Combined Modality Therapy for Stage III Non–Small-Cell Lung Cancer

With 40,000 to 50,000 patients diagnosed annually, stage III lung cancer represents approximately one third of all non–small-cell lung cancer cases. It is a heterogeneous disease stage encompassing stage IIIa, for which surgery in combination with chemotherapy and/or radiation therapy represents a treatment strategy for select patients, and stage IIIb, for which chemoradiation represents the prevailing standard of care. Overcoming unacceptably high rates of intrathoracic tumor failures remains a central obstacle. Current clinical trial efforts focus on targeted therapies, new chemotherapy regimens, dose-escalated radiation therapy, and improvements in radiation therapy treatment delivery.