Radiotherapy for lung cancer

Radiotherapy for lung cancer has evolved by the advancement of treatment machine and systemic therapy. At first, in non-small cell lung cancer, radiation dose escalation from 40 Gy to 60 Gy improved survival outcome in 20th century. In addition, combination with systemic therapy enabled us to get further improvement in survival outcome. In small cell-lung cancer, hyper-fractionation schedule 45 Gy in 30 fractions / 3 weeks (1.5 Gy twice in a day) was employed as a standard chemoradiotherapy schedule. Stereotactic radiotherapy has been installed for primary and metastatic lung cancer with superior outcome than conventional fractionation, and eligibility is open wider for oligomatastasis lesions. Of note, The Nagamori Memorial Center of Innovative Cancer Therapy and Research provided a first proton beam therapy (PBT) facility in Kyoto. As the PBT has superior dose distribution compared with photon therapy, we hope improving tumor control with higher irradiated dose without elevating the toxicity. (author)