[Stage IIIB non-small cell lung cancer. Is there a recommended treatment? ].
The prognosis of locally advanced inoperable non-small cell lung cancer (NSCLC) remains poor despite the advances in treatment achieved in recent years. Currently the best therapeutic strategy relies on concurrent radiotherapy and chemotherapy. This treatment should be reserved for patients of good performance status. Oesophagitis represents the limiting toxicity. If possible chemotherapy should be administered in full dosage during radiotherapy with the aim of controlling micrometastases. Combined cisplatin-etoposide remains a standard regime and cisplatin-vinorelbine offers a good efficacy/toxicity ratio. The choice between induction chemotherapy and consolidation chemotherapy remains uncertain. The addition of docetaxel as consolidation after radio-chemotherapy seems to improve survival but the results need to be confirmed by a randomised phase III trial. Recent technological advances in radiotherapy allow optimisation of the dose, improved results and reduced toxicity. The place of targeted therapies in the management strategy of stage III NSCLC is under investigation.
Fournel
P
P
Service de Pneumologie, Hôpital Nord, Saint-Etienne, France. pierre.fournel@chu-st-etienne.fr
D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D011379:Prognosis