Non Small Cell Lung Carcinoma Flashcards
1
Q
What is the most common histological type of lung cancer?
A
- SCC in small cell
- Adenocarcinoma overall
- About 20% of patients present with mixed histology
2
Q
Where do SCC originate?
A
- Develop in the small cells that cover the surface of the airways
3
Q
Where do adenocarcinomas develop?
A
- Goblet cells which produce mucus in epithelial lining
- Slow growing, peripheral part of the lung
4
Q
What is large cell carcinoma?
A
- 10-15% of lung cancers
- Grow quickly
- Typically in smokers
5
Q
What are the available lung funtion tests?
A
- FEV1
- Forced expiratory volume
- Volume of air that can be exhaled during a forced breath in t seconds (number and subscript)
6
Q
What are the possible surgical techniques?
A
- lobectomy
- segmentectomy
- wedge resection
7
Q
Who is not a candidate for surgery?
A
- 40% of patients unsuitable
- Lung function test <80%
- High risk, cardiac problems for example
8
Q
What is radiofrequency ablation?
A
- Microwave tumour
- probe inserted into the tumour
- evidence for RT is more established
9
Q
Who are candidates for SABR?
A
- Stage I-II
- Elderly/COPD
- 2 year survival is 90%, but lack of evidence proving higher survival than surgery
10
Q
What are the options for locally advanced disease?
A
- Radical surgery (2%)
- Radical RT (14%)
- Palliative RT (46%)
- No surgery - chemoRT is gold standard
11
Q
What are the typical chemo regimines ?
A
- cisplatin + etoposide
- remember causes kidney toxicity
12
Q
What is important during SABR treatment?
A
- Monitoring tumour movement
- High dose in few fractions
- There is inclusion and exclusion criteria for SABR
13
Q
What are SABR guidelines for treatment?
A
- Medically inoperable tumours T1-3 (<5cm) no nodal involvement
- 54Gy in 3# 5-8 days
- 55 in 5# 10-14 days
- 60Gy in 5# 10-14 days
- 60Gy in 8# 10-20 days
14
Q
What is the typical dose and fractionation for conventional radiotherapy?
A
- 54Gy in 36# over 12 days (CHART)
- 55Gy in 20#
