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In the USA, lung cancer is the number one cause of cancer-related death for both men and women. 1 In 2005, an estimated 175 000 new cases of lung cancer will be diagnosed and roughly 159 000 deaths from lung cancer will occur. Approximately 80% of patients with primary lung cancer are diagnosed with non-small cell lung cancer (NSCLC). 2

Radiation therapy remains a valuable therapeutic modality in the treatment of NSCLC. In early stage disease, definitive radiation therapy may be employed for patients who refuse or are medically unfit to undergo surgical resection. Radiation therapy may also be used as adjuvant therapy for patients with incomplete resection or node-positive disease. At initial presentation, many patients who receive a diagnosis of NSCLC have locally advanced disease. Historically, these patients were treated with primary thoracic radiation therapy with poor longterm survival rates secondary to both progression of local disease and development of distant metastases. With the goal of improving clinical outcomes, multiple permutations of combined-modality therapy for locally advanced NSCLC have been investigated. The optimal treatment for locally advanced NSCLC continues to evolve, but combined-modality therapy has led to improved survival rates versus treatment with radiation alone, and is the standard of care.