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In summary, numerous prognostic indicators for NSCLC patients have been defined and continue to be evaluated for impact on local control, survival, and treatment selection. It becomes clear that tumor induction and progression are determined by multiple steps and response to treatment on numerous codependent factors that must ultimately be considered in determining optimal treatment for any given patient. The ultimate goal would be an individualized approach to each patient considering all variables of stage, tumor biology, comorbidity, and QOL.

Significant progress has been made in recent years in The strategies for managing lung cancer. The multidisciplinary Lung cancer team principle has allowed more Cohesive and timely treatment for the patients and better Communication between specialists. New sophisticated techniques allow the modern thoracic surgeon to Offer potentially curative treatment to selected patients With either locally advanced disease or very limited pulmonary Reserves, who were previously denied surgery.

Radiotherapy has played a part in the management of locally advanced NSCLC for decades. It has provided an option of radical treatment in patients who present with inoperable disease. Recent advances in radiotherapy techniques and the combined modality treatment with chemotherapy have improved the outcome for these patients. Future developments for more accurate staging of disease with both anatomical and functional imaging, improved radiotherapy conformity with IMRT and image-guided radiotherapy, and the use of novel chemotherapeutic agents and biological agents in conjunction with radiotherapy, will further improve the outcome for NSCLC.

All patients with advanced NSCLC should be considered for palliative treatment. There is reasonable evidence that palliative radiotherapy is effective in symptom control and may prolong life in some patients. There remain questions as to how best to select patients who will gain a benefit from treatment and those who will not. Where palliation aims to improve quality of life, the impact of possible side effects should be carefully considered. Palliative radiotherapy should be just part of the multimodality management of these patients.