[The recent progress in chemoradiotherapy of lung cancer]

Abstract

This is a review of the recent progress in chemoradiotherapy of locally advanced lung cancer. In the limited disease stage of small cell lung cancer, a meta-analysis showed patients treated with a combination of chemotherapy and radiotherapy have a statistically significantly longer survival than those with chemotherapy alone. However, the timing of the combination of radiation and chemotherapy has not been clarified. One study favored late over early use of radiotherapy for survival. Another randomized study and a meta-analysis revealed earlier radiotherapy had a better prognosis. JCOG performed a randomized phase III study comparing concurrent chemoradiotherapy with chemotherapy followed by radiotherapy, and the final results will be published in the near future. In the past, radiotherapy alone had been considered standard therapy for inoperable locally advanced non-small cell lung cancer. Several randomized studies and meta-analyses demonstrated the combination of chemotherapy and radiotherapy produced better survival rates than by radiotherapy alone. Our randomized study indicated the addition of radiotherapy after chemotherapy is superior in long-term survival to chemotherapy alone. The West Japan Lung Cancer Group conduct a phase III randomized study comparing concurrent and sequential chemoradiotherapy, and the determination of survival is now in the follow-up stage. The role of induction chemoradiotherapy before surgical resection, comparison of chemoradiotherapy with induction chemoradiotherapy followed by surgery, and the effects and safety of the combination of new drugs and radiotherapy are now under investigation.