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The Role of Combined Modality Therapy for Stage III Nonsmall-Cell Lung Cancer

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Chemoradiation in Cancer Therapy

Part of the book series: Cancer Drug Discovery and Development ((CDD&D))

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Abstract

Despite recent advances in treatment, lung cancer is still the number one cause of cancer mortality in the United States (1). About 95% of the estimated 131,000 new cases of nonsmall-cell lung cancer (NSCLC) diagnosed in 2000 will die from their disease (2). The focus of this chapter is on the patients who present with locally advanced or stage III NSCLC (about 46,000 patients yearly). Although it is tempting to think of stage III NSCLC as a uniform stage category, it really contains patient subgroups with disparate tumor burdens and prognosis. Included in stage III are patients with involvement ranging from potentially resectable T3N1 (small T3 and microscopically involved N1 lymph node) to unresectable, locally advanced T4N3 disease (large primary invading mediastinal structures and contralateral mediastinal adenopathy) (3).

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References

  1. Greenlee RT, Murray T, Bolden S, et al. Cancer statistics 2000. CA Cancer] Clin 2000; 50: 7–33.

    Article  CAS  Google Scholar 

  2. Ginsberg RJ, Vokes EE, Raben A. Non-small cell lung cancer, in DeVita VT, Hellman S, Rosenberg SA (eds). Cancer, principles and Practices of Oncology, ( ed 5 ). Philadelphia, PA, Lippincott-Raven, 1997, pp. 858–911.

    Google Scholar 

  3. Mountain CF. Revisions in the international system for staging lung cancer. Chest 1997; 111: 1710–1717.

    Article  PubMed  CAS  Google Scholar 

  4. Vokes EE, Green MR. Current strategies for locoregionally advanced unresectable non-small cell lung cancer. Semin Oncol 1999; 26 (Suppl 15): 40–43.

    PubMed  CAS  Google Scholar 

  5. Roswit B, Patno ME, Rapp R, et al. The survival of patients with inoperable lung cancer: A large scale randomized study of radiation therapy versus placebo. Radiology 1968; 90: 688–697.

    PubMed  CAS  Google Scholar 

  6. Perez CA, Stanley K, Grundy G, et al. Impact of radiation technique and tumor extent in tumor control and survival of patients with unresectable non-oat cell carcinoma of the lung: Report of the Radiation Therapy Oncology Group. Cancer 1982; 50: 1091–1099.

    Article  PubMed  CAS  Google Scholar 

  7. Cox JD, Azamia N, Byhardt RW, et al. A randomized phase I/II trial of hyperfractionated radiation therapy with total doses of 60.0 Gy to 79.2 Gy: Possible survival benefit with greater than or equal to 69.6 Gy in favorable patients with radiation oncology group stage III non small cell lung carcinoma: Report of Radiation Therapy Oncology Group 83–11. J Clin Oncol 1990; 8: 1543–1555.

    PubMed  CAS  Google Scholar 

  8. Lilenbaum RC, Green MR. Multimodality therapy for non-small-cell lung cancer. Oncology 1994; 8: 25–36.

    PubMed  CAS  Google Scholar 

  9. Cox JD, Azamia N, Byhardt RW, et al. N2 (clinical) non-small cell carcinoma of the lung: Prospective trials of radiation therapy with total doses of 60 Gy by the Radiation Therapy Oncology Group. Int J Radiat Oncol Biol Phys 1991; 20: 7–12.

    Article  PubMed  CAS  Google Scholar 

  10. Sause WT, Scott C, Taylor S, et al. Radiation Therapy Oncology Group (RTOG) 88–08 and Eastern Cooperative Oncology Group (ECOG) 4588: Preliminary results of a phase III trial in regionally advanced, unresectable non small cell lung cancer. J. Nat. Cancer Inst 1995; 87: 198–205.

    Article  PubMed  CAS  Google Scholar 

  11. Sause W, Kolesar P, Taylor S, et al. Final results of phase III trial in regionally advanced unresectable non-small cell lung cancer. Chest 2000; 117: 358–364.

