Routine IMRT Should be Used for Locally Advanced NSCLC
Patients with non-small cell lung cancer (NSCLC) who were treated with intensity-modulated radiation therapy (IMRT) had lower cardiac doses and rates of severe pneumonitis than those treated with three-dimensional conformal external beam radiation therapy (3D-CRT), according to the results of a large, prospective clinical trial.

We advocate for the routine use of IMRT in locally advanced NSCLC to reduce both severe lung toxicity and doses of radiation delivered to the heart, the investigators wrote, adding that the findings of their study showed IMRT to be associated with improved quality of life in the NRG Oncology clinical trial RTOG.

In a secondary analysis of the NRG Oncology trial, the investigators compared IMRT and 3D-CRT. They evaluated RT dose escalation (60 vs. 74 Gy) and the addition of cetuximab (Erbitux, Lilly) to weekly carboplatin and paclitaxel chemotherapy. Of the 482 patients in this study, 47% received IMRT and 53% received 3D-CRT. More patients in the IMRT group had stage IIIB//N3 disease (38.6%) than in the 3D-CRT group (30.3%), and the median follow-up was 21.3 months....
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