Que faut-il associer à la radiothérapie dans les stades III des CBNPC et comment ?

Radiotherapy techniques have been optimised to permit delivery of the most precise possible dose and ensure that toxicity is kept to a minimum. Dose escalation was considered to be the key to achieving locoregional control, but the recent and extremely disappointing results of RTOG 0618 appear to suggest inferior outcomes in the 74 Gy groups than in the 60 Gy group. This sheds light on the limitations associated with defining the radiation dose physically and the progress that remains to be made in terms of treatments to be combined with radiotherapy. Work on developing the concept of the biological dose must be continued to enhance the local action of radiotherapy through the effects of associated treatments. The latest generation chemotherapy molecules and treatments targeting genetic anomalies have led to considerable progress in the treatment of stage IV lung cancer. Their addition to radiochemotherapeutic regimens for lung cancer is a natural continuation of their development as is the case for dedicated radiosensitizing molecules.