Radiotherapy for locally advanced non-small cell lung cancer

European Journal of Cancer

Volumn 45, Issue SUPPL. 1, 2009, Pages 113-125

  Girard, Nicolas ^a   Mornex, Françoise ^a  

^a CENTRE HOSPITALIER LYON SUD   (France)

Author keywords

[No Author keywords available]

Indexed keywords

BEVACIZUMAB; CARBOPLATIN; CETUXIMAB; CISPLATIN; DOCETAXEL; ERLOTINIB; ETOPOSIDE; FLUORODEOXYGLUCOSE F 18; GEFITINIB; GEMCITABINE; IFOSFAMIDE; MITOMYCIN; NAVELBINE; PACLITAXEL; VINBLASTINE; VINDESINE;

ADVANCED CANCER; ARTICLE; BLEEDING; BREATHING; CANCER COMBINATION CHEMOTHERAPY; CANCER LOCALIZATION; COMPUTER ASSISTED RADIOTHERAPY; DOSIMETRY; ESOPHAGITIS; ESOPHAGUS DISEASE; GASTROINTESTINAL SYMPTOM; GASTROINTESTINAL TOXICITY; GATED IMAGING; HEMATOLOGIC DISEASE; HUMAN; INTENSITY MODULATED RADIATION THERAPY; LOW DRUG DOSE; LUNG DISEASE; LUNG NON SMALL CELL CANCER; LUNG TOXICITY; PRACTICE GUIDELINE; PRIORITY JOURNAL; PROTON THERAPY; QUALITY CONTROL; RADIATION DOSE DISTRIBUTION; RADIATION DOSE FRACTIONATION; RADIATION PNEUMONIA; RADIOSENSITIZATION; SKIN DISEASE; STEREOTACTIC BODY RADIATION THERAPY; TREATMENT RESPONSE;

ANTINEOPLASTIC COMBINED CHEMOTHERAPY PROTOCOLS; CARCINOMA, NON-SMALL-CELL LUNG; CLINICAL TRIALS AS TOPIC; COMBINED MODALITY THERAPY; HUMANS; LUNG NEOPLASMS; PRACTICE GUIDELINES AS TOPIC; QUALITY CONTROL; RADIOTHERAPY DOSAGE;

EID: 70349150480     PISSN: 09598049     EISSN: None     Source Type: Journal    
DOI: 10.1016/S0959-8049(09)70023-1     Document Type: Article

References (82)

