ABSTRACT
@#Breast cancer is the most common malignancy and the fifth leading cause of cancer-related mortality in the world. Breast cancer is a global health problem that poses a heavy burden on patients and their families as well as socioeconomic development. As an important component in the management of breast cancer, radiotherapy plays a vital role in its comprehensive treatment. This review describes advances made toward the application of adjuvant radiotherapy in the treatment of breast cancer.
ABSTRACT
Objective To investigate the efficacy and safety of hypofractionated thoracic radiotherapy combined with EP chemotherapy in the treatment of limited-stage small-cell lung cancer (LS-SCLC). Methods A total of 117 patients with LS-SCLC were enrolled and randomly divided into test group (n=59) and control group (n=58). Patients in the experiment group were given hypofractionated thoracic radiotherapy combined with EP chemotherapy, while patients in the control group were given hyperfractionation radiotherapy combined with EP chemotherapy. Objective response rate (ORR), 2-year overall survival (OS), 2-year progression free survival (PFS), and immune cell level were used to evaluate clinical efficacy. We compared the incidence of side effects between the two groups. Results After the treatment, the ORR of patients in the test group was higher than that in the control group (P > 0.05). The mean OS and PFS of patients in the test group were significantly longer than those in the control group (P < 0.05). The levels of CD3+, CD4+, CD4+/CD8+, and NK cells in the test group were significantly higher, whereas the levels of CD8+ were significantly lower than those in the control group (P < 0.05). The incidence of radiation pneumonitis, radiation esophagitis, and severe dermatitis in the test group was significantly lower than that in the control group (P < 0.05). Conclusion Hypofractionated radiotherapy combined with EP chemotherapy for treatment of LS-SCLC can effectively improve the anticancer efficacy and patient survival, reduce the damage to the body's immune function, and alleviate adverse reaction of radiotherapy.
ABSTRACT
Objective To investigate the effect of different fractionated radiotherapy of hypofractionated radiotherapy (HFRT) and conventional fractionated radiotherapy (CFRT) on peripheral blood lymphocytes in patients with breast cancer. Methods This retrospective analysis enrolled 40 patients with early breast cancer who underwent radiotherapy post breast conserving surgery in Xuzhou Central Hospital from November 2019 to August 2021. The patients were randomly divided into the observation group (HFRT, n = 20) and the control group (CFRT, n = 20). Changes in peripheral blood lymphocyte count (PLC) before and during radiotherapy were compared between the two groups. Results The baseline PLC was comparable between the observation group and the control group (1.53 ± 0.54 vs 1.64 ± 0.56, P > 0.05). In both groups, the PLC declined steadily during radiotherapy, and the incidence of lymphopenia in the observation group was lower than that in the control group (32.5% vs 50.0%, P > 0.05); the PLC nadir was higher in the observation group than in the control group (0.91 ± 0.28 vs 0.55 ± 0.22, P < 0.001). The ratio of the PLC nadir during treatment to baseline was significantly higher in the observation group than in the control group (0.64 ± 0.24 vs 0.38 ± 0.21, P < 0.05). Conclusion Patients with breast cancer receiving HFRT show a lower risk of radiation-induced lymphopenia versus those receiving CFRT.
ABSTRACT
Radiotherapy is an essential part of comprehensive treatment, as well as a radical treatment for head and neck cancer (HNC). The COVID-19 has continued so far, imposing a great impact on cancer care. Since conventional fractionated radiotherapy (CFRT, 2 Gy/F) requires as long as more than six weeks of treatment time, a huge challenge for epidemic control is created for both hospitals and patients. Hypofractionated radiotherapy (Hypo-RT) may be more suitable than CFRT for patients during pandemic by increasing the fraction size, thus reducing fraction number and treatment duration. Early studies have explored the application of Hypo-RT in HNC in palliative setting, which partially proved its safety and effectiveness. Recently, the efforts have been made in definitive treatment using hypofractionated regimen, as well as its combination with systemic treatment and immunotherapy. Indeed, regarding the pandemic of COVID-19, Hypo-RT has been recommended by several expert consensus in the HNC. In this review, relevant research progress was summarized and clinical implication of Hypo-RT in COVID-19 pandemic era was discussed.
