Non-operative Management of Lung Cancer Flashcards
What are the principles of radiotherapy in the management of inoperable non-small cell lung cancer (NSCLC)?
Purpose: Primarily for local control of tumors in inoperable cases or for palliative care in advanced stages.
Techniques:
Conformal radiotherapy: Focuses on the tumor while minimizing damage to surrounding tissue.
Stereotactic body radiotherapy (SBRT): High-dose, precise radiation for small tumors.
Indication: Used in Stage I-III when surgery is not an option, or to shrink tumors causing symptoms like airway obstruction.
What are the principles of chemotherapy in the management of inoperable non-small cell lung cancer (NSCLC)?
Purpose: To shrink tumors, improve symptoms, and extend survival in advanced or metastatic disease.
Common regimens:
Platinum-based chemotherapy (cisplatin or carboplatin combined with pemetrexed or docetaxel).
Targeted therapies (e.g., EGFR inhibitors or ALK inhibitors) for tumors with specific genetic mutations.
Indication: Used for Stage III-IV or as adjuvant therapy after surgery to reduce recurrence.
What are the side effects of radiotherapy and chemotherapy for non-small cell lung cancer (NSCLC)?
Radiotherapy:
Fatigue
Skin irritation
Radiation pneumonitis (lung inflammation)
Difficulty swallowing (if the esophagus is affected)
Chemotherapy:
Nausea and vomiting
Myelosuppression (low blood counts)
Fatigue
Alopecia (hair loss)
Peripheral neuropathy
Risk of infections due to immune suppression.
What are the likely outcomes of radiotherapy and chemotherapy for inoperable non-small cell lung cancer (NSCLC)?
Chemotherapy: Improves symptoms and survival, though rarely curative in Stage IV.
Radiotherapy: Effective for symptom control (e.g., pain, obstruction) and can improve quality of life, especially in advanced disease.
What are the principles of chemotherapy in the management of small cell lung cancer (SCLC)?
First-line treatment: SCLC is highly responsive to chemotherapy.
Regimen:
Platinum-based chemotherapy (cisplatin or carboplatin) combined with etoposide (EP regimen).
Additional options include cyclophosphamide, vincristine, and irinotecan.
Indication: Used for both limited-stage and extensive-stage SCLC.
What are the principles of radiotherapy in the management of small cell lung cancer (SCLC)?
For limited-stage SCLC: Radiation is combined with chemotherapy for a potentially curative approach.
Prophylactic cranial irradiation (PCI): Given to reduce the risk of brain metastasis after complete remission.
Indication: Radiation is used for local control of tumors and preventing metastasis.
What are the likely outcomes of treatment for small cell lung cancer (SCLC)?
Limited-stage SCLC: With chemotherapy and radiation, it can be curative, and prognosis is better with early detection.
Extensive-stage SCLC: Prognosis is poor even with aggressive treatment; treatment is aimed at symptom control and improving quality of life.
What are the other treatment strategies important in the palliation of lung cancer?
Palliative Chemotherapy:
Goal: Shrink tumors causing symptoms (e.g., obstruction or pain) in advanced disease.
Drugs: Often involves platinum-based chemotherapy (cisplatin, carboplatin) or targeted therapies if genetic mutations are present.
Radiotherapy:
For symptom relief in advanced disease (e.g., bleeding, pain, obstruction).
Types:
External beam radiotherapy: For controlling pain or bleeding (e.g., bone or brain metastasis).
Endobronchial radiotherapy: To reduce tumor mass and relieve airway obstruction.
What other palliative strategies are used in lung cancer treatment?
Bronchoscopy:
Indication: To remove or debulk tumors obstructing the airways, which helps improve breathing and reduce infection risk.
Palliative Surgery:
Indication: For relieving obstruction or bleeding in cases where other treatments are not effective.
Example: Stent placement in the airway to open blockages.
What role does palliative care play in lung cancer management?
Goal: Focuses on improving quality of life rather than curing the disease.
Includes:
Pain management (e.g., opioids)
Managing dyspnea (difficulty breathing)
Providing emotional and psychological support
Addressing nutritional concerns and side effects
Hospice care for terminal-stage patients to ensure comfort in the final days.
