Rational Integration of Radiation and Chemotherapy in Patients with Unresectable Stage IIIA or IIIB NSCLC

Results from the Lung Cancer Study Group, Eastern Cooperative Oncology Group, and Radiation Therapy Oncology Group

¹ The Department of Radiation Oncology, H. Lee Moffitt Cancer Center Research Institute, Tampa, Fla.

The challenges of developing effective treatment for patients with locally advanced NSCLC remain formidable. The combination of moderate to great tumor bulk, poor local control with regional irradiation, and low sensitivity of these tumors to most chemotherapeutic agents make poor ingredients for the development of effective combined-modality therapy. Yet the evidence from multiple prospective trials conducted over the past decade suggests that modest progress is being made. The limited efficacy of the current component modalities suggest that combinations that can exploit defined mechanisms of radiation-drug interaction will be most effective, and trials that can evaluate mechanistic as well as clinical hypotheses will he of great importance. While the major focus in the management of lung cancer must be prevention through the avoidance or cessation of tobacco abuse, improvements in treatment for advanced disease will benefit several million patients in the coming years.