ABSTRACT
Radiotherapy is one of the important treatment strategies for localized prostate cancer. Conventional fractionated external beam radiotherapy is the standard dose-fraction regimen of radical radiotherapy for localized prostate cancer. In recent years, hypofractionated radiotherapy technique has been developed rapidly. The moderately hypofractionated radiotherapy has been considered as an alternative to conventional fractionated radiotherapy in conditional institutions. Increasing evidence has been obtained in the application of ultra-hypofractionated radiotherapy (also known as stereotactic body radiotherapy, SBRT) in patients with low-and intermediate-risk prostate cancer. However, the efficacy and safety of SBRT for high-risk prostate cancer have not been fully demonstrated. In this review, research progressess on the efficacy and safety of radical hypofractionated radiotherapy and the techniques of SBRT for prostate cancer were summarized.
ABSTRACT
Objective:To investigate the feasibility and adverse reactions of simultaneous integrated boost (SIB) in volumetric modulated arc therapy (VMAT) for early breast cancer after breast-conserving surgery.Methods:A total of 67 patients with early breast cancer after breast-conserving surgery at Zhongshan People's Hospital from September 2019 to May 2021 were enrolled. All patients received VMAT-SIB to the whole breast and tumor bed. The total breast dose and tumor bed dose were 40.5Gy/15 times every 3 weeks and 48 Gy/15 every 3 weeks respectively. The exposure dose of organs at risk and acute adverse reactions of radiotherapy were evaluated.Results:The average doses of planning target volume of the whole brease (PTV WB) and planning target volume of the boost(PTV BOOST) were (42.0±2.1) Gy and (49.9±0.8) Gy, respectively. The V 95% and V 105% of PTV WB and PTV BOOST were (98.8±1.2)% and (31.4±11.3)%, (99.8±0.6)% and (22.9±10.2)%, respectively. The V 5Gy, V 20Gy, V 30Gy and mean dose (D mean) of ipsilateral lung were (52.4±12.0)%, (15.3±4.5)%, (6.7±2.2)% and (11.0±2.4) Gy respectively. The V 18Gy, V 40Gy and D mean of heart were 3.80% (0.48%,9.60%), 0 (0,0.16%) and (6.7±2.1) Gy respectively. At the end of radiotherapy, 19 patients (29%) of all 67 patients had no acute skin toxicity, 41 patients (61%) showed radiation erythema, 5 patients (7%) had radioactive dry peeling and 2 patients (3%) had wet peeling mainly located in the nipple, areola area and breast folds. None of the patients had grade 3-4 acute skin reactions. Breast swelling and breast pain were found respectively in 9 patients (13%) and 7 patients (10%). No local recurrence or distant metastases were observed during the follow-up period. The 2-year disease-free survival rate was 100%. Conclusions:VMAT combined with SIB is feasible in the treatment of early breast cancer. The adverse reactions of radiotherapy are mild and well tolerated.
ABSTRACT
Objective:To evaluate the survival outcome and toxicity of hypofractionated radiotherapy (45 Gy/15f) in patients with locally advanced/advanced non-small cell lung cancer (NSCLC) who are ineligible for conventional fractionated radiotherapy.Methods:The early efficacy, survival and toxicity of inoperable patients ( n=64) with locally advanced/advanced NSCLC patients admitted to Cancer Hospital of Tianjin Medical University from 2014 to 2018 were retrospectively analyzed. Hypofractionated radiotherapy (45 Gy/15f) were performed by using intensity-modulated radiotherapy or volumetric-modulated arc therapy technologies on Pinnacle 9 planning system. Results:The median follow-up time was 26 months. The early efficacy was available in 58 patients: complete response for 2 cases (3%), partial response for 22(38%), stable disease for 28(44%) and progressive disease for 6(9%), respectively. The local control rate was 90%. The median time to progression (TTP) and the median overall survival (OS) for all patients was 8.2 months and 21.0 months, respectively. The 1-, 2-and 3-year TTP rate was 37%, 28%, 14% and the OS rate was 66%, 43% and 27%, respectively. The incidence of esophagitis was 17%( n=11), 19%( n=12) for radiation pneumonitis and 20%( n=13) for myelosuppression. No grade ≥3 esophagitis or pneumonia was found. Conclusion:Hypofractionated radiotherapy (45 Gy/15f) is efficacious and safe for patients with locally advanced/advanced NSCLC, which yields controllable adverse events.
