer; consulting fees from AstraZeneca and Reflexion; honoraria from AstraZeneca and Reflexion; and meeting support from AstraZeneca. The remaining authors declare no conflict of interest. Funding Information: Disclosures: Dr. Bucknell receives an Australian Government Scholarship, Australia and a research grant from the Royal Australian and New Zealand College of Radiologists, Australia. Drs. Louie, McDonald, and Hanna report receiving honoraria from AstraZeneca, United Kingdom. Dr. Iyengar reports participating in an advisory board from AstraZeneca. Dr. Faivre-Finn reports receiving grants from Elekta and AstraZeneca; consulting fees from AstraZeneca and Merck Sharp & Dohme, United Kingdom; honoraria from AstraZeneca; and payment from participating in an advisory board from AstraZeneca (all payments are made to the institution). Dr. Gomez reports receiving grants from Varian and AstraZeneca ; consulting fees from GRAIL, Olympus, and AstraZeneca; honoraria from Varian and MedLearning group; and meeting support from GRAIL. Dr. Chua reports receiving grants from the National Medical Research Council and the Duke–National University of Singapore Medical School; honoraria from AstraZeneca, Peer Voice, University of Hong Kong, and Hong Kong Stereotactic Body Radiation Therapy Study Group; and payment from participating in an advisory board from AstraZeneca. Dr. Chua reports having leadership roles including in the Advanced Radiation Technology Committee, Scientific Committee, Lung Cancer Consortium Singapore, and British Journal of Radiology. Dr. Siva reports receiving grants from Varian, Merck Sharp & Dohme , and Bayer; consulting fees from AstraZeneca and Reflexion; honoraria from AstraZeneca and Reflexion; and meeting support from AstraZeneca. The remaining authors declare no conflict of interest. Publisher Copyright: {\textcopyright} 2022",

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doi = "10.1016/j.jtho.2022.05.003",

language = "English",

volume = "17",

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AU - Bucknell, Nicholas W.

AU - Belderbos, José

AU - Palma, David A.

AU - Iyengar, Puneeth

AU - Samson, Pamela

AU - Chua, Kevin

AU - Gomez, Daniel

AU - McDonald, Fiona

AU - Louie, Alexander V.

AU - Faivre-Finn, Corinne

AU - Hanna, Gerard G.

AU - Siva, Shankar

AU - International Association for the Study of Lung Cancer Advanced Radiation Technology Committee

N1 - Funding Information: Disclosures: Dr. Bucknell receives an Australian Government Scholarship, Australia and a research grant from the Royal Australian and New Zealand College of Radiologists, Australia. Drs. Louie, McDonald, and Hanna report receiving honoraria from AstraZeneca, United Kingdom. Dr. Iyengar reports participating in an advisory board from AstraZeneca. Dr. Faivre-Finn reports receiving grants from Elekta and AstraZeneca; consulting fees from AstraZeneca and Merck Sharp & Dohme, United Kingdom; honoraria from AstraZeneca; and payment from participating in an advisory board from AstraZeneca (all payments are made to the institution). Dr. Gomez reports receiving grants from Varian and AstraZeneca; consulting fees from GRAIL, Olympus, and AstraZeneca; honoraria from Varian and MedLearning group; and meeting support from GRAIL. Dr. Chua reports receiving grants from the National Medical Research Council and the Duke–National University of Singapore Medical School; honoraria from AstraZeneca, Peer Voice, University of Hong Kong, and Hong Kong Stereotactic Body Radiation Therapy Study Group; and payment from participating in an advisory board from AstraZeneca. Dr. Chua reports having leadership roles including in the Advanced Radiation Technology Committee, Scientific Committee, Lung Cancer Consortium Singapore, and British Journal of Radiology. Dr. Siva reports receiving grants from Varian, Merck Sharp & Dohme, and Bayer; consulting fees from AstraZeneca and Reflexion; honoraria from AstraZeneca and Reflexion; and meeting support from AstraZeneca. The remaining authors declare no conflict of interest. Funding Information: Disclosures: Dr. Bucknell receives an Australian Government Scholarship, Australia and a research grant from the Royal Australian and New Zealand College of Radiologists, Australia. Drs. Louie, McDonald, and Hanna report receiving honoraria from AstraZeneca, United Kingdom. Dr. Iyengar reports participating in an advisory board from AstraZeneca. Dr. Faivre-Finn reports receiving grants from Elekta and AstraZeneca; consulting fees from AstraZeneca and Merck Sharp & Dohme, United Kingdom; honoraria from AstraZeneca; and payment from participating in an advisory board from AstraZeneca (all payments are made to the institution). Dr. Gomez reports receiving grants from Varian and AstraZeneca ; consulting fees from GRAIL, Olympus, and AstraZeneca; honoraria from Varian and MedLearning group; and meeting support from GRAIL. Dr. Chua reports receiving grants from the National Medical Research Council and the Duke–National University of Singapore Medical School; honoraria from AstraZeneca, Peer Voice, University of Hong Kong, and Hong Kong Stereotactic Body Radiation Therapy Study Group; and payment from participating in an advisory board from AstraZeneca. Dr. Chua reports having leadership roles including in the Advanced Radiation Technology Committee, Scientific Committee, Lung Cancer Consortium Singapore, and British Journal of Radiology. Dr. Siva reports receiving grants from Varian, Merck Sharp & Dohme , and Bayer; consulting fees from AstraZeneca and Reflexion; honoraria from AstraZeneca and Reflexion; and meeting support from AstraZeneca. The remaining authors declare no conflict of interest. Publisher Copyright: © 2022

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N2 - Toxicity concerns from thoracic radiation therapy in the treatment of lung cancers have changed substantially over the past few decades. Survival in the treatment of lung cancer has markedly improved and the introduction of advanced radiation and imaging techniques to treatment planning and delivery has made reducing toxicity possible. Phase 3 dose-escalation trials have revealed that excess dose to critical organs within the thorax can negatively impact overall survival. We summarize the existing literature on the known toxicities of thoracic radiation therapy, summarize the technological advances that have made toxicity reduction possible, and provide an overview of emerging technologies and biomarkers that are being evaluated to assess future toxicity reductions.

AB - Toxicity concerns from thoracic radiation therapy in the treatment of lung cancers have changed substantially over the past few decades. Survival in the treatment of lung cancer has markedly improved and the introduction of advanced radiation and imaging techniques to treatment planning and delivery has made reducing toxicity possible. Phase 3 dose-escalation trials have revealed that excess dose to critical organs within the thorax can negatively impact overall survival. We summarize the existing literature on the known toxicities of thoracic radiation therapy, summarize the technological advances that have made toxicity reduction possible, and provide an overview of emerging technologies and biomarkers that are being evaluated to assess future toxicity reductions.

KW - Early-stage lung cancer

KW - Locally advanced lung cancer

KW - Non–small cell lung cancer

KW - Radiation toxicity

KW - Small cell lung cancer

KW - Stereotactic body radiation therapy

U2 - 10.1016/j.jtho.2022.05.003

DO - 10.1016/j.jtho.2022.05.003

M3 - Review article

C2 - 35649502

AN - SCOPUS:85133298233

SN - 1556-0864

VL - 17

SP - 961

EP - 973

JO - Journal of Thoracic Oncology

JF - Journal of Thoracic Oncology

IS - 8

ER -

Avoiding Toxicity With Lung Radiation Therapy: An IASLC Perspective

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

UN SDGs

Access to Document

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Cite this