Behandeling van patiënten met niet-kleincellig longcarcinoom stadium III: gelijktijdig hooggedoseerde chemotherapie en radiotherapie

- The treatment of patients with locally advanced non-small cell lung cancer (stage III) has changed significantly in the past few years.

- Patients with a non-resectable stage IIIA/B tumour are given combined treatment consisting of chemotherapy and radiotherapy. These can be administered sequentially or concurrently.

- It has been shown recently that concurrent chemoradiotherapy gives a survival advantage in comparison with sequential chemoradiotherapy.

- Cisplatin and etoposide are usually the drugs of choice for chemotherapy in patients with stage III cancer.

- A biologically effective dose of radiotherapy equivalent to 60-66 Gy, over a maximum of 6.5 weeks, should be given.

- Surgery is possible for a selected group of patients, provided a complete objective mediastinal response has been achieved after chemoradiotherapy and a complete resection appears to be technically feasible. It is recommended to apply this treatment in a research setting.

- High-dose concurrent chemoradiotherapy is advised as the standard treatment for stage III non-small cell lung cancer in patients in good physical condition.

Ned Tijdschr Geneeskd. 2008;152:2714-7