[Combination of chemotherapy and radiotherapy for locally advanced non-small cell lung cancer]

Despite the progress in therapeutic strategies, overall survival of stage III non small cell lung cancers (NSCLC) is poor. Currently, the standard treatment for unresectable locally advanced NSCLC is concurrent chemoradiotherapy. However, oesophagitis is a major toxicity and this schedule should be reserved for patients with good performance status. Several platinum-based chemotherapies have been evaluated concurrently with radiotherapy and cisplatin-etoposide regimen remains the standard because full dose chemotherapy can be administered. Cisplatin-vinorelbine offers a good efficacy/toxicity profile. The optimal sequencing of concurrent chemoradiotherapy and chemotherapy is not well defined. Consolidation chemotherapy with docetaxel failed to show a better outcome. The new technologies in radiotherapy and dose escalation will certainly improve the efficacy of chemoradiotherapy and reduce toxicity. The integration of targeted therapies in the management of stage III NSCLC is also under investigation.