[Concomitant radiochemotherapy for locally advanced bronchial cancers: current results and prospects].
The prognosis of locally advanced lung cancer is reportedly poor in all histologic types. In non-small cell lung cancer, radiation therapy alone results in disappointing long-term survival. Three recent randomized trials, however, have shown a limited but significant improvement of survival with induction chemotherapy, though local control remained poor in these studies as well as in small-cell lung cancer treated with chemotherapy and late radiotherapy. Two randomized trials focusing on small-cell lung cancer have recently shown significant benefit due to the combination of early concurrent mediastinal irradiation and chemotherapy, with major improvement in local control and a more than 40% 2-year survival rate. The concept of concurrent chemoradiotherapy has also been studied in non-small cell carcinoma with several pilot studies leading to both encouraging results and improved survival rate (up to 40% at 2 years). Ongoing phase III trials are comparing sequential versus concurrent chemoradiotherapy and will define the role of radical surgery after chemoradiotherapy in locally advanced non-small cell lung cancer.
Reboul
F
F
DP6partement de cancérologie clinique, clinique Sainte-Catherine, Avignon, France.
Vincent
P
P
Brewer
Y
Y
Taulelle
M
M
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002283:Carcinoma, Bronchogenic / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy; D018288:Carcinoma, Small Cell / Q000473:pathology / Q000628:therapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome
D005047:Etoposide; D002945:Cisplatin