Factors of treatment effiency of inoperable stage III non-small cell lung cancer (review of literature)

In this review, the latest data on factors influencing efficiency of the treatment of locally advanced inoperable stage III non-small cell lung cancer (NSCLC) are analyzed. Concomitant chemoradiotherapy (CRT) is a current standard of treatment with the 5-year overall survival rate of 20-30 % and median survival time of 17-28 months. However, only a small proportion of patients (13-35 % by the data from population-based studies) can receive CRT. Radiotherapy is currently progressing towards new approaches, including IMRT and IGRT, showing promising results, however, these approaches are still experimental. Accelerated repopulation of clonogens is biological factor necessitating intensification of both RT and chemotherapy. For RT, accelerated hyperfractionation is an optimal way for that. There is some data evidencing negative role of delays in the radiation treatment to overall efficacy and even survival. Therefore, the optimal approach to the treatment of Stage III NSCLC seems to be early beginning of RT and short overall time for both RT and chemotherapy.