Non small cell lung cancer medical therapy stage I: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Non small cell lung cancer}} | {{Non small cell lung cancer}} | ||
{{CMG}}; {{AE}} {{Alonso}}{{MV}} | |||
{{CMG}}; {{AE}} {{Alonso}} | |||
==Overview== | ==Overview== | ||
Therapies for non-small cell lung cancer stage I include [[surgery]], [[radiation therapy]], or [[surgery]] and [[chemotherapy]] (if the tumor size is larger than 4cm). | |||
==Management Approach for Stage I Non-Small Cell Lung Cancer== | |||
Shown below is the algorithm on the treatment of the stage I non-small cell lung cancer based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.<ref name="NCCN">http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf</ref> | |||
== | {{familytree/start}} | ||
{{familytree | | | | | | | | | | A01 | | |A01=Is the [[tumor]] central or peripheral?}} | |||
{{familytree | | | | | | |,|-|-|-|^|-|-|.| | | | |}} | |||
{{familytree | | | | | | B01 | | | | | B02 | | | B01=Peripheral|B02=Central}} | |||
{{familytree | | | | | | |!| | | | | | |!| | |}} | |||
{{familytree | | | | | | C01 | | | | | |!| | | C01=Is the [[tumor]] T1 or T2a?}} | |||
{{familytree | | | |,|-|-|^|-|-|.| | | |!| | | |}} | |||
{{familytree | | | D01 | | | | D02 | | D03 | | | D01=T1ab, N0|D02=T2a, N0|D03=T1ab-2a, N0}} | |||
{{familytree | | | |!| | | | | |`|-|v|-|'| | | |}} | |||
{{familytree | | | E01 | | | | | | E02 | | | | E01='''Perform a pretreatment evaluation'''<br> | |||
* If not done, perform [[pulmonary function tests]]<br> | |||
* Perform [[bronchoscopy]] (if possible intraoperative)<br> | |||
* Perform a pathological [[lymph node evaluation]]<br> | |||
* If not done, order [[PET]] scan or [[CT scan]] | |||
|E02='''Perform a pretreatment evaluation'''<br> | |||
* If not done, perform [[pulmonary function tests]]<br> | |||
* Perform [[bronchoscopy]] (if possible intraoperative)<br> | |||
* Perform a pathological [[lymph node]] evaluation<br> | |||
* If not done, order [[PET]] scan or [[CT scan]]}} | |||
{{familytree | | | |!| | | | | | | |!| | | | |}} | |||
{{familytree | | | F01 | | | | | | F02 | | | | | F01=Does the pathological evaluation showed positive disease in the mediastinal [[lymph nodes]]?|F02=Does the pathological evaluation showed positive disease in the mediastinal [[lymph nodes]]?}} | |||
{{familytree | |,|-|^|-|.| | | |,|-|^|-|.| | |}} | |||
{{familytree | G01 | | G02 | | G03 | | G04 | | G01=Yes|G02=No|G03=Yes|G04=No}} | |||
{{familytree | |!| | | |!| | | |!| | | |!| | | |}} | |||
{{familytree | H01 | | H02 | | H03 | | H04 | | | | H01=[[Non small cell lung cancer medical therapy stage III|Click here for the stage III treatment]]|H02=Is the [[tumor]] operable?|H03=[[Non small cell lung cancer medical therapy stage III|Click here for the stage III treatment]]|H04=Is the tumor operable?}} | |||
{{familytree | | | |,|-|^|-|.| | | |,|-|^|-|.| | |}} | |||
{{familytree | | | I01 | | I02 | | I03 | | I04 | | | I01=Yes|I02=No|I03=Yes|I04=No}} | |||
{{familytree | | | |!| | | |!| | | |!| | | |!| | | |}} | |||
{{familytree | | | J01 | | J02 | | J03 | | J04 | | | J01=Surgical resection + [[lymph node]] dissection|J02=[[Non small cell lung cancer radiation therapy#Stereotactic Ablative Radiotherapy Usual Dosage|stereotactic ablative radiation therapy]]|J03=Surgical resection + [[lymph node]] dissection|J04=Does the patient presents metastasis to ipsilateral peribronchial and/or hiliar nodesand intrapulmonar nodes (N1)?}} | |||
{{familytree | | | | | | | | | | | | | |,|-|^|-|.| | |}} | |||
