[Radiotherapy for lung cancer. Integration with chemotherapy]

The combination of radiotherapy and chemotherapy in lung cancer (locally advanced non-small and small cell) may offer the benefits of radiotherapy in terms of local control and those of chemotherapy in terms of reducing metastatic dissemination of the disease. Several randomized studies have showed that radical radiotherapy combined with chemotherapy improves the survival of these patients at the expense of an increase in toxicity. The technological development and the improvements in software have allowed the introduction of new linear accelerators and a three-dimensional planning system with the intention of delivering higher irradiation doses in the tumor target, and minimizing the dose in adjacent normal tissues (lung, heart, esophagus and spinal cord). The volume of irradiation, the total dose, the fractionation, the schedule for the combination of radiotherapy and chemotherapy, as well as the influence of the prophylactic cranial irradiation in small cell lung cancer are points for discussion at the moment.