ABSTRACT

Radiochemotherapy has become the treatment of choice for locally or regionally advanced, surgically unresectable lung cancers, which make up the greatest proportion of cases. Compared with radiotherapy alone, this therapeutic combination has resulted in increased local tumor control and an improved survival rate (1,2). This approach increased median survival time from 8 to 9 months in the 1980s (3) to about 18 months in the early 21st century (1,2), and long-term survival has increased from 9% to about 15% (1,2). However, these improvements have been achieved at the expense of increased frequency and severity of normal tissue toxicity. The most common and dose limiting toxicities related to radiochemotherapy to lung cancer include treatment-related pneumonitis (TRP) and esophagitis. Grades 3 and 4 pneumonitis and fibrosis, which are sometimes fatal, have been observed in about 25-30% of patients (4,5). Treatment-related toxicity from radiation and chemotherapy as well as from lung cancer itself has become one of the major factors limiting therapeutic effectiveness. Here we summarize the current studies evaluated the toxicity and treatment outcome in non-small cell lung cancer (NSCLC) patients treated with conformal radiochemotherapy.