Non-operative Management of Lung Cancer Flashcards by Mai Alkari

Percentage of non-small cell carcinomas operable

25%

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Therapeutic options for lung cancer

Radiotherapy
Surgery 
Chemotherapy
Immunotherapy
Targeted therapies

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Essential info to determine optimal therapy

Pathology, stage and performance status

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Adjuvant therapy

Therapy given postoperatively

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Adjuvant therapy options in non-small cell carcinoma

Chemotherapy

Radiotherapy

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Neoadjuvant therapy

Therapy given before operating

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Stage III non-small cell carcinoma treatment

Induction chemotherapy followed by radical radiotherapy

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Stereotactic ablative therapy

Targeting radiotherapy directly at tumour

Used on tumours up to 4cm and >2cm from airways

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Stage IV non-small cell carcinoma treatment

Radiotherapy to primary tumour

Chemotherapy

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Average chemotherapy cycles in the UK

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Immunotherapy is used for

Metastatic disease

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Presenting symptom of non-small cell carcinoma bone pain from metastases

Pathological fracture

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Treatment for non-small cell carcinoma bone pain from metastases

Palliative radiotherapy

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Non-small cell lung cancer non-operative management

Adjuvant therapy 
Neoadjuvant therapy
Immunotherapy
Radical radiotherapy
Chemotherapy &amp; radiotherapy 
SABR
Targeted drugs

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Adjuvant immunotherapy option in non-small cell carcinoma

Durvalumab after chemo and RT

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Immunotherapy option in non-small cell carcinoma

Checkpoint inhibitors

Small cell lung cancer limited disease non-operative management

Chemotherapy
Immunotherapy
Thoracic and prophylactic cranial radiotherapy

Immunotherapy in small cell carcinoma

Combination of drugs e.g cisplatin and etoposide

Response rate in limited disease small cell carcinoma therapy

90%

Small cell lung cancer extensive disease non-operative management

Chemotherapy
Thoracic and prophylactic cranial radiation
Immunotherapy

Immunotherapy for small cell carcinoma brain metastases

Steroids

Response rate in extensive disease small cell carcinoma therapy

80%

Side effects of chemotherapy

Marrow suppression 
Nausea and vomiting
Fatigue and lethargy
Neuropathy
Hair loss
Increased risk of MI/stroke

Side effects of radiotherapy

Lethargy
Risk to surrounding organs
Pneumonitis
Dysphagia
Fibrosis 
Increased risk of MI and second malignancies

Side effects of immunotherapy

Inflammation

Lung cancer screening given to

At risk population