ABSTRACT
Objective:To analyze the adverse reactions, cosmetic effects and the improvement in positioning of breast cancer patients who received breast-conserving operation followed by hypofractionated radiotherapy and conventional radiotherapy based on the positioning of body membrane method with windowing method.Methods:From January 2019 to April 2020, 75 patients with breast cancer were randomly divided into two groups: hypofractionated radiotherapy (38 cases) administered with 42.4 Gy/16 fractions (2.65 Gy/fraction), and conventional group (37 cases) with 50 Gy/25 fractions (2.0 Gy/fraction). All of them were located by thermoplastic film, and the upper parts of the thermoplastic film were cut along the root of the breast. The adverse reactions, cosmetic effect and follow-up survival of the two groups were observed.Results:During the follow-up period, there was no recurrence in the two groups within 8 months. The local control rate and the survival rate of all the patients were both 100%. The total incidence of acute skin reaction in the two groups was 36.84% (14/38) in the hypofractionated group and 67.57% (25/37) in the conventional group ( χ2=7.09, P<0.05). The excellent and good rate of cosmetic effect was 89.47% (34/38) in the hypofractionated group and 78.38% (29/37) in the conventional group, but the difference was not statistically significant ( P>0.05). There were not statistically differences in the late skin reaction, leucopenia and thrombocytopenia between the two groups ( P>0.05). Conclusions:Breast-conserving surgery followed by hypofractionated radiotherapy with the positioning of body membrane windowing localization method is feasible and safe. Also, it can significantly reduce the acute radiation skin reactions. But the long-term effects still need to be confirmed by long-term follow-up.
ABSTRACT
Background: This study aims to report on our institutional experience of palliative radiotherapy (RT) in the locally advanced head and neck by cyclical hypofractionated RT (Quad Shot) which is a short-course palliative regimen with good patient compliance, low rates of acute toxicity, and good response rates. Objectives: The objectives of the study were to review the use of the Quad Shot technique at our institution to quantify the palliative response in locally advanced head-and-neck cancer. Materials and Methods: Between April 2017 and July 2019, 45 patients with biopsy-proven squamous cell carcinoma of the head-and-neck region at the Department of Radiotherapy, Nil Ratan Sircar Medical College, Kolkata, which were deemed to be fit for palliative RT by departmental tumor board were given cyclical hypofractionated palliative RT as 14 Gy in four fractions over 2 days, twice daily, repeated every 4 weeks for a maximum of 3 cycles. Retrospective assessment was done for improvement in pain and dysphagia and also response to treatment. Results: Pain response occurred in 66.7% of the patients. The mean pain scores decreased significantly from pre- to post-treatment, 47.4 to 21.5 (P < 0.0001). The mean initial dysphagia score improved from 21.9 to 38.2 (P = 0.0002). About 60% of patients developed mucositis (≤ Grade 2), while no Grade 3 mucositis was reported. A total of 30 patients had partial response (66.67%) and 6 patients had stable disease. However, a total of nine patients had progressive disease which included those patients that were given fewer courses of Quad Shot. Conclusion: In locally advanced head-and-neck cancer patients particularly with poor performance status or elderly patients who are in dire need of some form of local therapy for symptom control and palliation, the hypofractionated palliative RT regimen (Quad Shot) offers an effective and quick treatment option which is beneficial both clinically and in logistics issue.
