Therapy of localized non-small cell lung cancer (take home messages)

Surgery remains the mainstay in curative therapy of stage I and II NSCLC an d selected patients with stage III disease. The high rate of distant metast ases occuring in patients after complete surgical resection demonstrates th e need for effective adjuvant systemic therapy. However, outside of trials, (neo)adjuvant chemotherapy is currently not considered as an established s tandard in localized NSCLC. Postoperative radiotherapy increases local tumo r control in completely resected N2 disease and after R1/R2 resections and is generally recommended in these situations. In inoperable patients radiot herapy offers the only chance of cure. Combined radiochemotherapy and the h ighly accelerated CHART radiotherapy have been shown to be superior to stan dard radiotherapy. Progress in the treatment of localized NSCLC over the la st decades has been only modest and with the exception of favourable subgro ups, prognosis of NSCLC remains grim. In the light of the high rate of loca l and distant metastases multidisciplinary approaches appear necessary in t he vast majority of patients. (C) 2001 Elsevier Science Ireland Ltd. All ri ghts reserved.