title: Chemoradiotherapy of locally advanced nonsmall cell lung cancer: state of the art and perspectives.
abstract: OBJECTIVE
  The treatment of locally advanced nonsmall cell lung cancer (NSCLC) is becoming a significant challenge because of a growing proportion of patients with unresectable or potentially eligible for surgery after a multimodality treatment, stage II to III disease. Despite a multimodality approach consisting in concurrent chemoradiotherapy, the prognosis remains poor.
  
  
  RESULTS
  Different strategies, including induction and consolidation chemotherapy, chemotherapy regimens, fractionation and radiation doses have been evaluated in phase II and III trials, as well as new therapeutic approaches such as immunotherapy. For patients with resectable stage III disease the optimal strategy remains unclear. The American Society for Radiation and Clinical Oncology and the European Society for Medical Oncology published recent guidelines in 2015.
  
  
  CONCLUSIONS
  Concurrent chemoradiotherapy improves overall survival compared with sequential chemotherapy followed by radiation. Adding induction or consolidation chemotherapy to chemoradiotherapy does not appear to improve the outcome. Chemotherapy based on cisplatin combined with radiation is recommended in stage III NSCLC. The standard dose and fractionation of radiotherapy are 60 Gy, one daily fraction of 2 Gy over 6 weeks. Targeted therapies and immunotherapy may improve the management of locally advanced NSCLC in the future.
authors: aDépartement universitaire de radiothérapie, Centre Paul Strauss, UNICANCER, 3, rue de la porte de l'hôpitalbEA 3430, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, StrasbourgcDépartement de radiothérapie oncologique, centre hospitalier Lyon Sud, 165, chemin du Grand-Revoyet, Pierre-BénitedEA 3738, Université Claude Bernard Lyon-1, domaine Rockefeller, 8, avenue Rockefeller, Lyon, France.
authors: Delphine
authors: D
authors: Antoni
authors: Françoise
authors: F
authors: Mornex
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods*; D003131:Combined Modality Therapy / Q000379:methods; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D008175:Lung Neoplasms / Q000401:mortality / Q000628:therapy*; D058990:Molecular Targeted Therapy / Q000379:methods
chemical_list: D000970:Antineoplastic Agents