ABSTRACT
Objective@#To evaluate the safety and efficacy of helical tomotherapy using simultaneously integrated boost and simultaneous integrated protection technique in the treatment of unresectable biliary tract cancers.@*Methods@#The data of 23 patients with unresectable biliary tract cancer who received tomotherapy-based hypofractionated radiotherapy at Comprehensive Cancer Centre of Drum Tower Hospital,the Affiliated Drum Tower Clinical College of Nanjing Medical University between February 2015 and October 2017 were analyzed. There were 10 males and 13 females, aged from 40 to 85 years(median:58 years). Pathological type included intrahepatic cholangiocarcinomas(n=11), gallbladder cancers(n=6),extrahepatic cholangiocarcinomas(n=6). The irradiated sites covered primary tumors and areas of local invasion,including metastatic lymph nodes which were confined to the abdominal or retroperitoneal space. Dose escalation was achieved using simultaneously integrated boost(SIB) technique, and simultaneous integrated protection(SIP)technique was used to protect gastrointestinal tracts and other adjacent organs. Cox regression modal and Kaplan-Meier analysis were used to analyze the associations between patients′ characteristics and overall survival(OS).@*Results@#The median total radiation dose was 54 Gy(range: 28-72 Gy)and median biologically effective dose(BED)was 74.4 Gy(range: 37.8-115.2 Gy).The median planning target volume(PTV)was 445.79 cm3(range:126.02-950.12 cm3). Based on the various PTV,patients received 2.4-6.0 Gy/fraction with 8-28 fractions. The local control rate was 65.2% and the median OS was 11.3 months(range:2.1-31.9 months).The most common cause of death was out-field failure and only 3 patients died of in-field failures. The longest survival was 31.9 months. BED≥70 Gy significantly improved OS,compared to BED<70 Gy(16.8 months vs.5.1 months)(HR=0.146, 95%CI:0.028-0.762, P=0.022). No patients developed grade ≥4 toxicities.@*Conclusions@#Helical tomotherapy-based hypofractionated radiotherapy is effective and well tolerated for patients with unresectable biliary tract cancer. The dose escalation with higher BED could improve the survival for such patients.
ABSTRACT
Breast-conserving surgery plus adjuvant whole-breast irradiationmay reduce the risk of local tumors and improve living con-ditions of patients. Conventional whole-breast radiotherapy confers good tumor control and esthetic effects with lower toxicity. How-ever, treatment periods of 5-7 weeks are inconvenient for patients and may lead to the wastage of medical resources. Thus, increasing-ly more individuals tend to choose a short-term radiotherapy mode, such as hypofractionated radiotherapy or partial breast irradia-tion. Many published reports suggest that short-term radiotherapy is safe and effective, similar to conventional fractionation, with comparable tumor control and fewer side effects than noted with conventional fractionation. Therefore, in contrast to conventional whole-breast radiotherapy, short-time radiotherapy shows remarkable advantages in shortening the total treatment duration, reduc-ing medical costs, saving medical resources, and improving the quality of life of patients.
ABSTRACT
Objectives To evaluate the clinical efficacy and safety of hypofractionated radiotherapy for cancer patients with hepatic metastases. Methods From May 2007 to November 2016,45 patients ( male:female=20:25) with inoperable hepatic metastases were enrolled in this investigation. The median age was 58 years old ( range:25-83).The median Karnofsky performance score ( KPS) was 80.Primary colorectal cancer was detected in 14 patients,primary breast cancer in 9 and primary lung cancer in 6 cases. Twenty-one patients had extrahepatic metastases. A total of 52 lesions were treated. Thirty-four cases received radiotherapy for one single lesion. The fractional dose was 45 Gy/3 fractions and 60 Gy/10-15 fractions. The median gross tumor volume (GTV) was 10. 1 cm3(0. 3-175. 2 cm3) and 29. 8 cm3(5. 0-209. 6 cm3) for planning target volume ( PTV).Seventeen CT images were fused with MRI and IMRT was adopted in 43 cases. The median dose of PTV was 60 Gy (40-60 Gy) and 90 Gy (60-132 Gy) for bioequivalent dose (BED). Results The median follow-up time was 23. 5 months and the median survival time was 26. 0 months (95%CI:21.4-30.6 months).The 1-year local control (LC),disease-free survival (DFS) and overall survival ( OS ) were 94%, 27% and 91%, respectively. Six cases died of liver metastases and abnormal liver function. Conclusion Hypofractionated radiotherapy is an efficacious and safe local treatment for inoperable hepatic metastases.