    Article  PubMed  CAS  Google Scholar 

  12. Perez CA, Pajal TF, Rubion P, et al. Long term observations of the patterns of failure in patients with unresectable non-oat carcinoma of the lung treated with definitive radiotherapy. Report of the Radiation Therapy Oncology Group. Cancer 1982; 50: 1874–1881.

    Google Scholar 

  13. Saunders MI, Dische S, Barrett A, et al. Continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small cell lung cancer. A randomized multicentre trial. Lancet 1997; 350: 161–165.

    Article  PubMed  CAS  Google Scholar 

  14. Koh W, Griffin TW, Laramore GE, et al. Neutron versus photon radiation therapy for inoperable non-small cell lung cancer: results of a multicenter randomized trial. Int J Radiat Oncol Biol Phys 1993; 27: 499–505.

    Article  PubMed  CAS  Google Scholar 

  15. Duncan W. An evaluation of results of neutron therapy trials. Acta Oncologica 1994; 33: 299–306.

    Article  PubMed  CAS  Google Scholar 

  16. Brach B, Buhler C, Hayman MH, et al. Percutaneous computed tomography-guided fine needle brachytherapy of pulmonary malignancies. Chest 1994; 106: 268–274.

    Article  PubMed  CAS  Google Scholar 

  17. Aygun C, Weiner S, Scariato A, et al. Treatment of non-small cell lung cancer with external beam radiotherapy and high dose rate brachytherapy. Int J Radiat Oncol Biol Phys 1992; 23: 127–132.

    Article  PubMed  CAS  Google Scholar 

  18. Gupta NC, Bishop HA, Rogers JS, et al. Treatment outcome of lung cancer patients as optimized by preoperative whole-body positron emission tomography fluorodeoxyglucose imaging. Clinical Lung Cancer 2000; 2: 146–150.

    Article  PubMed  CAS  Google Scholar 

  19. Webb R, Gatsonis C, Zerhouni EA, et al. CT and MR imaging in staging non-small cell bronchogenic carcinoma. Radiology 1991; 178: 705–713.

    PubMed  CAS  Google Scholar 

  20. Patterson GA, Ginsberg RJ, Poon PY, et al. A prospective evaluation of magnetic resonance imaging, computed tomography, and mediastinoscopy in the preoperative assessment of mediastinal node status in bronchogenic carcinoma. J Thorac Cardiovasc Surg 1987; 94: 679–684.

    PubMed  CAS  Google Scholar 

  21. Watanabe Y, Shimizu J, Oda A, et al. Aggressive surgical intervention in N2 non-small cell cancer of the lung. Ann Thorac Surg 1991; 51: 253–261.

    Article  PubMed  CAS  Google Scholar 

  22. Luke WP, Pearson FG, Todd TRJ, et al. Prospective evaluation of mediastinoscopy for assessment of carcinoma of the lung. J Thorac Cardiovasc Surg 1986; 91: 53–56.

    PubMed  CAS  Google Scholar 

  23. Valk PE, Pounds TR, Hopkins DM, et al. Staging non-small cell lung cancer by whole-body positron emission tomographic imaging. AnnThor Surg 1995; 60: 1573–1582.

    Article  CAS  Google Scholar 

  24. Martini N, Flehinger BJ, Zaman MB, et al. Results of resection in non-oat cell carcinoma of the lung with mediastinal lymph node metastases. Ann Surg 1983; 198: 386–397.

    Article  PubMed  CAS  Google Scholar 

  25. Pearson FG, Delarue NC, Ilves R, et al. Significance of positive superior mediastinal nodes identified at mediastinoscopy in patients with resectable cancer of the lung. J Thorac Cardiovasc Surg 1982; 83: 1–11.

    PubMed  CAS  Google Scholar 

  26. Bonner JA, McGinnis WL, Stella PJ, et al. The possible advantage of hyperfractionated thoracic radiotherapy in the treatment of locally advanced non-small cell lung carcinoma: Results of the North Central Cancer Treatment Study Group Phase III trial. Cancer 1998; 82: 1037–1048.

    Article  PubMed  CAS  Google Scholar 

  27. Socinski M. The current status of adjuvant chemotherapy for resected non-small cell lung cancer. Semin Oncol 1999; 26 (Suppl 15): 34–39.

