Chest
Locally Advanced, Unresectable Non-Small Cell Lung Cancer: New Treatment Strategies
Section snippets
Current Management of Locally Advanced, Unresectable NSCLC
Approximately 40% of patients with newly diagnosed NSCLC first present with locally advanced disease, and the majority are inoperable.1 Traditionally, these patients were treated with radiotherapy alone, resulting in a median survival of approximately 9 to 10 months and a 5-year survival rate of approximately 7%.7 These discouraging results were largely due to the eventual development of extrathoracic metastases. Several investigators have tried combining local therapy (ie, radiotherapy) with
Improving Local Tumor Control
Although combined-modality treatment with chemotherapy and radiotherapy has improved survival in some patients with stage III NSCLC, most still succumb to the underlying disease.1 Tumor progression remains problematic, both locally within the chest and in extrathoracic sites. We will first examine the problem of local tumor control.
It is commonly estimated that radiotherapy alone affords intrathoracic control in up to 50% of NSCLC cases, provided a total dose ≥ 60 Gy is employed.11 However,
Improved Control of Systemic Disease
Several meta-analyses clearly showed that cisplatin-based chemotherapy can improve survival in patients with NSCLC.2, 35, 36 The modest survival advantage benefits primarily those patients treated with cisplatin-based combination regimens, although there is a trend toward improved survival with regimens containing vinca alkaloids or etoposide.2 Within the past few years, several new drugs have shown excellent activity against NSCLC, including the taxanes (paclitaxel and docetaxel), vinorelbine,
Summary
In summary, better local control, as well as greater control of extrathoracic micrometastases, should result in improved survival among patients with locally advanced NSCLC. The methods of improving local control are quite varied, and each merits continued investigation. Potentially, these techniques will lead to further improvement in the survival of NSCLC patients with locally advanced disease.
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Effect of amine and carboxyl functionalization of sub-micrometric MCM-41 spheres on controlled release of cisplatin
2013, Ceramics InternationalCitation Excerpt :Cisplatin, cis-diamminedichloroplatinum(II), is currently used, either on its own or combined with other therapeutic drugs, for the treatment of testicular [1,2], ovarian [3,4], cervical [5,6] and lung [7,8] cancers, as well as malignant mesothelioma [9,10] and other carcinomas.
Dosimetric correlations of acute esophagitis in lung cancer patients treated with radiotherapy
2005, International Journal of Radiation Oncology Biology Physics