Integrated treatments for non-small cell lung cancer

Even a small percent increase in survival rates after treatment for lung cancer can produce a large benefit in terms of absolute numbers of lives saved, due to the very high incidence of the disease. Clinical results after surgery alone or radiotherapy alone are far from being satisfactory. Therefore, the integration of surgery with radiotherapy (both in the preoperative and in the postoperative setting) has been increasingly tested in the clinic. Radio-chemotherapeutic approaches progressively more effective have been developed for patients with inoperable disease, but also in combination with surgery. This review focuses on the current practice and on the ongoing clinical research in this field. The important issue of the short- and long-term toxicity of combined modality treatments in these patients is also emphasized, along with the research efforts for minimizing toxicity, especially as far as radiotherapy is concerned.