Management of stage I and II nonsmall cell lung cancer.

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Date
2017-01-03ICR Author
Author
McDonald, F
De Waele, M
Hendriks, LEL
Faivre-Finn, C
Dingemans, A-MC
Van Schil, PE
Type
Journal Article
Metadata
Show full item recordAbstract
The incidence of stage I and II nonsmall cell lung cancer is likely to increase with the ageing population and introduction of screening for high-risk individuals. Optimal management requires multidisciplinary collaboration. Local treatments include surgery and radiotherapy and these are currently combined with (neo)adjuvant chemotherapy in specific cases to improve long-term outcome. Targeted therapies and immunotherapy may also become important therapeutic modalities in this patient group. For resectable disease in patients with low cardiopulmonary risk, complete surgical resection with lobectomy remains the gold standard. Minimally invasive techniques, conservative and sublobar resections are suitable for a subset of patients. Data are emerging that radiotherapy, especially stereotactic body radiation therapy, is a valid alternative in compromised patients who are high-risk candidates for surgery. Whether this is also true for good surgical candidates remains to be evaluated in randomised trials. In specific subgroups adjuvant chemotherapy has been shown to prolong survival; however, patient selection remains important. Neoadjuvant chemotherapy may yield similar results as adjuvant chemotherapy. The role of targeted therapies and immunotherapy in early stage nonsmall cell lung cancer has not yet been determined and results of randomised trials are awaited.
Collections
Subject
Humans
Carcinoma, Non-Small-Cell Lung
Lung Neoplasms
Neoplasm Staging
Combined Modality Therapy
Chemotherapy, Adjuvant
Radiosurgery
Pneumonectomy
Disease Management
Meta-Analysis as Topic
Randomized Controlled Trials as Topic
Language
eng
Date accepted
2016-10-04
License start date
2017-01-03
Citation
The European respiratory journal, 2017, 49 (1)