7
Recommendation 5.3
➤ Patients with stage III NSCLC who are not candidates for concurrent
chemoradiation but are candidates for chemotherapy should be
offered sequential chemotherapy and radiation therapy over radiation
alone. (Strong recommendation; EB-B-H)
Recommendation 5.4
➤ Patients with stage III NSCLC receiving concurrent chemoradiation
should be treated to 60 Gy. (Strong recommendation; EB-B-H)
Recommendation 5.5
➤ Doses higher than 60 Gy and up to 70 Gy may be considered for
selected patients, with careful attention to doses to heart, lungs, and
esophagus. (Strong recommendation; EB-B-L)
Recommendation 5.6
➤ Patients with stage III NSCLC receiving definitive radiation without
chemotherapy in standard fractionation may be considered for
radiation dose escalation and for modest hypofractionation from
2.15–4 Gy per fraction. (Weak recommendation; EB-B-L)
Recommendation 5.7
➤ Patients with stage III NSCLC receiving concurrent chemoradiation
without disease progression during the initial therapy should be
offered consolidation durvalumab for up to 12 months. (Strong
recommendation; EB-B-H)
Qualifying statement: There is insufficient evidence to alter the recommendation
for consolidation durvalumab following concurrent chemo-radiation for
molecularly defined subgroups (namely patients with an oncogenic driver
alteration or those with low/no expression of programmed death-ligand 1 [PD-
L1]).
