EDISCIENCES

ABSTRACT

Background Lung cancer is the most common cancer in the world and the lead- ing cause of cancer related mortality in Western countries. Particu- larly, more than two thirds of lung cancer patients are 65 years or older, many of whom have competing comorbidities. Radiotherapy plays a key role in both curative and palliative treatments for this disease in older patients with cancer. Methods In this review we provide the available evidence in the literature to gauge the results of the therapy for older patients with lung cancer and we give an overview of the standard of care and future direc- tions in NSCLC treatment. Furthermore, it will demonstrate how the evolution of RT for NSCLC has been underpinned by improvements in radiotherapy technology. Results Recent advances include stereotactic body radiotherapy (SBRT), which is now established as a curative-intent treatment option for older patients with early-stage NSCLC who are medically inopera- ble, or at high risk for surgical complications. This has expanded the indications for radiotherapy in lung cancer and improved outcomes both in terms of increasing survival and reducing toxicity. Conclusions Improved delivery techniques have facilitated studies evaluating the role of SBRT in limited stage NSCLC and in oligometastatic settings too. Although outcomes in locally advanced NSCLC remain disap- pointing for many patients, future progress may come about from an improved understanding of disease biology and the development of radiotherapy approaches that further reduce normal tissue irradia- tion.