{{familytree | | | | | | | | | | | | | K01 | | K02 | | |K01=Yes|K02=No}} | |||
{{familytree | | | | | | | | | | | | | |!| | | |!| | | |}} | |||
{{familytree | | | | | | | | | | | | | L01 | | L02 | | | L01=[[Non small cell lung cancer chemotherapy#Chemotherapy plus radiation therapy|chemotherapy + radiation therapy]]|L02=[[Non small cell lung cancer radiation therapy#Stereotactic Ablative Radiotherapy Usual Dosage|stereotactic ablative radiation therapy]]<br>Adjuvant [[Non small cell lung cancer chemotherapy|chemotherapy]] should be added for high-risk stages}} | |||
{{familytree/end}} | |||
==References== | |||
{{reflist|2}} | |||
[[Category:Disease]] | [[Category:Disease]] | ||
Line 17: | Line 52: | ||
[[Category:Pulmonology]] | [[Category:Pulmonology]] | ||
[[Category:Lung cancer]] | [[Category:Lung cancer]] | ||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | [[Category:Oncology]] | ||
[[Category:Medicine]] | |||
[[Category:Pulmonology]] | |||
[[Category:Surgery]] |
Latest revision as of 23:18, 23 February 2018
Non Small Cell Lung Cancer Microchapters |
Differentiating Non Small Cell Lung Cancer from other Diseases |
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Diagnosis |
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Non small cell lung cancer medical therapy stage I On the Web |
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Non small cell lung cancer medical therapy stage I in the news |
Directions to Hospitals Treating Non small cell carcinoma of the lung |
Risk calculators and risk factors for Non small cell lung cancer medical therapy stage I |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]Maria Fernanda Villarreal, M.D. [3]
Overview
Therapies for non-small cell lung cancer stage I include surgery, radiation therapy, or surgery and chemotherapy (if the tumor size is larger than 4cm).
Management Approach for Stage I Non-Small Cell Lung Cancer
Shown below is the algorithm on the treatment of the stage I non-small cell lung cancer based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.[1]
Is the tumor central or peripheral? | |||||||||||||||||||||||||||||||||||||||||||
Peripheral | Central | ||||||||||||||||||||||||||||||||||||||||||
Is the tumor T1 or T2a? | |||||||||||||||||||||||||||||||||||||||||||
T1ab, N0 | T2a, N0 | T1ab-2a, N0 | |||||||||||||||||||||||||||||||||||||||||
Perform a pretreatment evaluation
| Perform a pretreatment evaluation | ||||||||||||||||||||||||||||||||||||||||||
Does the pathological evaluation showed positive disease in the mediastinal lymph nodes? | Does the pathological evaluation showed positive disease in the mediastinal lymph nodes? | ||||||||||||||||||||||||||||||||||||||||||
Yes | No | Yes | No | ||||||||||||||||||||||||||||||||||||||||
Click here for the stage III treatment | Is the tumor operable? | Click here for the stage III treatment | Is the tumor operable? | ||||||||||||||||||||||||||||||||||||||||
Yes | No | Yes | No | ||||||||||||||||||||||||||||||||||||||||
Surgical resection + lymph node dissection | stereotactic ablative radiation therapy | Surgical resection + lymph node dissection | Does the patient presents metastasis to ipsilateral peribronchial and/or hiliar nodesand intrapulmonar nodes (N1)? | ||||||||||||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||||||||||||||
chemotherapy + radiation therapy | stereotactic ablative radiation therapy Adjuvant chemotherapy should be added for high-risk stages | ||||||||||||||||||||||||||||||||||||||||||