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Locally Advanced Non-Small Cell Lung Cancer: Different Strategies for Different Diseases.

Annals of oncology(2006)

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摘要
Non-small cell lung cancer presents in more than 30% of cases in a locally advanced stage (IIIA–IIIB) [1]. This clinical scenario is characterized by a marked variability of presentation and, as a consequence, by differential therapeutical approaches mainly arranged in a multimodality fashion, with surgery (potentially resectable disease at the onset or after induction chemotherapy) still maintaining a preminent role with prognostic projection. Others factors influencing the prognosis, even in a lesser extent, are the age and the Performance Status, which play a critical role in the treatment(s) choice, especially when a neoadjuvant and/or adjuvant therapy is needed or when the systemic chemotherapy is associated to radiation treatment, either sequential or concomitant. Spira et al. stress the importance of a multidisciplinary approach in the treatment of locally advanced NSCLC, particularly in the subset of patients with resectable disease, treated with platinumcontaining chemotherapy schedule (as an adjuvant or neoadjuvant), and the difference in survival rate for this patients population, comparing to the group of patients non suitable to surgery [2] (Table 1).
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