Radiation therapy for non-small cell lung cancer : the role of combined molecular and anatomical imaging

This thesis comprises a series of studies that focus on approaches for improving potentially curative radiation therapy (RT) administered to patients with lung cancer and the significant role of combined molecular and anatomical imaging technologies in this field. Radiation therapy is the primary modality utilised for treating locally advanced non-small cell lung cancer (NSCLC) and early stage disease in patients unsuitable for surgical intervention. Despite continual attempts to improve the administration of RT for lung tumours, our ability to enhance local tumour control and patient survival have barely improved in the last four decades. Tremendous scope therefore remains to enhance the effectiveness of treatment delivered to patients who are diagnosed with this sinister disease. <p>[…]</p> <p>The work described in this thesis indicates that timely treatment after diagnosis is essential for NSCLC as is customisation of radiation therapy treatment plans for individual patients. The concept of geographic miss introduced here was found to be useful to describe both the differences between treatment techniques and the variations in target coverage due to updated and improved imaging information. Together, the initiatives described in this thesis utilise anatomical and molecular imaging to characterise NSCLC in the pre and on-treatment phases of RT. Compared to the current standardised approach to RT delivery, these studies are aimed at delivering personalised regimes guided by the individual anatomical and functional characteristics of these tumours. It is hoped that the future application of these findings will achieve greater success, both in terms of tumour control and long term survival, for patients undergoing RT for the treatment of NSCLC.</p>