ABSTRACT
Objective@#To evaluate the efficacy, toxicity and cosmetic outcomes of hypofractionated simultaneous integrated boost intensity-modulated radiotherapy (IMRT-SIB) after breast conservative surgery (BCS) for early breast cancer patients.@*Methods@#A total of 76 patients with stage TisT1-2N0M0 breast cancer treated with BCS were enrolled in the analysis. The patients who underwent breast radiotherapy without regional lymph node irridiation and hypo fractionated IMRT/VMAT were used. All patients received whole breast IMRT/VMAT with tumor bed SIB. The doses delivered to the whole breast was 42.4 Gy in 16 fractions, and the dose delivered to tumor bed for SIB was 49.6 Gy in 16 fractions. Cosmetic evaluation was based on the Harvard system. Acute and late toxicities were scored according to CACAT version 3.0. Survival and recurrence rates were calculated by Kaplan-Meier method. The univariate and multivariate analysis were conducted with logistic regression.@*Results@#The median follow-up was 29 months (range 16-40 months). The follow-up rate was 100%. The 1-, 2-and 3-year overall survival rates were 100%. No recurrence or metastasis was observed in this study. The incidence of grade 1 acute skin toxicity was 68.4%, grade 2 was 7.9%. The late skin toxicity of grade 1 was 13.1%, grade 2 was 2.6%.In all, 82.4% of patients had excellent and good cosmetic outcome. The Mean dose of the tumor bed was predictive factor for grade 2 dermatitis.@*Conclusion@#The efficacy, cosmetic effect, the acute and late treatment-related toxicity of hypofractionated IMRT/VMAT-SIB in patients with early breast cancer following BCS might be acceptable. A longer follow-up is needed to define the efficacy on outcomes.@*Trial registration@#Chinese clinical trial registry, ChiCTR1800016287
ABSTRACT
Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second [FEV1] ≤ 1 L) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally advanced node-positive non-small cell lung cancer (NSCLC) patients with very limited lung function treated with induction chemotherapy and moderate hypofractionated image-guided radiotherapy (Hypo-IGRT). Hypo-IGRT was delivered to a total dose of 45 Gy to the primary tumor and involved lymph nodes. Planning was based on positron emission tomography-computed tomography (PET/ CT) and four-dimensional computed tomography (4D-CT). Internal target volume (ITV) was defined as the overlap of gross tumor volume delineated on 10 phases of 4D-CT. ITV to planning target volume margin was 5 mm in all directions. Both patients showed good clinical and radiological response. No relevant toxicity was documented. Hypo-IGRT is feasible treatment option in locally advanced node-positive NSCLC patients with very limited lung function (FEV1 ≤ 1 L).
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung , Electrons , Four-Dimensional Computed Tomography , Induction Chemotherapy , Lung Neoplasms , Lung , Lymph Nodes , Palliative Care , Prognosis , Radiotherapy , Radiotherapy, Image-Guided , Tumor BurdenABSTRACT
Radiotherapy(RT) is one of the principle treatment options for prostate cancer.Modern RT and surgery show similar progression-free survival in localized prostate cancer.Adjuvant RT compared to observation significantly diminishes the risk of prostate-specific antigen (PSA) progression and local failure for patients at the highest risk for recurrence after radical prostatectomy,including with seminal vesicle invasion,extraprostatic extension,extensive positive margins,and detectable postoperative PSA.Salvage RT is effective at controlling local recurrence and reduces the risk of distant metastasis and prostate cancerspecific mortality (PCSM) for patients with PSA or local recurrence after prostatectomy.Hypofractionated radiotherapy of recent years' reports shows similar cancer control rates without an increased risk of late toxicity in comparison to conventional regimens.The addition of androgen-deprivation therapy (ADT) to radiation improves the overall survival and biochemical progression-free survival(bPFS) for intermediate-risk and high-risk patients.
ABSTRACT
Background: As hypofractionated radiotherapy for post-operative breast cancer patients safe, effective and more convenient, it might be beneficial for patients of developing countries like ours. Objective: This study was done to evaluate the safety and efficacy of hypofractionated whole breast radiation therapy in patients who underwent breast conserving surgery and hypofractionated radiation therapy in patients who underwent mastectomy and axillary clearance. Materials and method: This cross sectional study was conducted in Delta Hospital Ltd, Dhaka, Bangladesh, including 50 postoperative patients, (12 patients in Breast Conservation Therapy group and 38 in Post Mastectomy Radiation Therapy group), with invasive ductal carcinoma of breast treated with this hypofractionated radiotherapy protocol during the last 1.5 year. The patients were treated with 3DCRT, LINAC, 6 MV photon and appropriate electron energy. Results: Minimal post treatment acute morbidity was observed. Forty seven patients (94%) had grade-I acute skin toxicity and only 3 patients (6%) developed grade-II acute skin toxicity. Conclusion: Hypofractionated radiotherapy is as safe and effective as conventional fractionated radiotherapy and superior in terms of convenience.
