Optimizing chemoradiation therapy approaches to unresectable stage III non-small cell lung cancer

There have been important recent advances in the management of inoperable n on-small cell lung cancer. Concurrent cisplatinum- or carboplatin-based che motherapy and 60 to 64 Gy of thoracic radiation therapy has replaced sequen tial therapy as the new standard therapy for good-risk patients. New agents such as docetaxel, gemcitabine, and irinotecan are being tested to replace the standard chemotherapy given during thoracic radiation. Phase II studie s of induction or consolidation chemotherapy have also shown promise but th ese agents have not yet been proven to improve outcome in a prospective ran domized study. New strategies for optimizing thoracic radiation, primarily by dose escalation with three-dimensional conformal technique, have also le d to an improved therapeutic ratio. Alternative strategies may be required for poor-risk, elderly patients. Curr Opin Oncol 2001, 13:110-115 (C) 2001 Lippincott Williams & Wilkins, Inc.