1. D'Addario G., Felip E., and ESMO Guidelines Working Group. Non-small-cell lung cancer: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol 1 (2008) S2 ii39-40.
2. Goldstraw P., Crowley J., Chansky K., et al., International Association for the Study of Lung Cancer International Staging Committee, Participating Institutions. The IASLC Lung Cancer Staging Project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM Classification of malignant tumours. J Thorac Oncol 2 (2007) 706-714
3. Andre F., Grunenwald D., Pignon J.P., et al. Survival of patients with resected N2 non-small-cell lung cancer: evidence for a subclassification and implications. J Clin Oncol 18 (2000) 2981-2989
4. Groome P.A., Bolejack V., Crowley J.J., et al., IASLC International Staging Committee, Cancer Research and Biostatistics, Observers to the Committee, Participating Institutions. The IASLC Lung Cancer Staging Project: validation of the proposals for revision of the T, N, and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol 2 (2007) 694-705
5. Roswit B., Patno M.E., Rapp R., et al. The survival of patients with inoperable lung cancer: a large-scale randomized study of radiation therapy versus placebo. Radiology 90 (1968) 688-697
6. Kubota K., Furuse K., Kawahara M., et al. Role of radiotherapy in combined modality treatment of locally advanced non-small-cell lung cancer. J Clin Oncol 12 (1994) 1547-1552
7. Sause W.T., Scott C., Taylor S., et al. Radiation Therapy Oncology Group (RTOG) 88-08 and Eastern Cooperative Oncology Group (ECOG) 4588: preliminary results of a phase III trial in regionally advanced, unresectable non-small-cell lung cancer. J Natl Cancer Inst 87 (1995) 198-205
8. Le Chevalier T., Arriagada R., Quoix E., et al. Radiotherapy alone versus combined chemotherapy and radiotherapy in non resectable non-small-cell lung cancer: first analysis of a randomized trial in 353 patients. J Natl Cancer Inst 83 (1991) 417-423
9. Dillman R.O., Herndon J., Seagren S.L., Eaton Jr. W.L., and Green M.R. Improved survival in stage III non-small-cell lung cancer: seven-year follow-up of cancer and leukemia group B (CALGB) 8433 trial. J Natl Cancer Inst 88 (1996) 1210-1215
10. Schaake-Koning C., van den Bogaert W., Dalesio O., et al. Effects of concomitant cisplatin and radiotherapy on inoperable non-small-cell lung cancer. N Engl J Med 326 (1992) 524-530
11. Trovo M.G., Minatel E., Franchin G., et al. Radiotherapy versus radiotherapy enhanced by cisplatin in stage III non-small cell lung cancer. Int J Radiat Oncol Biol Phys 24 (1992) 11-15
12. Schild S.E., Stella P.J., Geyer S.M., et al. Phase III trial comparing chemotherapy plus once-daily or twice-daily radiotherapy in Stage III non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 54 (2002) 370-378
13. Non-small Cell Lung Cancer Collaborative Group. Chemother-apy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomised clinical trials. BMJ 311 (1995) 899-909
14. Rolland E., Le Chevalier T., Auperin A., et al. Sequential radio-chemotherapy versus radiotherapy alone and concomitant RT-CT versus RT alone in locally advanced non-small-cell lung cancer: Two meta-analyses using individual patient data from randomized clinical trials. J Thorac Oncol 2 (2007) S309
15. Clamon G., Herndon J., Eaton W., et al. A feasibility study of extended chemotherapy for locally advanced non-small cell lung cancer: a phase II trial of cancer and leukemia group B. Cancer Invest 12 (1994) 273-282
16. Furuse K., Fukuoka M., Kawahara M., et al. Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III non-small-cell lung cancer. J Clin Oncol 17 (1999) 2692-2699
17. Ulutin H.C., Güden M., Oysul K., Sürenkök S., and Pak Y. Split-course radiotherapy with or without concurrent or sequential chemotherapy in non-small cell lung cancer. Radiat Med 18 (2000) 93-96
18. Zatloukal P., Petruzelka L., Zemanova M., et al. Concurrent versus sequential radiochemotherapy with vinorelbine plus cisplatin (V-P) in locally advanced non-small cell lung cancer. A randomized study. Lung Cancer 46 (2004) 87-98
