plateau has been reached...median survival time of 17 months
Patients with unresectable locally advanced stage III disease (IIIA and IIIB without malignant pleural effusion) also comprise an important target population in clinical research. Although there is a better chance of a positive outcome in such patients given that overt disease is limited to the thoracic cavity, it has become clear in recent years that a plateau has been reached in terms of what is achievable with chemotherapy and radiotherapy in this setting. Survival figures currently observed in selected patients with stage III NSCLC treated with concurrent chemoradiotherapy are in the order of a median survival time of 17 months and a 3-year survival rate of 25% [30]. Although these clearly represent an improvement in outlook from only a few years ago, novel strategies which improve survival while not increasing toxicity to unacceptable levels are urgently needed. To this end, attention has turned to whether the incorporation of consolidation or maintenance therapy into treatment regimens for stage III disease might improve clinical outcome. Although current data are somewhat limited, several randomized studies have been carried out in this setting.
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