    Google Scholar 

  28. Sawyer TE, Bonner JA. Postoperative irradiation in non-small cell lung cancer. Sem Rad Oncol 2000; 10: 280–288.

    Article  CAS  Google Scholar 

  29. Weisenburger TH, Gail M. The Lung Cancer Study Group: Effects of postoperative mediastinal radiation on completely resected stage II and stage III epidermoid cancer of the lung. N Engl J Med 1986; 315: 1377–1381.

    Article  Google Scholar 

  30. Stephens RJ, Girling DJ, Bleehen NM, et al. The role of post-operative radiotherapy in non-small-cell lung cancer: A multicentre randomized trial in patients with pathologically staged T1–2, N1–2, MO disease. Medical Research Council Lung Cancer Working Party. Br J Cancer 1996; 74: 632–639.

    Article  PubMed  CAS  Google Scholar 

  31. PORT Meta-analysis Trialists Group. Postoperative radiotherapy in non-small-cell lung cancer: Systematic review and meta-analysis of individual patient data from nine randomized controlled trials. Lancet 1998; 352: 257–263.

    Article  Google Scholar 

  32. Choi NC, Grillo HC, Gardiello M, et al. Basis for new strategies in postoperative radiotherapy of bronchogenic carcinoma. Int J Radiat Oncol Biol Phys 1980; 6: 31–35.

    Article  PubMed  CAS  Google Scholar 

  33. Kirsh MM, Sloan H. Mediastinal metastases in bronchogenic carcinoma: Influence of postoperative irradiation, cell type, and location. Ann Thorac Surg 1982; 33: 459–463.

    Article  PubMed  CAS  Google Scholar 

  34. Sawyer TE, Bonner JA, Gould PM, et al. The impact of surgical adjuvant thoracic radiation therapy for patients with nonsmall-cell lung carcinoma with ipsilateral mediastinal lymph node involvement. Cancer 1997; 80: 1399–1408.

    Article  PubMed  CAS  Google Scholar 

  35. Lad TE. Post-surgical therapy in stage I, II, IIIA non-small cell lung cancer [Review]. Hematology-Oncology Clinics of North America 1990; 4: 1111–1119.

    Google Scholar 

  36. Niiranen A, Niitamo-Korhonen S, Kouri M, et al. Adjuvant chemotherapy after radical surgery for nonsmall-cell lung cancer. A randomized study: J Clin Oncol 1992; 10: 1927–1932.

    PubMed  CAS  Google Scholar 

  37. Wada H, Hitomi S, Teramatsu T. Adjuvant chemotherapy after complete resection in non-small-cell lung cancer. J Clin Oncol 1996; 14: 1048–1054.

    PubMed  CAS  Google Scholar 

  38. Keller S, Adak S, Fossella F, et al. Randomized prospective comparison of adjuvant mediastinal radiation with or without concurrent chemotherapy with cisplatin and etoposide for patients with completely resected T1–3N1–2M0 NSCLC: US intergroup lung trial 0115. Proc Am Soc Thera Rad Oncol (ASTRO). IJROBP 45 ##, 1999 (abstr).

    Google Scholar 

  39. Shields TW, Higgins GA Jr, Lawton R, et al. Preoperative x-ray therapy as an adjuvant in the treatment of bronchogenic carcinoma. J Thorac Cardiovasc Surg 1970; 59: 49–61.

    PubMed  CAS  Google Scholar 

  40. Payne DG. Preoperative radiation therapy in non-small cell carcinoma of the lung. Lung Cancer 1991; 7: 47–56.

    Article  Google Scholar 

  41. Payne DG. Is preoperative or postoperative radiation therapy indicated in non-small cell cancer of the lung? Lung Cancer 1994; 10 (Suppl 1): S205 - S212.

    Article  PubMed  Google Scholar 

  42. Lad T, Wagner H, Piantadosi S. Randomized Phase II evaluation of preoperative chemotherapy alone and radiotherapy alone in stage IIIa non-small cell lung cancer. (Abstract) Proc Amer Soc Clin Oncol 1991; 10: 258.

