The American Society for Radiation Oncology (ASTRO) has issued evidence-based guidelines for the use of external-beam radiation therapy, endobronchial brachytherapy, and concurrent chemotherapy to provide palliative care and treat thoracic symptoms caused by advanced lung cancer.
The guidelines, published in the April issue of Practical Radiation Oncology, were developed to provide recommendations for uniform treatment of symptoms relating to the spread of lung cancer, such as cough, shortness of breath, bronchial obstruction, and chest pain.
They were developed by a multidisciplinary task force co-chaired by Dr. George Rodrigues, radiation oncologist and clinical scientist at London Health Sciences Centre in Ontario, and Dr. Benjamin Movsas, chairman of radiation oncology at Henry Ford Health System.
The task force has identified a variety of regimens of thoracic external-beam radiation therapy for palliation of symptoms. Moderately higher dose regimens are associated with a modest improvement in survival for selected patients, primarily those who have good performance status.
The guidelines do not recommend the use of endobronchial brachytherapy, citing lack of evidence to support this treatment for palliative management of lung cancer.
Chemotherapy should only be administered sequentially with radiation therapy because the task force did not identify any added benefit for patients to administering it at the same time.
