A current review of dose-escalated radiotherapy in locally advanced non-small cell lung cancer

The mainstay therapy for locally advanced non-small cell lung cancer is concurrent chemoradiotherapy. Loco-regional recurrence constitutes the predominant failure patterns. Previous studies confirmed the relationship between increased biological equivalent doses and improved overall survival. However, the large randomized phase III study, RTOG0617, failed to demonstrate the benefit of dose-escalation to 74Gy compared with 60Gy by simply increasing fraction numbers. Therefore, exploring of safe and effective methods to increase radiation dose is warranted. In this article, we summarized the recent progression of dose-escalation study from three aspects: altered fractionation, personalized radiotherapy regimen and new techniques.