J Lung Cancer.  2009 Jun;8(1):1-7. 10.6058/jlc.2009.8.1.1.

Management of Locally Advanced Non-small Cell Lung Cancer

  • 1Department of Radiation Oncology, UT Southwestern Medical Center at Dallas, Dallas, USA. Hak.Choy@UTSouthwestern.


Locally advanced Non-small cell lung cancer (NSCLC) is a commonly encountered diagnosis. Historically the treatment of locally advanced NSCLC has involved radiation therapy. Clinical trials have shown a benefit to the addition of chemotherapy. In recent years studies have further defined the role of chemotherapy by provided data showing the benefit of concurrent chemotherapy and radiation therapy followed by consolidation with more chemotherapy. Technological advances in radiation therapy have made dose escalation feasible and the current treatment paradigm is now evolving further as dose escalation data becomes available.


Non-small cell lung cancer; Combined modality therapy

MeSH Terms

Carcinoma, Non-Small-Cell Lung
Combined Modality Therapy



1. World cancer report: International Agency for Research on Cancer. Edited by. BW Stewart, editor. and. P Kleihues, editor. 2003. WHO Publications Center Geneva Swiss.
2. Dillman RO, Seagren SL, Propert KJ, et al. A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in stage III nonsmall-cell lung cancer. N Engl J Med. 1990; 323:940–945.
3. Dillman RO, Herndon J, Seagren SL, Eaton WL Jr, Green MR. Improved survival in stage III nonsmall-cell lung cancer: seven-year follow-up of cancer and leukemia group B (CALGB) 8433 trial. J Natl Cancer Inst. 1996; 88:1210–1215.
4. Le Chevalier T, Arriagada R, Quoix E, et al. Radiotherapy alone versus combined chemotherapy and radiotherapy in nonresectable nonsmall-cell lung cancer: first analysis of a randomized trial in 353 patients. J Natl Cancer Inst. 1991; 83:417–423.
5. Le Chevalier T, Arriagada R, Tarayre M, et al. Significant effect of adjuvant chemotherapy on survival in locally advanced nonsmall-cell lung carcinoma. J Natl Cancer Inst. 1992; 84:58.
6. Sause WT, Scott C, Taylor S, et al. Radiation Therapy Oncology Group (RTOG) 88–08 and Eastern Cooperative Oncology Group (ECOG) 4588: preliminary results of a phase III trial in regionally advanced, unresectable nonsmall-cell lung cancer. J Natl Cancer Inst. 1995; 87:198–205.
7. Sause W, Kolesar P, Taylor S IV, et al. Final results of phase III trial in regionally advanced unresectable nonsmall cell lung cancer: Radiation Therapy Oncology Group, Eastern Cooperative Oncology Group, and Southwest Oncology Group. Chest. 2000; 117:358–364.
8. Curran W, Scott C, Langer C. Phase III comparison of sequential vs. concurrent chemoradiation for patients with unresected stage III nonsmall cell lung cancer (NSCLC): report of Radiation Therapy Oncology Group (RTOG) 9410. Proc Am Soc Clin Oncol. 2000; 19:A1891.
9. Curran WJ Jr, Scott C, Langer C, et al. Long-term benefit is observed in a phase III comparison of sequential vs concurrent chemoradiation for patients with unresected stage III NSCLC: RTOG 9410. Proc Am Soc Clin Oncol. 2003; 22:A621.
10. Zatloukal P, Petruzelka L, Zemanova M, et al. Concurrent versus sequential chemoradiotherapy with cisplatin and vinorelbine in locally advanced nonsmall cell lung cancer: a randomized study. Lung Cancer. 2004; 46:87–98.
11. Furuse K, Fukuoka M, Kawahara M, et al. Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III nonsmall-cell lung cancer. J Clin Oncol. 1999; 17:2692–2699.
12. Albain KS, Crowley JJ, Turrisi AT 3rd, et al. Concurrent cisplatin, etoposide, and chest radiotherapy in pathologic stage IIIB nonsmall-cell lung cancer: a Southwest Oncology Group phase II study, SWOG 9019. J Clin Oncol. 2002; 20:3454–3460.
13. Gandara DR, Chansky K, Albain KS, et al. Consolidation docetaxel after concurrent chemoradiotherapy in stage IIIB nonsmall-cell lung cancer: phase II Southwest Oncology Group Study S9504. J Clin Oncol. 2003; 21:2004–2010.
14. Gandara DR, Chansky K, Gaspar LE, Albain KS, Lara PN Jr, Crowley J. Long term survival in stage IIIB nonsmall cell lung cancer (NSCLC) treated with consolidation docetaxel following concurrent chemoradiotherapy (SWOG S9504). Proc Am Soc Clin Oncol. 2005; 23:A7059.
15. Belani CP, Choy H, Bonomi P, et al. Combined chemoradiotherapy regimens of paclitaxel and carboplatin for locally advanced nonsmall-cell lung cancer: a randomized phase II locally advanced multimodality protocol. J Clin Oncol. 2005; 23:5883–5891.
16. Albain KS, Rusch VW, Crowley JJ, et al. Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA (N2) and IIIB nonsmall cell lung cancer: mature results of Southwest Oncology Group phase II study 8805. J Clin Oncol. 1995; 13:1880–1892.
17. van Meerbeeck JP, Kramer G, van Schil PE, et al. A randomized trial of radical surgery (S) versus thoracic radiotherapy (TRT) in patients (pts) with stage IIIA-N2 nonsmall cell lung cancer (NSCLC) after response to induction chemotherapy (ICT) (EORTC 08941). Proc Am Soc Clin Oncol. 2005; 23:A7015.
18. Perez CA, Pajak TF, Rubin P, et al. Long-term observations of the patterns of failure in patients with unresectable non-oat cell carcinoma of the lung treated with definitive radiotherapy: report by the Radiation Therapy Oncology Group. Cancer. 1987; 59:1874–1881.
19. Bradley JD, Graham M, Suzanne S, at al. Phase I results of RTOG 0117: a phase I/II dose intensification study using 3DCRT and concurrent chemotherapy for patients with inoperable nonsmall cell lung cancer. Proc Am Soc Clin Oncol. 2005; 23:A7063.
20. Schild SE, McGinnis WL, Graham D, et al. Results of a Phase I trial of concurrent chemotherapy and escalating doses of radiation for unresectable nonsmall-cell lung cancer. Int J Radiat Oncol Biol Phys. 2006; 65:1106–1111.
21. Socinski MA, Morris DE, Halle JS, et al. Induction and concurrent chemotherapy with high-dose thoracic conformal radiation therapy in unresectable stage IIIA and IIIB non-small-cell lung cancer: a dose-escalation phase I trial. J Clin Oncol. 2004; 22:4341–4350.
22. Lee CB, Socinski MA, Lin L, et al. High-dose 3D chemoradiotherapy trials in stage III nonsmall cell lung cancer (NSCLC) at the University of North Carolina: Long-term follow up and late complications. Proc Am Soc Clin Oncol. 2006; 24:A7145.
Full Text Links
  • JLC
export Copy
  • Twitter
  • Facebook
Similar articles
Copyright © 2023 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr