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Lung Cancer

Early Stage Disease

Overview

For early stage (I, II), operable cancers in healthy patients, surgical removal is normally accepted as the treatment of choice, with reported cure rates as high as 70% or more ( 1, 2). If a patient has an early stage cancer, but their ability to withstand surgery is in question because of coexisting medical problems (a condition generally referred to as “medically inoperable”), they may be offered radiotherapy instead of surgery. Extended disease-free survival is also observed with radiotherapy, though the reported rates tend to be lower compared with surgical results (3, 4, 5).

Technical Challenges

Although considerable technical progress in radiotherapy has occurred in the past decade, including Three-Dimensional Conformal radiotherapy (3DCRT) and Intensity Modulated radiotherapy (IMRT), there are a number of reasons why even sophisticated  radiotherapy may still produce a suboptimal result for bronchogenic carcinoma. Briefly, these include:

1. Radiation Dose/Therapeutic Margin
2. Respiratory Tumor Motion
3. Limited Number of Targeting Angles with Conventional Devices