[Recent issues in the treatment of advanced non-small-cell lung cancer]

Unfortunately, most patients with non-small cell lung cancer (NSCLC) present with clinically unresectable advanced neoplasms. Since local treatment like surgery and radiation is not satisfactory for advanced NSCLC, effective systemic chemotherapy is necessary. But NSCLC is relatively resistant to chemotherapy. This report discusses the some recent issues in the treatment for advanced NSCLC. the issues are the following: 1) effect of post-operative chemotherapy and pre-operative induction chemotherapy in the patients with stage IIIA N2 disease; 2) efficacy combining chemotherapy with thoracic radiotherapy (TRT) in unresectable, locally advanced NSCLC; 3) timely combination of TRT and chemotherapy; 4) effect of chemotherapeutic agents as radiosensitizer; 5) potential effect of combination of TRT and new agents in unresectable, locally advanced NSCLC; 6) contribution of surgery following induction chemo-radiotherapy in locally advanced NSCLC; 7) reasons why response rate in cancer chemotherapy for advanced NSCLC does not always correlate with survival; 8) survival benefit of cancer chemotherapy in metastatic NSCLC; and 9) promising new agents (irinotecan, paclitaxel, docetaxel, vinorelbine and gemcitabine) along with combination chemotherapy, including these new agents.