Chemotherapy for unresectable non-small cell lung cancer

The treatment of unresectable non-small cell lung cancer remains a frustrating clinical dilemma. Objective response rates with single agents are brief and rarely complete. Although response rates are higher for combination chemotherapy regimens, they remain disappointing. Since patients with more advanced disease typically have a greater tumor burden, with concomitant decreases in performance status and weight, few studies have demonstrated a survival benefit with chemotherapy. Nevertheless, selected patients should be offered the option of treatment with combination chemotherapy. Candidates for chemotherapy include individuals with good performance status, minimal weight loss, and minimal bulk disease. Patients should understand the limitations of cisplatin-based chemotherapy. Treatment should be discontinued after two to three cycles in the absence of obvious improvement.