Multimodality Therapy for Locally Advanced Non-Small Cell Lung Cancer and the Associated Problems

Abstract

Locally advanced non-small cell lung cancer (NSCLC) is a heterogenous disease, with considerable variations in prognosis and treatment options. The treatment for locally-advanced NSCLC is divided into two groups: resectable and unresectable. The standard treatment for unresectable locally-advanced NSCLC is chemoradiotherapy, and advances in EGFR receptor and immune checkpoint inhibitors have produced a number of novel treatment options. The standard treatment for resectable T4 NSCLC is combined resection with the surrounding organ. The exclusion of N2 disease is necessary because the mortality and morbidity rates are very high, and the survival of T4N2 disease is not satisfactory. The treatment for resectable N2 disease remains controversial because only limited merits of resection have been demonstrated in clinical trials. Novel anticancer agents and new molecularly targeted drugs, as well as advances in radiation and surgical technology, are expected to improve outcomes in the near future.