Dr. Decker on Distinct Roles of Radiation in Lung Cancer

Roy Decker, MD, PhD, associate professor of Therapeutic Radiology, Yale Cancer Center, discusses traditional roles of radiation therapy in the treatment of patients with lung cancer.

This longstanding modality has several distinct roles in the current treatment landscape, Decker says. For example, patients with stage I lung cancer are treated with stereotactic body radiation when they are deemed inoperable or ineligible for curative surgery. For those with locally advanced disease, the standard of care is to give chemotherapy and radiation concurrently with curative intent. Some patients also receive chemoradiation in the adjuvant setting, after an attempt at curative surgical resection, Decker adds.

For patients with stage IV metastatic disease, radiation is typically used in a palliative role, as a way to limit pain from bone or central nervous system metastases. With the emergence of effective therapies in the metastatic setting, the management of metastatic disease becomes more important, Decker notes. A newly critical indication for radiation therapy is in oligometastatic disease—patients who have metastases, but at limited sites.