Concurrent radiochemotherapy in the treatment of locally advanced non-small cell lung cancer

Locally advanced disease non-small cell lung cancer (NSCLC) represents one of the major focuses in thoracic oncology. Although surgery can be attempted in cases of favorable, mostly minimal disease (ie, stage IIIA), the results with surgery alone are disappointing. Therefore, radiation therapy (RT) and chemotherapy (CHT) are nowadays frequently used as an adjunct to surgery. The vast majority of patients, however, are inoperable from the outset. For them, RT and CHT are now considered standard treatment approach. Although early studies favored induction CHT followed by radical RT over RT alone, concurrent RT/CHT also was shown to be superior to RT alone. Recent data has shown an advantage for concurrent RT/CHT over induction CHT and radical RT due to an improvement in local tumor control. Further optimization of combined RT and CHT is necessary to tailor the treatment according to various pretreatment patient and tumor characteristics.