Lung cancer radiation therapy in Australia and New Zealand: Patterns of practice

Syed Muntasser Islam, Shalini K. Vinod, Margot Lehman, Shankar Siva, Tomas Kron, Patrick M. Dwyer, Lois Holloway, Louis Lao, Mei Ling Yap, Jeremy D. Ruben

Research output: Contribution to journalArticleResearchpeer-review

6 Citations (Scopus)


Introduction: The RANZCR Faculty of Radiation Oncology Lung Interest Cooperative (FROLIC) surveyed patterns of lung cancer radiation therapy practice for non−small cell (NSCLC) and small cell lung cancer (SCLC) to evaluate current patterns of care and potential for improvement. Methods: In October 2014, Radiation Oncologists (ROs) from all 62 departments in Australia and New Zealand were invited to a web-based survey directed at those treating lung cancer. Questions covered current radiation therapy practice as well as quality measures. Results: Fifty-eight per cent of respondents used 4D-CT simulation. For curative treatment, 98% employed 3D-CRT and 34% intensity modulated radiotherapy (IMRT) techniques. Treatment verification was primarily performed using cone-beam CT (86%). In NSCLC, the commonest curative dose-fractionation regime was 60 Gy/30# (96%) and for palliative intent, 30 Gy/10# (76%). Forty-four per cent treated patients with stereotactic ablative body radiotherapy (SABR) and half treated central tumours with this technique. In fit patients with synchronous solitary brain metastases, 80% would give radical treatment. For curative-intent SCLC, 45–50.4 Gy/25–28# (61%) and 45 Gy/30#/1.5 Gy b.d. (48%) were used. Ninety-four per cent discussed lung cancer patients at multidisciplinary meetings. Contours were peer-reviewed by 74% and 50% for conventional fractionation and SABR respectively. Conclusion: A significant proportion of ROs did not have access to 4D-CT. The majority used 3D image verification and consistently prescribed evidence based doses. A significant number did not participate in peer-review of contours. Practice in IMRT and synchronous oligo-metastatic disease is variable and should be an area of future research. Utilising survey findings, FROLIC is developing consensus recommendations to guide practice.

Original languageEnglish
Pages (from-to)677-685
Number of pages9
JournalJournal of Medical Imaging and Radiation Oncology
Issue number5
Publication statusPublished - Oct 2016


  • 4D-CT
  • IMRT
  • lung cancer
  • oligo-metastatic
  • patterns of practice
  • SABR

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