Unresectable stageⅢnon-small-cell lung cancer:Have we made any progress?

• 作者: Carolien De Tollenaere Karim Vermaelen Katrien Vandecasteele Veerle Surmont Yolande Lievens
• 来源期刊: 世界呼吸病学杂志
• 学科: 医学
• 关键词: StageⅢnon-small-cell lung carcinoma CHEMORADIOTHERAPY Induction CHEMOTHERAPY Molecular targeted therapy Consolidation CHEMOTHERAPY Doseescalation Altered fractionation Advanced radiotherapy techniques PROPHYLACTIC CRANIAL irradiation
• 年，卷（期）: 2015,（2）
• 页码范围: 140-151
• 页数: 12页
• 分类号: R743.3

摘要

Lung cancer is responsible for the most cancer deaths worldwide with an incidence that is still rising.One third of patients have unresectable stageⅢA or stageⅢB disease.The standard of care for locally advanced disease in patients with good performance status consists of combined modality therapy in particular concurrent chemoradiotherapy.But despite a lot of efforts done in the past,local control and survival of patients with unresectable stageⅢnon-small-cell lung cancer(NSCLC)remains poor.Improving outcomes for patients with unresectable stageⅢNSCLC has therefore been an area of ongoing research.Research has focused on improving systemic therapy,improving radiation therapy or adding a maintenance therapy to consolidate the initial therapy.Also implementation of newer targeted therapies and immunotherapy has been investigated as well as the option of prophylactic cranial irradiation.This article reviews the latest literature on improving local control and preventing distant metastases.It seems that we have reached a plateau with conventional chemotherapy.Radiotherapy dose escalation did not improve outcome although increasing radiation dose-intensity with new radiotherapy techniques and the use of newer agents,e.g.,immunotherapy might be promising.In the future well-designed clinical trials are necessary to prove those promising results.