Locally Advanced Non-small Cell Lung Cancer: The Past, Present, and Future

Abstract

Approximately a third of patients with newly diagnosed non-small cell lung cancer (NSCLC) have locally or regionally advanced disease not amenable for surgical resection. Concurrent chemoradiation is the standard of therapy for patients with unresectable locally advanced NSCLC who have a good performance status and no significant weight loss. Prospective studies conducted over the past two decades have addressed several important questions regarding systemic therapy and thoracic radiation. They include the role of induction/consolidation chemotherapy, integration of newer chemotherapy agents with radiation and the impact of molecularly targeted agents. Improved radiation therapy techniques and precise targeting of the tumors have played a key role in this setting. Moreover, it has been shown that higher than conventional doses of thoracic radiation can be administered safely in combination with chemotherapy. This review will discuss these issues in detail and outline the strategies that need to be employed to improve the outcomes in patients with locally advanced NSCLC.

Preoperative serum CA125 is an independent predictor for prognosis in operable patients with non-small cell lung cancer

“…This result also indicated that CEA as an unfavorable prognostic maker for NSCLC patients. 3 Hazard ratio (HR) for death with respect to normal CA125 concentration. 4 Bold-italic values are statistically significant (p < 0.05).…”

“…Despite the improvements in the diagnosis and treatment in recent years, the 5-year survival rates of lung cancer remain as low as 16 %, with significant variation depending on the stage of disease at the time of diagnosis [2]. The majority of people diagnosed with NSCLC are at a late stage and therefore not suitable for surgery [3]. The prognosis of advanced NSCLC patients is variable and may depend on different prognostic factors, including biological features of cancer cells.…”

Prognostic Significance of Diabetes Mellitus in Locally Advanced Non-small Cell Lung Cancer

“…Non-small cell lung cancer (NSCLC) accounts for 80-85 % of lung cancer cases, and approximately 30 % of patients have unresectable, locally advanced disease at diagnosis [2]. Sause et al reported that combining chemotherapy and radiotherapy brought a further survival benefit [3].…”

18F-FDG PET Early Response Evaluation of Locally Advanced Non–Small Cell Lung Cancer Treated with Concomitant Chemoradiotherapy

“…Management of patients with locally advanced non-small cell lung cancer (NSCLC) has changed significantly in the past few years (1,2). Concomitant chemoradiotherapy is the standard of care in fit patients (Eastern Cooperative Oncology Group [ECOG] performance status grade, 0-1) (3).…”