Combinations of Radiation Therapy and Chemotherapy for Non-Small Cell and Small-Cell Lung Carcinoma

Significant strides have been made in chemotherapy and radiation therapy (RT) for the treatment of both nonsmall cell lung cancer (NSCLC) and small-cell lung cancer (SCLC). This chapter highlights important components of the treatment of this disease with these modalities. A biologic basis for combining radiation with chemotherapy is given, followed by an overview of key concepts of this management strategy for NSCLC, including the timing of therapy, the role of surgery as part of a trimodality treatment approach, the use of chemoradiation as definitive therapy, and important aspects of radiation treatment planning. This discussion is followed by a synopsis of the rationale for using chemoradiation for SCLC, including details on the relative timing of these two techniques, acceptable radiation fractionation regimens, and the role of prophylactic cranial irradiation. Our goal is to offer a fundamental view of the concepts to be used by clinicians treating patients with NSCLC and SCLC.