Comments on treatment strategy for locally advanced non-small cell lung cancer.

In spite of significant improvement in local and in systemic treatment, long-term survival of patients with locally advanced non-small cell lung cancer (NSCLC) remains disappointing. The main reason may be our reluctance to explore the optimal ways of combining new modalities of irradiation with the new drugs. A survey of on-going clinical trials points to weak scientific collaboration between radiotherapists and medical oncologists. A comparison of different treatment strategies reveals that only the best local treatment combined with the best systemic treatment can lead to a clinically meaningful improvement in long-term survival. Curing a higher percentage of patients is the first step in our attempts to combat therapeutic nihilism. Copyright 2002 Elsevier Science Ireland Ltd.