Biological basis of chemo-radiation

Radiation therapy has been for years treatment of choice of locally advanced non small cell lung cancer. Improvement due to the combination of radiation and chemotherapy has been shown recently through several randomized trials and a recent meta-analysis. These results may be explained by biological mechanisms, yet un-completely explored, which are detailed in this review and applied to lung cancer. The optimal combination scheme is not yet defined, even trough the concurrent approach is promising, at the expense of an increased toxicity which is the limiting factor of treatment escalation doses. Biological findings and future results of randomized trials will hopefully open new avenues in the therapeutic strategy of this poor prognosis disease. (authors)