Modern radiotherapy techniques in lung cancer

Abstract

During the last decade, technology has provided remarkable improvements and accessibility to cutting edge techniques in many departments. The major goal is set to improve quality of life and toxicity profiles of mediastinal treatments without compromising the local control and overall survival. Moving from 2D to 3D and 4D simulation has exposed the secrets of moving targets to individualize margins on specified targets and organs at risk, in addition to ensure precision to minimize the interobserver variability in target delineation via incorporation of FDG–PET fusion in customization. Image-guided radiotherapy with either planar or volumetric imaging increased accurate and appropriate daily localization, promoting comfort to encourage dose escalation or respiratory phase-specific treatment strategies along with motion management in thoracic malignancies. As randomized trials are lacking for many new technologies, knowledge-based tailoring and implementation of any site and stage-specific requirement per patient has been a common practice in the recent years, such as SBRT, IMRT, VMAT, or protons.