    Google Scholar 

  43. Martini N, Kris MG, Flehinger BJ, et al. Preoperative chemotherapy for stage IIIA (N2) lung cancer: The Sloan-Kettering experience with 136 patients. Ann Thorac Surg 1993; 55: 1365–1374.

    Article  PubMed  CAS  Google Scholar 

  44. Sugarbaker DJ, Herndon J, Kohman LJ, and the Cancer and Leukemia Group B Thoracic Surgery Group. Results of Cancer and Leukemia Group B protocol 8935. A multiinstitutional phase II trimodality trial for stage IIIA (N2) non-small cell lung cancer. J Thorac Cardiovasc Surg 1995; 109: 473–485.

    Article  PubMed  Google Scholar 

  45. Rosell R, Gomez-Codina J, Camps C, et al. A randomized trial comparing preoperative chemotherapy plus surgery with surgery alone in patients with non-small cell lung cancer. N Eng J Med 1994; 330: 153–158.

    Article  CAS  Google Scholar 

  46. Yoneda S, Hibino S, Gotoh I, et al. A comparative trial of induction chemoradiotherapy followed by surgery or immediate surgery for stage III NSCLC (abstract 1128). Proc Am Soc Clin Oncol 1995; 14: 367.

    Google Scholar 

  47. Roth J, Fossella F, Komaki R, et al. A randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage III non-small-cell lung cancer. J Natl Cancer Inst 1994; 86: 673–680.

    Article  PubMed  CAS  Google Scholar 

  48. Pass H, Pogrebniak H, Steinberg SM, et al. Randomized trial of neoadjuvant therapy for lung cancer: Interim analysis. Ann Thorac Surg 1992; 53: 992–1008.

    Article  PubMed  CAS  Google Scholar 

  49. Splinter TAW, va Schil PE, Kramer GWPM, et al. Randomized trial of surgery versus radiotherapy in patients with stage IIIA (N2) non-small cell lung cancer after a response to induction chemotherapy. EORTC 08941. Clinical Lung Cancer 2000; 2: 69–72.

    Article  PubMed  CAS  Google Scholar 

  50. Eagan RT, Ruud C, Lee RE, et al. Pilot study of induction therapy with cyclophosphamide, doxirubicin, and cisplatin (CAP) and chest irradiation prior to thoracotomy in initially inoperable stage III non-small lung cancer. Cancer Treat Rep 1987; 71: 895–900.

    PubMed  CAS  Google Scholar 

  51. Weiden PL, Piantadosi S. Preoperative chemotherapy (cisplatin and fluorouracil) and radiation therapy in stage III non-small cell lung cancer: A phase II study of the Lung Cancer Study Group. J Natl Cancer Inst 1991; 83: 266–272.

    Article  PubMed  CAS  Google Scholar 

  52. Faber LP, Kittle CF, Warren WH, et al. Properative chemotherapy and irradiation for stage III non-small cell lung cancer. Ann Thor Surg 1989; 47: 669–675.

    Article  CAS  Google Scholar 

  53. Strauss GM, Herndon JE, Sherman DD, et al. Neoadjuvant chemotherapy and radiotherapy followed by surgery in stage IIIA non-small cell carcinoma of the lung: Report of a Cancer and Leukemia Group B phase II study. J Clin Oncol 1992; 10: 1237–1244.

    PubMed  CAS  Google Scholar 

  54. Albain K, Rusch V, Crowley J, et al. Concurrent cisplatin/etoposide plus chest radiotherapy followed by surgery for stages IIIA (N2) and IIIB non-small-cell lung cancer: Mature results of Southwestern Oncology Group phase II study 8805. J Clin Oncol 1995; 13: 1880–1892.

    PubMed  CAS  Google Scholar 

  55. Yashar J, Weitberg AB, Glicksman AS, et al. Preoperative chemotherapy and radiation therapy for stage IIIa carcinoma of the lung. Ann Thor Surg 1992; 53: 445–448.

    Article  CAS  Google Scholar 

  56. Fowler WC, Langer CJ, Curran WJ, et al. Postoperative complications after combined neoadjuvant treatment of lung cancer. Ann Thorac Surg 1993; 55: 986–989.

