Are More Aggressive Therapies Able to Improve Treatment of Locally Advanced Non-Small Cell Lung Cancer: Combined Modality Treatment?

Non-small cell lung cancer continues to be a major oncologic problem, with approximately 3-month increase in median survival per decade since the 1970s. Thus, newer strategies are needed to improve outcomes in non-small cell lung cancer. New treatment strategies include optimizing and intensifying radiation therapy (RT) delivery, as well as improving systemic therapy with newly developed targeted agents. Three-dimensional treatment planning is a key technology for optimizing RT delivery. Additionally, improvements in radiation therapy will clearly require better target delineation and dose-intensification of RT. With newer, possibly less toxic agents such as the epidermal growth factor receptor inhibitors, RT and systemic therapy (with chemo- and/or targeted therapies) may be optimized in the concurrent setting, perhaps reserving more cytotoxic regimens either for the induction or maintenance settings.