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Stage III lung cancer: two or three modalities? The continued role of thoracic radiotherapy.

Publication ,  Journal Article
Kelsey, CR; Werner-Wasik, M; Marks, LB
Published in: Oncology (Williston Park)
September 2006

Lung cancer is the leading cause of cancer mortality in the United States. A significant number of patients present with disease involving mediastinal lymph nodes. As survival after surgery alone for stage III disease is poor, radiation therapy and chemotherapy have been evaluated in the neoadjuvant and adjuvant settings to improve outcomes. The benefit of adjuvant chemotherapy in the subgroup of patients with N2 disease is uncertain. Small randomized trials enrolling patients with stage III disease have shown a benefit of neoadjuvant chemotherapy over surgery alone. Whether neoadjuvant chemotherapy is superior to adjuvant chemotherapy is under investigation. Furthermore, whether neoadjuvant chemoradiotherapy is superior to neoadjuvant chemotherapy is controversial, and few randomized studies comparing these approaches have been reported. Nevertheless, neoadjuvant chemoradiotherapy appears to be associated with higher rates of resection, higher rates of clearance of mediastinal nodal disease, and better local/regional control. The use of postoperative radiation therapy (PORT) has declined since the publication of the 1998 meta-analysis suggested a detriment in survival with this strategy. However, radiation techniques are improving and emerging data support the use of carefully delivered PORT Finally, it remains unclear whether surgical resection offers an advantage over definitive chemoradiotherapy alone for stage III disease. In summary, locally advanced NSCLC remains a formidable challenge with few cures, and optimal treatment requires the careful use of surgery, chemotherapy, and radiation therapy.

Duke Scholars

Published In

Oncology (Williston Park)

ISSN

0890-9091

Publication Date

September 2006

Volume

20

Issue

10

Start / End Page

1210 / 1219

Location

United States

Related Subject Headings

  • United States
  • Research Design
  • Randomized Controlled Trials as Topic
  • Radiotherapy, Adjuvant
  • Prospective Studies
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Lung Neoplasms
  • Humans
  • Chemotherapy, Adjuvant
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kelsey, C. R., Werner-Wasik, M., & Marks, L. B. (2006). Stage III lung cancer: two or three modalities? The continued role of thoracic radiotherapy. Oncology (Williston Park), 20(10), 1210–1219.
Kelsey, Chris R., Maria Werner-Wasik, and Lawrence B. Marks. “Stage III lung cancer: two or three modalities? The continued role of thoracic radiotherapy.Oncology (Williston Park) 20, no. 10 (September 2006): 1210–19.
Kelsey CR, Werner-Wasik M, Marks LB. Stage III lung cancer: two or three modalities? The continued role of thoracic radiotherapy. Oncology (Williston Park). 2006 Sep;20(10):1210–9.
Kelsey, Chris R., et al. “Stage III lung cancer: two or three modalities? The continued role of thoracic radiotherapy.Oncology (Williston Park), vol. 20, no. 10, Sept. 2006, pp. 1210–19.
Kelsey CR, Werner-Wasik M, Marks LB. Stage III lung cancer: two or three modalities? The continued role of thoracic radiotherapy. Oncology (Williston Park). 2006 Sep;20(10):1210–1219.

Published In

Oncology (Williston Park)

ISSN

0890-9091

Publication Date

September 2006

Volume

20

Issue

10

Start / End Page

1210 / 1219

Location

United States

Related Subject Headings

  • United States
  • Research Design
  • Randomized Controlled Trials as Topic
  • Radiotherapy, Adjuvant
  • Prospective Studies
  • Neoplasm Staging
  • Neoadjuvant Therapy
  • Lung Neoplasms
  • Humans
  • Chemotherapy, Adjuvant