19. Fournel P., Robinet G., Thomas P., et al. Randomized phase III trial of sequential chemoradiotherapy compared with concurrent chemoradiotherapy in locally advanced non-small-cell lung cancer: Groupe Lyon-Saint-Étienne d'Oncologie Thoracique - Groupe Français de Pneumo-Cancérologie NPC 95-01 study. J Clin Oncol 23 (2005) 5910-5917
20. Belani C.P., Choy H., Bonomi P., et al. Combined chemotherapy regimens of paclitaxel and carboplatin for locally advanced non-small-cell lung cancer: a randomized phase II locally advanced multi-modality protocol. J Clin Oncol 23 (2005) 5883-5891
21. Curran W.J., Scott C., and Langer R. Phase III comparison of sequential vs. concurrent chemoradiation for patients with unresected stage III non-small-cell lung cancer (NSCLC): Initial report of Radiation Therapy Oncology Group (RTOG) 9410. Proc Am Soc Clin Oncol 1891 (2000) (abstract).
22. Huber R.M., Flentje M., Gosse H., et al. Induction chemotherapy and following simultaneous radiochemotherapy versus induction chemotherapy and radiotherapy alone in inoperable NSCLC (Stage IIIA/IIIB): Update of CT/RT 99/97. Proc Am Soc Clin Oncol 7075 (2004) (abstract).
23. Belderbos J., Uitterhoeve L., Belderbos H., et al. Randomised trial of sequential versus concurrent chemo-radiotherapy in patients with inoperable non-small cell lung cancer (EORTC 08972-22973). Eur J Cancer 43 (2007) 114-121
24. Auperin A., Rolland E., Curran W.J., et al. Concomitant radio-chemotherapy (RT-CT) versus sequential RT-CT in locally advanced non-small cell lung cancer (NSCLC): A meta-analysis using individual patient data (IPD) from randomized clinical trials (RCTs). J Thorac Oncol 2 (2007) S310
25. Gopal R., Starkschall G., Tucker S.L., et al. Effects of radiotherapy and chemotherapy on lung function in patients with non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 56 (2003) 114-120
26. International Commission on Radiation Units and Mea-surements. ICRU Report 62: Prescribing, Recording, and Reporting Photon Beam Therapy (Supplement to ICRU Report 50). International Commission on Radiation Units and Measurements, Bethesda, USA, 1999.
27. Giraud P., De Rycke Y., Dubray B., et al. Conformal radiotherapy (CRT) planning for lung cancer: analysis of intrathoracic organ motion during extreme phases of breathing. Int J Radiat Oncol Biol Phys 51 (2001) 1081-1092
28. Rudat V., Flentje M., Oetzel D., Menke M., Schlegel W., and Wannenmacher M. Influence of the positioning error on 3D conformal dose distributions during fractionated radiotherapy. Radiother Oncol 33 (1994) 56-63
29. Tsujino K., Hirota S., Endo M., et al. Predictive value of dose-volume histogram parameters for predicting radiation pneumonitis after concurrent chemoradiation for lung cancer. Int J Radiat Oncol Biol Phys 55 (2003) 110-115
30. Chapet O., Kong F.M., Lee J.S., Hayman J.A., and Ten Haken R.K. Normal tissue complication probability modeling for acute esophagitis in patients treated with conformal radiation therapy for non-small cell lung cancer. Radiother Oncol 77 (2005) 176-181
31. Graham M.V., Purdy J.A., Emami B., et al. Clinical dose-volume histogram analysis for pneumonitis after 3D treatment for non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys 45 (1999) 323-329
32. Emami B., Lyman J., Brown A., et al. Tolerance of normal tissue to therapeutic irradiation. Int J Radiat Oncol Biol Phys 21 (1991) 109-122
33. Hurkmans C.W., Remeijer P., Lebesque J.V., and Mijnheer B.J. Set-up verification using portal imaging; review of current clinical practice. Radiother Oncol 58 (2001) 105-120
34. Bissonnette J.P., Purdie T.G., Higgins J.A., Li W., and Bezjak A. Cone-beam computed tomographic image guidance for lung cancer radiation therapy. Int J Radiat Oncol Biol Phys 73 (2009) 927-934
