Non small cell lung cancer medical therapy stage II: Difference between revisions
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{{familytree | F01 | | F02 | | | F01=[[Non small cell carcinoma of the lung medical therapy stage III|Click here for the stage III treatment]]|F02=Is the [[tumor]] operable?}} | {{familytree | F01 | | F02 | | | F01=[[Non small cell carcinoma of the lung medical therapy stage III|Click here for the stage III treatment]]|F02=Is the [[tumor]] operable?}} | ||
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{{familytree | | | | {{familytree | | G01 | | | | G02 | | G01=Yes|G02=No}} | ||
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{{familytree | | | | {{familytree | | H01 | | | | H02 | | | | H01=Surgical resection + [[lymph node]] dissection|H02=Does the patient presents metastasis to ipsilateral [[Tracheobroncuial lymph nodes|peribronchial]] and/or [[Tracheobroncuial lymph nodes|hiliar nodes]] and intrapulmonar nodes (N1)?}} | ||
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{{familytree | | | {{familytree | | I03 | | I01 | | I02 | | | | | I01=Yes|I02=No|I03=If lymph node extension is detected initiate neoadjuvant[[Non small cell carcinoma of the lung chemotherapy#Chemotherapy plus radiation therapy|chemotherapy + radiation therapy]]}} | ||
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{{familytree | | | | | J01 | | J02 | | J01=[[Non small cell carcinoma of the lung chemotherapy#Chemotherapy plus Radiation Therapy|chemotherapy + radiation therapy]]|J02=[[Non small cell carcinoma of the lung medical therapy radiation therapy|radiation therapy with stereotactic ablative radiotherapy]]<br>Adjuvant [[Non small cell carcinoma of the lung chemotherapy|Chemotherapy]] should be added for high-risk stages}} | {{familytree | | | | | | J01 | | J02 | | J01=[[Non small cell carcinoma of the lung chemotherapy#Chemotherapy plus Radiation Therapy|chemotherapy + radiation therapy]]|J02=[[Non small cell carcinoma of the lung medical therapy radiation therapy|radiation therapy with stereotactic ablative radiotherapy]]<br>Adjuvant [[Non small cell carcinoma of the lung chemotherapy|Chemotherapy]] should be added for high-risk stages}} | ||
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Revision as of 03:43, 27 June 2014
Non Small Cell Lung Cancer Microchapters |
Differentiating Non Small Cell Lung Cancer from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]
Overview
Medical Therapy for Stage II Non-Small Cell Lung Cancer
Stage IIA
Shown below is the algorithm on the treatment of the stage IIA non-small cell lung cancer based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.[1]
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Perform a pretreatment evaluation
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Does the pathological evaluation showed positive disease in the mediastinal lymph nodes? | |||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||
Click here for the stage III treatment | Is the tumor operable? | ||||||||||||||||||||||||||||||
Yes | No | ||||||||||||||||||||||||||||||
Surgical resection + lymph node dissection | Does the patient presents metastasis to ipsilateral peribronchial and/or hiliar nodes and intrapulmonar nodes (N1)? | ||||||||||||||||||||||||||||||
If lymph node extension is detected initiate neoadjuvantchemotherapy + radiation therapy | Yes | No | |||||||||||||||||||||||||||||
chemotherapy + radiation therapy | radiation therapy with stereotactic ablative radiotherapy Adjuvant Chemotherapy should be added for high-risk stages | ||||||||||||||||||||||||||||||
Stage IIB
Shown below is the algorithm on the treatment of the stage IIB non-small cell lung cancer based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.[1]
Perform a pretreatment evaluation
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What is the location of the tumor? | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Superior suculus tumor | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
T3 (Invasion to adjacent structures), N0 | Preferred option: Surgery + pathological determination of microscopic residual tumor | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Neoadjuvant chemotherapy | Are margins from the surgical piece positive or negative for residual tumor? | Perform surgery + pathological determination of residual tumor | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Surgery + adjuvant chemotherapy | Negative (R0) | Positive: Is the residual tumor microscopic (R1) or macroscopic (R2) | Are margins from the surgical piece positive or negative for residual tumor? | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Adjuvant chemotherapy | Microscopic (R1) | Macroscopic (R2) | Negative (R0) | Positive (R1-2) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
Tumor resection + adjuvant chemotherapy OR chemotherapy + radiation therapy, followed or not by chemotherapy | Tumor resection + adjuvant chemotherapy OR chemotherapy + radiation therapy | Observation | Tumor resection | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||