Quiz: Radiotherapy for Lung Cancer

July 1, 2017

Use of radiation therapy in the adjuvant, concurrent, and postoperative setting is a critical component in the care of patients with lung cancer. Take this quiz to see when radiation therapy should be used, with what agents, and in what disease stage.

Use of radiation therapy in the adjuvant, concurrent, and postoperative setting is a critical component in the care of patients with lung cancer. Take this quiz to see when radiation therapy should be used, with what agents, and in what disease stage.

Question 1

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Answer

C. N2. The National Comprehensive Cancer Network (NCCN) guidelines for non–small-cell lung cancer (NSCLC) note that data from SEER found postoperative radiation therapy to be detrimental for N0 or N1 stage disease; however, in patients with N2 nodal stage that was surgically diagnosed, a survival benefit was found.

Question 2

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Answer

C. Cisplatin/pemetrexed.

 

Pemetrexed with either cisplatin or carboplatin is recommended in patients with non-squamous NSCLC. The NCCN recommends that carboplatin/paclitaxel, cisplatin/etoposide, and cisplatin/vinblastine be used in concurrent chemoradiation regimens for all histologies.

Question 3

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Answer

A. 5%. The optimal timing of thoracic radiation therapy relative to chemotherapy has been thoroughly evaluated, according to the National Cancer Institute’s treatment guide on SCLC, noting that data suggest a small benefit to early thoracic radiation therapy.

Question 4

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Answer

A. Significantly decreased symptomatic brain metastases. A total of 4.6% of patients treated with prophylactic cranial irradiation had symptomatic brain metastases, compared with 29.7% in the observation arm (P < .00001), according to the study. Median overall survival was 24.2 months in the prophylactic cranial irradiation arm and 21.9 months in the observation arm (P = .52). At 3 months, global quality of life was worse in the prophylactic cranial irradiation arm (P = .02), “but not afterwards,” the authors noted.

Question 5

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Answer

C. N2 disease. Adjuvant radiation therapy is not recommended for patients with resected stage I or II disease or as routine use in those with stage IIIA N2 disease. “However, a postoperative multimodality evaluation, including a consultation with a radiation oncologist, is recommended to assess benefits and risks of adjuvant radiation therapy for each patient with N2 disease,” the guideline stated.