ABSTRACT
We present a case of unresectable cancer of the base of tongue treated with hypofractionated 3D conformal radiotherapy and concomitant chemotherapy. Based on the excellent tumour response in this radiotherapy regimen and international experience in short course treatments we shortly reviewed, we propose that this therapeutic approach could be considered in a curative setting for patients unsuitable for the a standard long course radiochemotherapy schedule.
Subject(s)
Humans , Appointments and Schedules , Chemoradiotherapy , Drug Therapy , Radiotherapy , Radiotherapy, Conformal , TongueABSTRACT
We report a case of infantile fibrosarcoma in an 8-month-old boy manifested as a right-sided lower leg mass. Repeated local recurrence and distant metastasis were noted during the following three-year period. Whole body fluoro-deoxyglucose positron emission tomography scan revealed an asymptomatic metastasis involving the fourth lumbar vertebrae. The patient received chemotherapy (VAC regimen) with Cyberknife(R) stereotactic hypofractionated radiotherapy (26 Gy; 4 fractions). This treatment reduced tumor size by 23% without acute radiation toxicity even after 33 months. This case suggests that combining chemotherapy and this form of radiotherapy may be safe and effective against childhood spinal metastasis.
Subject(s)
Humans , Infant , Male , Drug Therapy , Fibrosarcoma , Leg , Lumbar Vertebrae , Neoplasm Metastasis , Positron-Emission Tomography , Radiotherapy , RecurrenceABSTRACT
Objective:To obtain stable radioresistant non-small-cell lung cancer (NSCLC) cell lines and identify the genetic pattern of conventional fractioned and hypofractionated radiotherapy. Methods:A549 NSCLC cells were treated with 6 MV of x-rays through conventional fractionated (2 Gy, 17 f) and hypofractionated irradiation (4 Gy, 7 f) to establish a radiation resistance cell model. Tumor cell radioresistance was determined using a clonogenic assay andγ-H2AX immunofluorescence staining combined with confocal microscopy. After extracting total mRNA from the cells, a whole genome expression microarray was applied to detect differential gene expression. The genes with at least a twofold increase in expression (P<0.05) were analyzed, and the pathway (Q<0.05) methods were used to further analyze the chip results. Results:After irradiating the A549 cells, two radioresistant cell lines were obtained, namely, the A549R2Gy-R and the A549R4Gy-R cell lines. The A549R2Gy-R cell line was radioresistant to the conventional fractionated irradiation, whereas the A549R4Gy-R cell line was ra-dioresistant to hypofractionated irradiation. Microarray analysis showed that the A549R2Gy-R cells exhibited 1 701 differentially expressed genes (357 upregulated, 1 344 downregulated) compared with the parental A549 cell. By contrast, the hypofractionated irradiation-resistant A549R4Gy-R cells had 944 upregulated genes and 2 602 downregulated genes compared with the A549 cells. The A549R2Gy-R cells exhibited 318 upregulated genes and 699 downregulated genes compared with the A549R4Gy-R cells. Several signaling pathways were implicated in radioresistance when conventional fractionated radiotherapy was compared with hypofractionated irradiation radiotherapy using path way-significant enrichment analysis, especially the PI3K and Erb B channel signaling pathway kinase. Conclusion:Multiple genes and signaling pathways are involved in the development of radiation resistance in NSCLC. The underlined radioresistance mechanisms under conventional and hypofractionated radiotherapy need further study and elucidation to provide new targets for drug development.
ABSTRACT
Radiotherapy is a primary treatment for lung cancer, especially for non-small cell lung cancer (NSCLC). Compared with conventional fractionated radiotherapy, hypofractionated radiotherapy (HFRT) is a powerful method in NSCLC treatment because of its convenience and excellent clinical efficacy. Although HFRT has been significantly developed for treating NSCLC, radiation resistance with an unknown molecular mechanism is still observed in tumors. The PI3K/AKT/mTOR signaling pathway significantly affects resistance to conventional fractionated radiotherapy. However, whether this pathway induces radiation resistance to HFRT remains unclear. The underlying molecular mechanisms between HFRT and the PI3K/AKT/mTOR signal pathway may be used as targets in radiation sensitivity or in the modification of radiation resistance in NSCLC patients. New predictive biomarkers can also be expected in the PI3K/AKT/mTOR signaling pathway when the clinical specimen is screened using HFRT.