Non Surgical Management Of Lung Cancer Flashcards
Describe the non surgical management of stage 1 and stage 11 lung cancer?
Patients with stage 1 and 2 lung cancer usually get surgery to remove their tumor.
Non operative management includes neoadjuvant and adjuvant therapy.
Neoadjuvant theapy: given before surgery. Trial however showed that pre operative chemotherapy had no benefit,
Adjuvant therapy; given after surgery. Radiotherapy is only given if there is incomplete resection of the tumor. Chemotherapy is given which increases 5 year survival by 15%.
Describe the non surgical management of stage III NSCLC.
Radical radiotherapy - given in high dose radical concentration because accelerated treatment does better but it is more toxic. Causes fibrosis of the lungs therefore pulmonary function testing has to be carried out prior to insure the patient can withstand the therapy.
Radical chemotherapy - survival is better than radiotherapy alone. No chemotherapy regime is the same. Increases 2 year survival to 27%. Maintenance chemo (pemetrexed) is given after 4 cycles of chemo to improve survival from 3-5 months.
Describe the non surgical management of stage IV NSCLC.
Stage IV NSCLC is incurable and mostly palliative care is given.
Radiotherapy to the primary tumor or systemic chemotherapy is given to give symptomatic benefit and survival advantage.
Describe a new non operative treatment for NSLC.
Nivolumab is a drug which is a PD-1 inhibitor.
It is effective for patients who have a mutation in the EGFR gene (> 50% of patients with adenocarcinoma)
It has great results and significant survival rates.
Describe the non surgical treatment for limited SCLC.
In limited disease, chemo treatment of choice is given. Drugs Cisplatin and Etoposide is used given. Early radiotherapy and preventative brain radiotherapy is also given to prevent brain metastasis - (Prophylactic cranial radiotherapy)
Describe the non surgical management of advanced SCLC.
4 cycles only of combination chemotherapy.
Thoracic radiotherapy
Radiotherapy and steroids is given if there is brain metastasis.
What is average survival of a pateint with limited disease SCLC and
1) Has treatment?
2) Has no treatment?
16 months with treatment
8 months without treatment
What is the average survival for a patient with advanced small cell lung cancer and has treatment?
8 months with treatment
What does it mean when ‘the quality of life should be measured when treating a patient with cancer’.
It means that we have to be careful that if we are not curing the tumor, then we have to make sure that the side effects of the treatment aren’t worse than the illness alone.
The treatment has to be tolerable so make sure that there isn’t a risk of them dying from the treatment.
