Introduction: The management of patients with cancer, presenting an immediate life-threatening risk is a complex and controversial subject. The admission of those patients to the care unit poses a real dilemma, we are torn between the desire to go to the limits of technical possibilities especialy for young patients. Materials and methods: We report 4 cases of patients, admitted in intensive care unit for respiratory distress causes by a tumor. These patients were intubation because of hypoxemia, and then received curative chemotherapy in the intensive care unit. Discussion: A few years ago, admission to intensive care unit for onco-hematology patients was unthinkable. It still is nowadays, we are torn between the desires to go to the limits of technical possibilities especialy for young patients. A study of ICU admissions for any type of lung carcinoma (80% of Non-Small Cell Bronchial Cancers) shows that of the 22,538 patients in stages III-IV, 16360 leave the hospital and 4,889 survive at 6 months. Only 11% of mechanically ventilated patients leave the hospital. In our study, one of the four patients treated with chemotherapy responded well, a ratio of 25%. Conclusion: Admission decisions of patient with neoplasia to the ICU should be made on a case-by-case basis, somewhere between the two ends of the decision-making spectrum, based on the clinical evaluation and after discussions with the oncologist andpatient