Non-operative Management of Lung Cancer Flashcards

1
Q

What are the histological subtypes of lung cancer?

A
  • Non-small cell lung cancer

- Small cell lung cancer

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2
Q

What forms of NSCLC are there?

A
  • Squamous
  • Adenocarcinoma
  • Large cell undifferentiated
  • NOS
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3
Q

What is the proliferation rate of NSCLC?

A

Doubles every 129 days

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4
Q

What must be considered in the treatment of lung cancer?

A
  • Tumour type
  • Stage
  • ECOG performance status
  • Patient wishes
  • Options
  • Aims of therapy
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5
Q

What treatment options are there?

A
  • Surgery
  • Radiotherapy
  • Chemotherapy
  • Combination
  • Targeted therapy
  • Supportive care only
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6
Q

What is the aim of NSCLC adjuvant therapy?

A

Postoperative in order to increase the chance of cure

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7
Q

What demonstrates a significant survival advantage for stage III NSCLC?

A

Neoadjuvant chemotherapy

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8
Q

What is essential in stage III NSCLC radical RT?

A

Pulmonary function tests

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9
Q

What is the average number of cycles of chemo in the UK?

A

4

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10
Q

What improves survival in stage III and IV NSCLC by a further 3 to 5 months?

A

Maintenance chemotherapy with Pemetrexed

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11
Q

What may the presenting symptom in bone metastasis?

A

Pathological fracture

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12
Q

When does bone pain from metastases usually occur?

A

Any site but often worse at night

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13
Q

What mutations have been identified which lead to adenocarcinoma?

A
  • EGFR mutation
  • ALK translocation
  • BRAF mutation
  • ROS alteration
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14
Q

Who are targeted drugs suitable for?

A

Patients unfit for chemotherapy

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15
Q

What does nivolumab BMS do?

A

Blocks the binding of PD-1 to PD-L1 and PD-L2 which potentiates the activity of T-lymphocytes by preventing them from being inactivated

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16
Q

What is the proliferation rate of SCLC?

A

Doubles every 29 days

17
Q

How does SCLC present?

A
  • Presentation is identical to NSCLC
  • Secretory syndromes present
  • SIADH, ACTH
18
Q

What are the treatment options for SCLC LD?

A
  • Chemotherapy
  • Combination of drugs
  • Early thoracic RT
  • Prophylactic cranial radiation
19
Q

What proves to have no advantage in SCLC LD?

A
  • High dose chemo
  • Alternating chemo
  • Maintenance chemo
  • Chemo on demand
  • Maintenance interferon, MMPI, targeted therapies
20
Q

What are the treatment options for SCLC ED?

A
  • 4 cycles combination chemo
  • Consolidation thoracic RT
  • PCI
  • Single fraction RT to palliate if unfit for chemo
  • RT and steroids if brain metastasis