35. Kolitsi Z., Dahl O., Van Loon R., et al. Quality assurance in conformal radiotherapy: DYNARAD consensus report on practice guidelines. Radiother Oncol 45 (1997) 217-223
36. Measurement Quality Assurance for Ionizing Radiation Dosimetry (ICRU Report 76). J ICRU 6 (2006)
37. Martel-Lafay I., Clavère P., Labat J., et al. Radiation Therapy (RT) Quality Control (QC) in a French multicentric randomised phase II trial - GLOT GFPC IFCT 02.01 - including Concurrent Chemoradiation (CCRT) for unresectable stage III Non Small Cell Lung Cancer (NSCLC). Int J Radiat Biol Phys S149 (2006) 1034 (abstract).
38. Fournel P., Vergnenégre A., Robinet G., et al. Induction (ICT) or consolidation chemotherapy (CT) with cisplatin (C) and paclitaxel (P) plus concurrent chemo-radiation (CT/TRT) with cisplatin and vinorelbine (V) for unresectable non-small cell lung cancer (NSCLC) patients (pts): Randomized phase II trial GFPC-GLOT-IFCT 02-01. J Clin Oncol 24 (2006) 7048 (abstract).
39. Hayman J.A., Martel M.K., Ten Haken R.K., et al. Dose escalation in non-small-cell lung cancer using three-dimensional conformal radiation therapy: update of a phase I trial. J Clin Oncol 19 (2001) 127-136
40. Rosenman J.G., Halle J.S., Socinski M.A., et al. High-dose conformal radiotherapy for treatment of stage IIIA/IIIB non-small-cell lung cancer: technical issues and results of a phase I/II trial. Int J Radiat Oncol Biol Phys 54 (2002) 348-356
41. Wu K.L., Jiang G.L., Liao Y., et al. Three-dimensional conformal radiation therapy for non-small-cell lung cancer: a phase I/II dose escalation clinical trial. Int J Radiat Oncol Biol Phys 57 (2003) 1336-1344
42. Socinski M.A., Morris D.E., Halle J.S., et al. Induction and concurrent chemotherapy with high-dose thoracic conformal radiation therapy in unresectable stage IIIA and IIIB non-small-cell lung cancer: a dose-escalation phase I trial. J Clin Oncol 22 (2004) 4341-4350
43. Marks L.B., Garst J., Socinski M.A., et al. Carboplatin/Paclitaxel or carboplatin/vinorelbine followed by accelerated hyperfractionated conformal radiation therapy: report of a prospective phase I dose escalation trial from the Carolina conformal therapy consortium. J Clin Oncol 22 (2004) 4329-4340
44. Bradley J., Graham M.V., Winter K., et al. Toxicity and outcome results of RTOG 9311 : a phase I-II dose-escalation study using three-dimensional conformal radiotherapie in patients with inoperable non-small-cell lung carcinoma. Int J Radiat Oncol Biol Phys 61 (2005) 318-328
45. Kong F.M., Hayman J.A., Griffith K.A., et al. Final toxicity results of a radiation-dose escalation study in patients with non-small-cell lung cancer (NSCLC): predictors for radiation pneumonitis and fibrosis. Int J Radiat Oncol Biol Phys 65 (2006) 1075-1086
46. Belderbos J.S., Heemsbergen W.D., De Jaeger K., Baas P., and Lebesque J.V. Final results of a Phase I/II dose escalation trial in non-small-cell lung cancer using three-dimensional conformal radiotherapy. Int J Radiat Oncol Biol Phys 66 (2006) 126-134
47. Urbanic J.J., Turrisi III A.T., Sharma A.K., et al. Conformal high dose external radiation therapy, 80.5 Gy, alone for medically inoperable non-small cell lung cancer: a retrospective analysis. J Thorac Oncol 1 (2006) 112-119
48. Sura S., Yorke E., Jackson A., and Rosenzweig K.E. High-dose radiotherapy for the treatment of inoperable non-small cell lung cancer. Cancer J 13 (2007) 238-242
49. Socinski M.A., Blackstock A.W., Bogart J.A., et al. Randomized phase II trial of induction chem. otherapy followed by concurrent chemotherapy and dose-escalated thoracic conformal radiotherapy (74 Gy) in stage III non-small-cell lung cancer: CALGB 30105. J Clin Oncol 26 (2008) 2457-2463
50. Stinchcombe T.E., Morris D.E., Lee C.B., et al. Induction chemotherapy with carboplatin, irinotecan, and paclitaxel followed by high dose three-dimension conformal thoracic radiotherapy (74 Gy) with concurrent carboplatin, paclitaxel, and gefitinib in unresectable stage IIIA and stage IIIB non-small cell lung cancer. J Thorac Oncol 3 (2008) 250-257
