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Stage III non-small cell lung cancer (NSCLC) includes a highly heterogeneous group of patients with differences in the extent and localization of disease. Many aspects of stage III disease are controversial. The data supporting treatment approaches are often subject to a number of limitations, due to the heterogeneous patient populations involved in the trials. Furthermore, the definition of stage III disease has changed over time, and early studies were frequently inadequately powered to detect small differences in therapeutic outcome, were not randomized, or had a limited follow-up times. Major improvements in therapy, including the use of more active chemotherapy agents and refinements in radiation and surgical techniques, also limit the interpretation of earlier clinical trials. Lastly, improvements in pretreatment staging have led to reclassification of patients with relatively minimal metastatic disease as stage IV rather than stage III, leading to an apparent increase in the overall survival of both stage III and IV patients. Median overall stage III NSCLC survival ranges from 9 to 34 months. Higher survival rates are observed in younger Caucasian women with good performance status, adenocarcinoma, mutations, stage IIIA, and in patients with multidisciplinary-team-based diagnoses.

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Residential radon exposure is a major public health problem. It is the second greatest cause of lung cancer, after smoking, and the greatest in never-smokers. This study shows the indoor radon exposure distribution in Galicia and estimates the percentage of dwellings exceeding reference levels. It is based on 3245 residential radon measurements obtained from the Galician Radon Map project and from controls of two previous case-control studies on residential radon and lung cancer. Results show a high median residential radon concentration in Galicia (99 Bq m), with 49.3% of dwellings having a radon concentration above 100 Bq m and 11.1% having a concentration above 300 Bq m. Ourense and Pontevedra, located in South Galicia, are the provinces with the highest median indoor radon concentrations (137 Bq m and 123.5 Bq m, respectively). Results also show lower radon levels in progressively higher building storeys. These high residential radon concentrations confirm Galicia as a radon-prone area. A policy on radon should be developed and implemented in Galicia to minimize the residential radon exposure of the population.

The aim of this study was to analyse the relationship between exposure to residential radon and chronic obstructive pulmonary disease (COPD) by means of a systematic review. Material and Methods: A search was conducted in PubMed and OVID for papers making reference to the radon-COPD relationship. No search filters were applied, whether by date of publication, study type or sample size. All studies not written in English or Spanish were discarded. Results: A total of 174 and 57 papers were found in PubMed and OVID, respectively: of these, 13 (11 on miners and 2 on the general population) fulfilled the inclusion criteria. Only four of the studies on cohorts of miners analysed COPD as a specific disease, and only one reported statistically significant results. In addition, many of these studies lacked information on tobacco use among miners. In contrast, studies conducted on the general public showed an association between mortality and hospital admissions, on the one hand, and residential radon on the other. Conclusion: There are not enough studies to provide a basis for confirming or ruling out an association between radon exposure and COPD. Nonetheless, the most recent general population studies point to evidence of a possible association. In view of the heterogeneity of available studies, it is impossible to say whether this gas may or may not affect COPD morbidity and mortality, until such a time as further studies are carried out.

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