Multidisciplinary management of non-small cell lung cancer in the community

A community-based, multidisciplinary approach, incorporating chemotherapy may provide benefit to patients with non-small cell lung cancer. Drug-induced cytoreduction may make it possible to perform surgery on patients hitherto inoperable, and may facilitate radiotherapy in other patients with regionally advanced disease. Several criteria must be met before the institution of this approach. The drugs selected must be effective in a majority of patients and toxic side effects must be within tolerable limits; candidates must be screened carefully with regard to age, stage, histology, performance status, past medical history, and they should be able to understand the potential risks involved. Importantly, support must be obtained from referring physicians, surgeons, and radiation therapists.