    Article  PubMed  CAS  Google Scholar 

  57. Thomas M, Rube C, Semik M, et al. Impact of preoperative bimodality induction including twice-daily radiation on tumor regression and survival in stage III non-small cell lung cancer. J Clin Oncol 1999; 17: 1185–1193.

    PubMed  CAS  Google Scholar 

  58. Eberhardt W, Wilke H, Stamatis G, et al. Preoperative chemotherapy followed by concurrent chemoradiation therapy based on hyperfractionated accelerated radiotherapy and definitive surgery in locally advanced non-small cell lung cancer. Mature results of a phase II trial. J Clin Oncol 1998; 16: 622–634.

    PubMed  CAS  Google Scholar 

  59. Rapp E, Pater JL, Willan A, et al. Chemotherapy can prolong survival in patients with advanced non-small cell lung cancer. Report of a Canadian multicenter randomized trial. J Clin Oncol 1988; 6: 633–641.

    PubMed  CAS  Google Scholar 

  60. Chemotherapy in non-small cell lung cancer: a meta-analysis using updated data on individual patients from 52 randomized clinical trials. Non-small Cell Lung Cancer Collaborative Group. BMJ 1995; 311:899–909.

    Google Scholar 

  61. Friess GG, Balkadi M, Harvey WH. Simultaneous cisplatin and etoposide with radiation therapy in loco-regional non-small cell lung cancer. Final results of a pilot trial. IN: Small Cell Lung Cancer and Non-small Cell Lung Cancer. Gralla Ri, Einhorn LH (eds). Royal Society of Medicine Services Limited, 1989, pp. 121–126.

    Google Scholar 

  62. Dillman RO, Herndon J, Seagren SL, et al. Improved survival in stage III non-small cell lung cancer: Seven-year follow-up of Cancer and Leukemia Group B (CALGB) 8433 trial. J Nail Cancer Inst 1996; 88: 1210–1215.

    Article  CAS  Google Scholar 

  63. Le Chevalier T, Arriagada R, Quoix E, et al. Radiotherapy alone versus combined chemotherapy and radiotherapy in resectable non-small cell lung cancer: First analysis of a randomized trial in 353 patients. J Natl Cancer Inst 1991; 83: 417–423.

    Article  PubMed  Google Scholar 

  64. Wagner H, Antonia S, Shaw G, et al. Induction Chemotherapy with Carboplatin and Paclitaxel followed by Hyperfractionated Accelerated Radiation for Patients with Unresectable Stage IIA and IIB NonSmall-Cell Lung Cancer. Proc Am Soc Clin Oncol 1998; 17: 469a (abstr).

    Google Scholar 

  65. Pritchard RS, Anthony SP. Chemotherapy plus radiotherapy compared with radiotherapy alone in the treatment of locally advanced, unresectable, non-small cell lung cancer: A meta-analysis. Ann Intern Med 1996; 125: 723–729.

    PubMed  CAS  Google Scholar 

  66. Schaake-Koning C, Van den Bogaert W, Dalesio O, et al. Effects of concomitant cisplatin and radiotherapy on inoperable non small cell lung cancer. N Engl J Med 1992; 326: 524–530.

    Article  PubMed  CAS  Google Scholar 

  67. Jeremic B, Shibamoto Y, Acimovic L, et al. Hyperfractionated radiation therapy with or without concurrent low-dose daily carboplatin/etoposide for stage III non-small cell lung cancer: a randomized study. J Clin Oncol 1996; 14: 1065–1107.

    PubMed  CAS  Google Scholar 

  68. Shaw EG, McGinnis WL, Jett JR, et al. Pilot study of accelerated hyper-fractionated thoracic radiation therapy plus concomitant cisplatin chemotherapy in patients with unresectable stage III non small cell lung cancer. J Natl Cancer Inst 1993; 85: 321–323.

    Article  PubMed  CAS  Google Scholar 

  69. Belani CP, Ramanathan RK. Combined modality treatment of locally advanced non-small cell lung cancer: Incorporation of novel chemotherapeutic agents. Chest 1998; 113 (Suppl 1): 535–60S.

