New approaches to radiotherapy as definitive treatment for inoperable lung cancer

The standard curative approach for the treatment of inoperable non-small cell lung cancer (NSCLC) is definitive radiotherapy. Advanced treatment techniques have been developed that maximize radiation dose delivery to the tumor while minimizing the dose to critical surrounding structures. These radiation therapy techniques include three-dimensional conformal radiotherapy, intensity modulated radiation therapy, stereotactic body radiotherapy, and particle beam radiotherapy. Biological imaging with (18)F-FDG-PET and other novel tracers in development have shown the potential to improve target delineation and patient selection for curative treatment. Tumor motion control with respiratory gating techniques and image-guided radiation therapy are recent developments that provide the radiation oncologist with accurate tumor localization on the treatment machine. This review article summarizes the literature on these topics and other state-of-the-art radiation therapy techniques in the management of inoperable NSCLC.