51. Belliere A., Girard N., Chapet O., et al. Feasibility of high-dose three-dimensional radiation therapy in the treatment of localized non-small cell lung cancer. Cancer Radiother (2009) in press].
52. Saunders M., Dische S., Barrett A., Harvey A., Griffiths G., and Par-mar M. Continuous, hyperfractionated, accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small cell lung cancer: mature data from the randomised multicentre trial. Radioth Oncol 52 (1999) 137-148
53. Yom S.S., Liao Z., Liu H.H., et al. Initial evaluation of treatment-related pneumonitis in advanced-stage non-small-cell lung cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 68 (2007) 94-102
54. Chapet O., Khodri M., Jalade P., et al. Potential benefits of using non coplanar field and intensity modulated radiation therapy to preserve the heart in irradiation of lung tumors in the middle and lower lobes. Radiother Oncol 80 (2006) 333-340
55. Wong J.W., Sharpe M.B., Jaffray D.A., et al. The use of active breathing control (ABC) to reduce margin for breathing motion. Int J Radiat Oncol Biol Phys 44 (1999) 911-919
56. Rosenzweig K.E., Hanley J., Mah D., et al. The deep inspiration breath-hold technique in the treatment of inoperable non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 48 (2000) 81-87
57. Cesaretti J.A., Pennathur A., Rosenstein B.S., Swanson S.J., and Fernando H.C. Stereotactic radiosurgery for thoracic malignancies. Ann Thorac Surg 85 (2008) S785-S791
58. Hiraoka M., and Nagata Y. Stereotactic body radiation therapy for early-stage non-small cell lung cancer: the Japanese experience. Int J Clin Oncol 9 (2004) 352-355
59. Vokes E.E., Herndon II J.E., Crawford J., et al. Randomized phase II study of cisplatin with gemcitabine or paclitaxel or vinorelbine as induction chemotherapy followed by concomitant chemoradiotherapy for stage IIIb non-small-cell lung cancer: cancer and leukemia group B study 9431. J Clin Oncol 20 (2002) 4191-4198
60. Scalliet P., Goor C., Galdermans D., et al. Gemzar® (gemcitabine) with thoracic radiotherapy - a phase II pilot study in chemonaive patients with advanced non-small cell lung cancer. Proc Am Soc Clin Oncol 17 (1998) 1923 (abstract).
61. Mornex F., and Girard N. Gemcitabine and radiation therapy in non-small cell lung cancer: state of the art. Ann Oncol 17 (2006) 1743-1747
62. Gervais R., Ducolone A., Le chevalier T., et al. Conventional radiation (RT) with daily carboplatin (Cb) compared to RT alone after induction chemotherapy (ICT) [vinorelbine (Vr)-cisplatin (P)]: Final results of a randomized phase III trial in stage III unresectable non small cell lung (NSCLC) cancer. Study CRG/BMS/NPC/96 of the French Lung Cancer Study Group FNCLCC and IFCT. Proc Am Soc Clin Oncol 7016 (2005) (abstract).
63. Komaki R., Seiferheld W., Ettinger D., Lee J.S., Movsas B., and Sause W. Randomized phase II chemotherapy and radiotherapy trial for patients with locally advanced inoperable non-small-cell lung cancer: long-term follow-up of RTOG 92-04. Int J Radiat Oncol Biol Phys 53 (2002) 548-557
64. Gandara D.R., Chansky K., Albain K.S., et al. Consolidation docetaxel after concurrent chemoradiotherapy in stage IIIB non-small-cell lung cancer: phase II Southwest Oncology Group Study S9504. J Clin Oncol 21 (2003) 2004-2010
65. Vokes E.E., Herndon II J.E., Kelley M.J., et al. Induction chemotherapy followed by chemoradiotherapy compared with chemoradiotherapy alone for regionally advanced unresectable stage III non-small-cell lung cancer: Cancer and Leukemia Group B. J Clin Oncol 25 (2007) 1698-1704
66. Hanna N.H., Neubauer M., Nasari R., et al. Phase III trial of cisplatin (P) plus etoposide (E) plus concurrent chest radiation (XRT) with or without consolidation docetaxel (D) in patients (pts) with inoperable stage III non-small cell lung cancer (NSCLC): HOG LUN 01-24/USO-023. J Clin Oncol 25 (2007) 7512 (abstract).