    Google Scholar 

  70. Choy H, DeVore RD, Hande KR, et al. Phase II study of paclitaxel, carboplatin, and hyperfractionated radiation therapy for locally advanced inoperable non-small cell lung cancer. A Vanderbilt Cancer Center Affiliate Network (VCCAN) Trial. Proc Am Soc Clin Oncol 1998; 17: 467a (abstr).

    Google Scholar 

  71. Furuse K, Fukuoka M, Kawahara M, et al. Phase III study of concurrent versus sequential thoracic radiotherapy in combination with mitomycin, vindesine, and cisplatin in unresectable stage III non-small cell lung cancer. J Clin Oncol 1999; 17: 2692–2699.

    PubMed  CAS  Google Scholar 

  72. Komaki R, Seiferheld W, Curran W, et al. Sequential vs. concurrent chemotherapy and radiation therapy for inoperable non-small cell lung cancer (NSCLC): Analysis of failures in a Phase III study (RTOG 9410) Proc Am Soc Thera Rad Oncol (ASTRO). IJROBP 2000; 48: 5A (abstr).

    Google Scholar 

  73. Edelman Mi, Gandara DR. Promising new agents in the treatment of non-small cell lung cancer. Cancer Chemother Pharmacol 1996; 37: 385–393.

    Article  PubMed  CAS  Google Scholar 

  74. Gandara DR, Edelman MJ, Lara PN, et al. Current status and novel therapeutic approaches in advanced non-small cell lung cancer. ASCO Educational Book, Spring: 362–369, 1999.

    Google Scholar 

  75. Tishler RB, Schiff PB, Geard CR, et al. Taxol: A novel radiation sensitizer. Int JRadiat Oncol Biol Phys 1992; 22: 613–617.

    Article  CAS  Google Scholar 

  76. Rockwell S, Grindley GB. Effect of 2’,2’-difluorodeoxycytidine on the viability and radiosensitivity of EMT6 cell in vitro. Oncol Res 1992; 4: 151–155.

    CAS  Google Scholar 

  77. Boothman DA, Wang M, Schea RA, et al. Post-treatment exposure to camptothecon enhances the lethal effects of x-rays on resistant human malignant melanoma cells. Int J Radiat Biol Phys 1992; 42: 939–948.

    Google Scholar 

  78. Kim JH, Kim SH, Kolozsvary A, et al. Potentiation of radiation response in human carcinoma cells in vitro and murine fibrosarcoma cell in vivo by topotecan, an inhibitor of DNA topoisomerase I. Int J Radiat Oncol Biol Phys 1992; 22: 515–518.

    Article  PubMed  CAS  Google Scholar 

  79. Von Pawel J, Von Roemeling T. Survival benefit from Tirazone (tirapazamine) and cisplatin in advanced non small cell lung cancer (NSCLC) patients: Final results from the phase III CATAPULT trial. Proc Am Soc Clin Oncol 1998; 17: 454a (abstr 1749).

    Google Scholar 

  80. Langer C, Scott C, Byhardt R, et al. Effect of advanced age on outcome in Radiation Therapy Oncology Group studies of locally advanced NSCLC. Lung Cancer 2000; 29(Suppl 1)104:A-340.

    Google Scholar 

  81. Movsas B, Scott C, Sause W, et al. Age dramatically impacts on the quality-adjusted time without symptoms of toxicity (Q-Twist) in locally advanced non-small cell lung cancer - A Radiation Therapy Oncology Group (RTOG) analysis. Proc Am Soc Thera Rad Oncol (ASTRO). IJROBP 2000; 48: 92A (abstr).

    Google Scholar 

  82. Langer CJ, Hsu C, Curran W, Komaki R, Lee JS, Byhardt R, Sause W. Do elderly patients with locally advanced non-small cell lung cancer (NSCLC) benefit from combined modality therapy? A secondary analysis of RTOG 94–10. IJROBP 2001; 51: 31A (abstr).

    Google Scholar 

  83. Komaki R, Scott CB, Byhardt RW, et al. Failure patterns by prognostic group determined by recursive partitioning analysis (RPA) of 1,547 patients on four Radiation Therapy Oncology Group studies in inoperable non-small cell lung cancer (NSCLC). Int J Radiat Oncol Biol Phys 1998; 42: 263–267.

