Locally Advanced Lung Cancer: Is It Time to Take Cardiac Protection Seriously in Radiation Planning?

During the past couple of years, interest has been substantial in the potential cardiac toxicity associated with radiation therapy (RT) for locally advanced (LA) non-small cell lung cancer (NSCLC). The publication of the seminal RTOG (Radiation Therapy Oncology Group) 0617 randomized trial included an intriguing association of RT heart doses with overall survival (OS) on a secondary multivariable analysis (1). This was followed by subsequent publications suggesting the importance of intensity modulated RT (IMRT) planning and cancer center volume on outcomes (2, 3).

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