67. Van Meerbeeck J.P., Cardenal F., Vansteenkiste J., et al. Mature results of PulmonArt: Involved-field 3D radiotherapy (RT) and docetaxel/cisplatin chemotherapy (CT) in a randomised phase 2 study comparing concurrent CT-RT followed by consolidation CT, with induction CT followed by concurrent CT-RT in patients (pts) with stage III non-small cell lung cancer (NSCLC). J Thorac Oncol 2 (2007) S349
68. Garrido P., Arellano A., Massuti B., et al. Randomized phase II trial using concomitant chemoradiation plus induction (I) or consolidation (C) chemotherapy (CT) for unresectable stage III non-small cell lung cancer (NSCLC) patients (p). Mature results of the SLCG 0008 study. J Thorac Oncol 2 (2007) S365
69. Kim M.K., Kim S.W., Choi E.K., et al. Induction chemotherapy followed by concurrent chemoradiotherapy (CCRT) versus CCRT alone for unresectable stage III non-small cell lung cancer (NSCLC): randomized phase III trial. J Thorac Oncol 2 (2007) S308
70. Pao W., and Girard N. Clinical applications of kinase inhibitors in solid tumors. In: Bradshaw R., and Dennis E. (Eds). The handbook of cell signaling (2009), Elsevier Inc., San Diego, CA [in press].
71. Ready N., Janne P., Herndon J., et al. Chemoradiotherapy (CRT) and gefitinib (G) in stage III non-small cell lung cancer (NSCLC): A CALGB stratified phase II trial. J Clin Oncol 24 (2006) (abstr 7046).0
72. Martinez E., Martinez M., Viñolas N., et al. Feasibility and tolerability of the addition of erlotinib to 3D thoracic radiotherapy (RT) in patients (p) with unresectable NSCLC: A prospective randomized phase II study. J Clin Oncol 26 (2008) (abstr 7563).
73. Bonner J.A., Harari P.M., Giralt J., et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med 354 (2006) 567-578
74. Hughes S., Liong J., Miah A., et al. A brief report on the safety study of induction chemotherapy followed by synchronous radiotherapy and cetuximab in stage III non-small cell lung cancer (NSCLC): SCRATCH study. J Thorac Oncol 3 (2008) 648-651
75. Blumenschein G.R., Paulus R., Curran W.J., et al. A phase II study of cetuximab (C225) in combination with chemoradiation (CRT) in patients (PTS) with stage IIIA/B non-small cell lung cancer (NSCLC): A report of the 2 year and median survival (MS) for the RTOG 0324 trial. J Clin Oncol 26 (2008) (abstr 7516).
76. Olsen C.C., Paulus R., Komaki R., et al. RTOG 0324: A phase II study of cetuximab (C225) in combination with chemoradiation (CRT) in patients with stage IIIA/B non-small cell lung cancer (NSCLC) - Association between EGFR gene copy number and patients' outcome. J Clin Oncol 26 (2008) 7607 (abstract).
77. Jensen A.D., Münter M.W., Bischoff H., et al. Treatment of non-small cell lung cancer with intensity-modulated radiation therapy in combination with cetuximab: the NEAR protocol (NCT00115518). BMC Cancer 6 (2006) 122
78. Johnson D.H., Fehrenbacher L., Novotny W.F., et al. Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel with carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol 22 (2004) 2184-2191
79. Sandler A., Gray R., Perry M.C., et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med 355 (2006) 2542-2550
80. Socinski M.A., Morris D.E., Stinchcombe T.E., et al. Incorporation of bevacizumab (B) and erlotinib (Er) with induction (I) and concurrent (C) carboplatin (Cb)/paclitaxel (P) and 74 Gy of thoracic radiotherapy in stage III non-small cell lung cancer (NSCLC). J Clin Oncol 26 (2008) 7517 (abstract).
81. van Meerbeeck J.P., Kramer G., van Schil P.E., et al. A randomized trial of radical surgery (S) versus thoracic radiotherapy (TRT) in patients (pts) with stage IIIA-N2 non-small cell lung cancer (NSCLC) after response to induction chemotherapy (ICT) (EORTC 08941). Proc Am Soc Clin Oncol 23 (2005) 7015 (abstract).
82. Salazar O.M., Sandhu T.S., Lattin P.B., et al. Once-weekly, high-dose stereotactic body radiotherapy for lung cancer: 6-year analysis of 60 early-stage, 42 locally advanced, and 7 metastatic lung cancers. Int J Radiat Oncol Biol Phys 72 (2008) 707-715