Lung Tumors

Question 1

Epidemiology of lung cancer

Answer 1

• first cause of death
• higher risk in females
• 5 year survival: 5-15%

Question 2

Etiology of lung cancer

Answer 2

• tobacco smoking
• carcinogens (benzene, arsenic), asbestos, nickel, silica, radiation
• genetic predisposition: LiFraumeni syndrome (p53), Werner syndrome, BRCA mutation

Question 3

Histology of lung cancer

Answer 3

• preinvasive: squamous dysplasia, atypical adenomatous hyperplasia
• SCLC: more aggressive
• NSCLC: surgery until IIIA
• ACC: common amongst women non-smokers
• SCC: common amongst men smokers
• LCC

Question 4

Symptoms of lung cancer

Answer 4

• asymptomatic
• unproductive cough
• dyspnea
• weight loss
• hemoptysis
• chest pain
• atelectasis

Question 5

Diagnosis of lung cancer

Answer 5

• chest X-ray
• CT
• MRI
• PET
• CAT scan
• bronchoscopy
• transthoracal biopsy
• video assisted thorascopy (VAT)
• fine needle aspiration cytology (FNAC)

Question 6

Radiotherapy for lung cancers

Answer 6

• neadjuvant, adjuvant, curative and palliative radiotherapy
• EBRT and brachytherapy
• SBRT
• LINAC/Cyberknife
• Radiochemo: paclitaxel/carboplatin (radiosensitizer)
• SCLC is more radiosensitive

Question 7

Surgical therapy for lung cancer

Answer 7

• stage I-IIIa: first priority if possible
• more feasible for NSCLC: segmentectomy, lobectomy, bilobectomy, pneumonectomy
• the Mountain-Dresler lymph node classification
• conventional open surgery
• VATS

Question 8

Pharmacological therapy for lung cancer

Answer 8

• first generation chemo: cisplatin, carboplatin and etoposide
• second generation chemo: paclitaxel, docetaxel and gemcitabine
• targeted therapy: EGFR, VEGF, ALK inhibition
• immunotherapy: PD-L1, CTLA4 inhibition