Radiation therapy preparation for patients with lung cancer: current approaches

ABSTRACT

Radiation therapy (RT) is the main method of treatment in 50-80% of patients with lung cancer (LC) since only 20-25% of the total number of patients with this pathology undergo surgery. In the early stages of the disease, RT being the main method of treatment is associated with the “functional” inability of the patient, or surgery refusal, but in the late stages, it is connected with the size of the tumor and metastases. The aim of RT is to kill tumor cells using high doses of radiation while minimizing damage to surrounding healthy tissue, which is possible only with the use of high-technology radiotherapy. The improvement of RT methods can be determined by a decrease in the radiation volume and an increase in doses, which lead to damage of tumor cells. This can be achieved using conformal radiation therapy (CRT), where the three-dimensional shape and internal structure of the field maximally correspond to the shape and structure of the target in the patient body, while the radiation doses of surrounding healthy tissues are lower than the tolerable ones. Modern CRT technologies include IntensityModulated Radiation Therapy (IMRT), Image-Guided Radiation Therapy (IGRT), and breathing-synchronized RT. Radiation therapy preparation includes the following: obtaining anatomical and topographic information about the tumor and adjacent structures; selection of the radiation sources and conditions; anatomical topographic image entry into the planning system; creation of planning programs for virtual simulation; practical implementation of the selected RT technique and radiation conditions; and quality control of pre-radiation therapy preparation. Thus, the optimization of topometry methods in the preradiation preparation of patients with LC using modern equipment and new methods, providing accurate spatial and dosimetric distribution of energy in the pathological lesion, contributes to further progress in the treatment of severe oncological pathology.