[Treatment of non-small cell lung cancers (NSCLC)]

The survival of patients with non-small-cell lung cancer (NSCLS) is closely related to surgery, but the tumour is resectable in only 25% of them. With the exception of T1 N0, where the 5-year survival rate exceeds 60%, the 2-year survival does not rise above 50%. New data are raising hopes of better results, and it appears that the so-called "neoadjuvant" treatments might increase the curability of resectable tumours. Recent randomized trials have shown that it could be of interest to combine chemotherapy and radiotherapy in unresectable localized tumours. On the other hand, therapeutic combinations containing cisplatin constitute a step forward in the treatment of metastatic cancers, with a high response rate (28 to 56%) prolonging the patients' survival. Finally, the advances achieved in treatments aimed at combating the undesirable effects of chemotherapy, notably nausea and vomiting, will make it more acceptable and therefore provide a better quality of life. Several randomized trials are in progress and will perhaps facilitate the setting up of new decision making trees for the treatment of NSCLC.