Editorial on: multidisciplinary therapy of marginally operable stage IIIA non-small cell lung cancer

Yang and colleagues report on a multidisciplinary management strategy for marginally operable stage IIIA non-small cell lung cancer (NSCLC) (1). The authors used a very broad definition of “marginally operable,” as tumors with bulky or multistation N2 disease, invasion of a rib or diaphragm, atelectasis, or superior sulcus tumors. From 2006 to 2013, a treatment strategy termed “phased concurrent chemoradiotherapy” (CCRT) was employed, followed by assessment 4 weeks after CCRT to assess operability (Group A, N=16). If the patient was deemed to be inoperable, the patient received more chemotherapy and a boost of up to 30 Gy of radiation (Group B, N=12). The authors then compared these two groups to patients who underwent definitive CCRT (Group C, N=19). Per the authors, the purported rationale for this phased approach in the “marginally operable” patient is “to decrease the toxicities associated with CCRT and to maximize resectability”.