    Article  PubMed  CAS  Google Scholar 

  84. Sause WT, Scott C, Taylor S, et al. Phase II trial of combination chemotherapy and irradiation in non-small cell lung cancer, Radiation Therapy Oncology Group 88–04. Am J Clin Oncol 1992; 15:163–167.

    Google Scholar 

  85. Komaki R, Scott C, Ettinger D, et al. Randomized study of chemotherapy/radiation therapy combinations for favorable patients with locally advanced inoperable nonsmall-cell lung cancer: Radiation Therapy Oncology Group (RTOG) 92–04. Int J Radiat Oncol Biol Phys 1997; 38: 149–155.

    Article  PubMed  CAS  Google Scholar 

  86. Clamon G. Herndon J. Cooper R, et al. Radiosensitization with carboplatin for patients with unresectable stage III non-small-cell lung cancer: A phase III trial of the Cancer and Leukemia Group B and the Eastern Cooperative Oncology Group J Clin Oncol 1999; 17:4–11.

    Google Scholar 

  87. Vokes EE, Leopold KA, Herndon JE II, et al. A randomized phase II trial of gemcitabine or paclitaxel or vinorelbine with cisplatin as induction chemotherapy and concomitant chemo-radiotherapy for unresectable stage III non-small cell lung cancer. Proc Am Soc Clin Oncol 1999; 18: 459A (abstr).

    Google Scholar 

  88. Green MR, Rocha Lima CM, Sherman CA. Radiation and chemotherapy for patients with stage III non-small cell lung cancer. Sem Rad Oncol 2000; 10: 289–295.

    Article  CAS  Google Scholar 

  89. Gandara DR, Lovato LC, Albain KS, et al. Prolonged survival in pathologic stage IIIB non-small cell lung cancer with concurrent chemoradiotherapy followed by consolidation docetaxel: A phase II study (S9504) of the Southwest Oncology Group (SWOG). Proc Am Soc Clin Oncol 2000; 19:1916A (abstr).

    Google Scholar 

  90. Evans W, Will B, Berthelot J, et al. Cost of combined modality interventions for stage III non-small-cell lung cancer. J Clin Oncol 1997; 15: 3038–3048.

    PubMed  CAS  Google Scholar 

  91. Konski A, Scott C, Movsas B, et al. Cost-utility analysis of various treatments for non-small cell carcinoma of the lung (Abstract). Eur J Cancer 2000; 36: 519.

    Google Scholar 

  92. American Society of Clinical Oncology. Clinical practice guidelines for the treatment of unresectable non-small-cell lung cancer. J Clin Oncol 1997; 15: 2996–3018.

    Google Scholar 

  93. Burkes R, Shepard F, Ginsberg R, et al. Induction chemotherapy with MVP in patients with stage IIIA (N2) unresectable non-small cell lung cancer. The Toronto experience (abstract 1078). Proc Am Soc Clin Oncol 1994; 13:327.

    Google Scholar 

  94. Choi N, Carey R, Daly W, et al. Potential impact on survival of improved tumor downstaging and resection rate by preoperative twice-daily radiation and concurrent chemotherapy in stage IIIA nonsmall-cell lung cancer. J Clin Oncol 1997; 15:712–722.

    Google Scholar 

  95. Granone P, Margaritora S, Cesario A, et al. Concurrent radio-chemotherapy in N2 non small cell lung cancer: interim analysis. Eur J Cardio-thoracic Surgery 1997; 12: 366–371.

    Article  CAS  Google Scholar 

  96. Strauss GM, Langer MP, Elias AD, et al. Multimodality treatment of stage IIIA non-small cell lung carcinoma: A critical review of the literature and strategies for future research. J Clin Oncol 1992; 10: 829–838.

    PubMed  CAS  Google Scholar 

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Byhardt, R.W. (2003). The Role of Combined Modality Therapy for Stage III Nonsmall-Cell Lung Cancer. In: Choy, H. (eds) Chemoradiation in Cancer Therapy. Cancer Drug Discovery and Development. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-325-5_9

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