Malignant lung diseases are a major topic in community health. The incidence for lung cancer rapidly increased in the last century (1), and today it is the most common malignant disease worldwide. In the United States, bronchial carcinoma is the leading malignant disease for both genders, and in 2000, the incidence was 164,000 with a morbidity of 157,000 (2). Pulmonary metastases are also a challenge and occur in patients with a variety of cancers. Between 20% and 30% of patients afflicted with cancer generate pulmonary metastases (3).

The prognoses for bronchial carcinomas and metastases remain poor. Resection of stage I and II carcinomas offers the best chance in long-term survival (4–7), but only 25% to 30% of these tumors are resectable (4–6). Survival rates for bronchial carcinomas and pulmonary metastases are similar, with a mean survival for all bronchial carcinomas of 12 months (4) and a mean survival after diagnosis of non-resectable lung metastases of less than 1 year (8). Five-year survival rates of 10% for all bronchial carcinomas (5) have been reported, with a mean 5-year survival rate of 23% to 50% after resection (4, 9–11) and 1% (4) for unresectable carcinomas. In patients with lung metastases who undergo pulmonary resection, a 5-year survival rate of 20% to 46% (12–19) has been reported.

As an alternative to resection or as a neoadjuvant therapeutic option, various therapies such as radiotherapy or chemotherapy have been developed (1), and in particular, systemic chemotherapy has shown encouraging results (16, 20).