title: Superiority of concomitant chemoradiation over sequential chemoradiation in inoperable, locally advanced non-small cell lung cancer: challenges in the selection of appropriate chemotherapy.
abstract: Treatment of inoperable, locally advanced non-small cell lung cancer (LA-NSCLC) is challenging and requires a multidisciplinary approach considering both local therapy and systemic therapy. Based on the results from several phase III studies and 2 meta-analyses, the use of concomitant chemoradiation therapy (ChRT) could significantly improve overall survival and is considered the standard of care in LA-NSCLC with good performance status. Currently, no evidence has shown a significant survival benefit of third-generation regimens applied in combination with ChRT compared with second-generation regimens. For regimens concomitant with radiation therapy, full-dose chemotherapy (such as cisplatin and etoposide or cisplatin and vinblastine) might be preferred. Additional full-dose consolidation paclitaxel-carboplatin is recommended when patients receive weekly paclitaxel-carboplatin ChRT. Effective novel chemotherapy agents or targeted therapies are required to further improve the outcome of patients with LA-NSCLC. In addition, personalized medicine concomitant with radiation therapy is a promising approach. However, little evidence exists concerning the effectiveness of this novel approach.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Nan
authors.initials: N
authors.lastname: Bi
authors.affiliation: Department of Radiation Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. Electronic address: wlhwq@yahoo.com.
authors.forename: Luhua
authors.initials: L
authors.lastname: Wang
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D015996:Survival Rate