Non-operative Management of Lung Cancer Flashcards
What does the treatment type depend on?
Tumour type Stage ECOG performance status Patient wishes Aim of therapy (curative or palliative)
What are the different treatment options?
Surgery Radiotherapy - curative (radical) or palliative Chemotherapy Combination Targeted therapies
Define the classes of the Eastern Cooperative Group (ECOG) performance status measurement
0 - asymptomatic 1 - symptomatic - light work 2 - has to rest <50% of day 3 - has to rest >50% of dat 4 - bed bound
What is adjuvant therapy?
Therapy after surgery to attempt to increase chance of survival
What is neoadjuvant therapy?
Therapy before surgery to attempt to increase chance of survival
Does adjuvant radiotherapy increase survival in stage I and II NSCLC patients?
No it is detrimental unless there is spread to mediastinal nodes or involves margins
Is neoadjuvant chemotherapy advantageous in stage III NSCLC?
Yes, increases chances of survival
In patients with stage III NSCLC is survival rate better with just RT or with chemoRT?
With chemoRT
What is the management of stage IV NSCLC?
Incurable, therefore palliative treatment:
RT to primary tumour
Chemo equal symptom benefit and survival advantage
How many cycles of chemo is given to patients with stage III or IV NSCLC?
3 is as good as 6 cycles, but average in UK is 4
What can cause bone pain in lung cancer?
Bone metastases
What is the palliative therapy for bone mets?
Radiotherapy (single fraction)
Orthopaedic surgery
Neurosurgeons for cord compression
What is the palliative therapy for brain mets?
Resection
Radiotherapy
Steroid or erlotinib
What is limited disease in SCLC?
When the disease is stage to one hemithorax
What is the treatment for limited disease in SCLC?
Chemotherapy
Combination of drugs
Early thoracic RT better
Prophylactic cranial radiation (PCI)
