Treatment of stage III non-small cell lung cancer with thoracic radiation therapy and simultaneous platinum chemotherapy.

Preclinical trials have shown platinum compounds to enhance radiation, and clinical trials that tested simultaneous cisplatin and radiation in a variety of tumors have demonstrated acceptable toxicity. Subsequent reports described the use of platinum chemotherapy and concurrent thoracic radiation therapy for the treatment of locally advanced non-small cell lung cancer. In patients whose disease was considered unresectable, investigators have tested cisplatin primarily as a single agent. Phase III trials compared single-agent cisplatin and simultaneous radiation with radiation alone. Selected phase II trials studied cisplatin, or carboplatin and radiation. Two phase II trials evaluated cisplatin-containing combination chemotherapy and simultaneous split-course radiation therapy in nonsurgical patients. In contrast to nonsurgical trials, studies of preoperative treatment have tested cisplatin-containing combination chemotherapy regimens and simultaneous radiation. Of particular interest are the implications of these studies for future phase III trials.