Dr Park on the Role of Radiation Therapy in NSCLC

Henry S. Park, MD, MPH, associate professor, therapeutic radiology, vice chair, Clinical Research, chief, Thoracic Radiotherapy Program, Therapeutic Radiology, Yale School of Medicine, discusses the importance of considering radiation therapy in patients with non–small cell lung cancer (NSCLC) and how this therapeutic approach can work in concert with targeted therapy and other systemic therapies.

The advent of immunotherapies and targeted agents in NSCLC have strengthened the role of radiation therapy in this patient population, Park says. Many patients with NSCLC, even those with advanced stages of disease who were once considered incurable, who receive radiation therapy along with other systemic options have improved prognoses and survival rates compared with historical outcomes, Park explains.

Often, patients with 1 or 2 sites of disease progression in the primary tumor or outside the primary tumor and lymph nodes can undergo radiation therapy to target those sites, Park notes. As systemic therapies for patients with NSCLC are becoming more effective and tolerable, patients may stay on these therapies for increasingly long periods, and radiation therapy can help maintain the efficacy of those therapies in some patients, Park emphasizes. As a result, medical oncologists may refer patients for radiation therapy, especially those with advanced disease, although radiation is also a key approach in many patients with earlier-stage NSCLC, Park says. For instance, radiation is often the foundation of curative-intent therapy in patients who cannot undergo surgery, as well as in those who can undergo surgery but may not be the most fit surgical candidates, and in those who prefer to avoid a surgical approach, according to Park. For instance, in patients with stage III NSCLC, radiation therapy in conjunction with immunotherapy has improved therapeutic outcomes, and future research may indicate further improvements with the addition of targeted therapy across the NSCLC population, Park concludes.