Combined-modality treatment of non-small-cell lung cancer stages I-III (take home messages)

Combined-modality approaches including surgery, radiotherapy and chemotherapy have led to a clear improvement of treatment results in localised NSCLC. For stages I and II, postoperative adjuvant chemotherapy may lead to an improved progression-free survival. In stage IIIA, preoperative chemotherapy, respectively radio-chemotherapy, increases the incidence of complete resections. Compared to radio-chemotherapy alone the implementation of surgery in stage IIIA(N2)-patients leads to a better progression-free survival. For stage IIIB simultaneous radio-chemotherapy with or without additional sequential chemotherapy has become the new standard of treatment for patients in sufficient clinical condition. In the future, the implementation of further individual selection and prognostic parameters including tumour volume, location of the tumour, response to induction treatment, co-morbidities and molecular tumour analysis may contribute to further individualise the treatment approach.