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NSCLC Treatment by Stage

Overview
CIS & Stage I
Stage II & IIIA
Stage IIIB & IV

Overview

General Information About Non-Small Cell Lung Cancer (NCI's cancer.gov)
Outline of treatment options for non-small cell lung cancer presented by stage. Aimed at patients. See also the physician version. [6/03]



CIS & Stage I

Treatment of Stage I NSCLC (CHEST)
Abstract of the evidence-based lung cancer treatment guideline published by the American College of Chest Physicians (ACCP) in the supplement to the January 2003 issue of CHEST. Recommends that Stage I NSCLC patients who are medically fit be considered for aggressive local therapy. Notes that curative treatment is possible and that surgical resection is the accepted treatment for Stage I patients. Neoadjuvant chemotherapy (chemotherapy prior to surgery) is feasible and safe with trials ongoing to further elucidate efficacy. Primary radiation therapy should be considered for inoperable patients. Additional recommendations and assessments are included. Aimed at physicians. [1/03]

Treatment of Early Stage NSCLC (CHEST)
Abstract of the evidence-based lung cancer treatment guideline published by the American College of Chest Physicians (ACCP) in the supplement to the January 2003 issue of CHEST. Photodynamic therapy (PDT), brachytherapy, electrocautery, cryotherapy, and Nd-YAG laser therapy are therapeutic options that have been used recently for primary treatment of early radiographically occult cancers. Reviews the evidence for the use of these treatment options in the management of early lug cancer. Additional recommendations and assessments are included. Aimed at physicians. [1/03]

Postoperative Adjuvant Therapy for Stage 1B NSCLC (EJCTS)
Abstract of a study reported in the August 2001 issue of the European Journal of Cardiothoracic Surgery that concluded adjuvant chemotherapy may reduce recurrences and prolong overall survival in Stage IB NSCLC patients deemed radically operated. [8/01]

Endoscopic Treatment of Early-Stage Lung Cancer (Moffitt Cancer Center))
by Francis D. Sheski, MD and Praveen N. Mathur, MBBS
v.7, no. 1 Cancer Control (Jan./Feb. 2000)
Discusses detection (by fluorescence bronchoscopy) and potential endoscopic treatment of lung carcinoma in situ (CIS). Reviews endoscopic techniques, including photodynamic therapy, laser therapy (Nd:YAG), brachytherapy, electrocautery, and cryotherapy. Aimed at physicians. Registration required for free access to Medscape. [2/00]

Treatment of Stage I NSCLC - Recent MEDLINE Abstracts



Stage II & IIIA

Treatment of Stage II NSCLC (CHEST)
Abstract of the evidence-based lung cancer treatment guideline published by the American College of Chest Physicians (ACCP) in the supplement to the January 2003 issue of CHEST. Notes that Stage II NSCLC patients are a heterogeneous group and that the extent of data regarding treatment is limited, except for the case of adjuvant therapy. Additional recommendations and assessments are included. Aimed at physicians. [1/03]

Treatment of Stage IIIA NSCLC (CHEST)
Abstract of the evidence-based lung cancer treatment guideline published by the American College of Chest Physicians (ACCP) in the supplement to the January 2003 issue of CHEST. Notes that Stage IIIA NSCLC patients represent a relatively heterogeneous group of patients with disease range from apparently resectable tumors with occult microscopic nodal metastases to unresectable, bulky multistation nodal disease. Notes that controversy abounds as to the optimal treatment of the various stage IIIA subsets. Multimodality therapy of some type appears to be preferable in stage IIIA patients. Additional recommendations and assessments are included. Aimed at physicians. [1/03]

Three-Pronged Approach an Added Treatment Option for NSCLC Spread to Surrounding Lymph Nodes (NCI's cancer.gov)
Reports on a study presented at the 2003 ASCO annual meeting that found patients with NSCLC that has spread to surrounding lymph nodes who were treated with a three-pronged approach using chemotherapy, radiation and surgery lived longer than patients treated with just chemotherapy and radiation. Notes that it remains unclear whether three-pronged treatment extends patients' overall survival compared to the two-pronged approach. [6/03]

Stage III Lung Cancer: More to be Done (Medscape)
Summarizes the issues surrounding optimal management of stage III NSCLC as presented at the ASCO 2001 lung cancer poster session. Aimed at physicians. Registration required for free access to Medscape. [5/01]

What is the Optimal Treatment for Stage IIIA NSCLC?
(cancernetwork.com)
by John C. Ruckdeschel, MD
from "Cancer Consultations: Lung Cancer"
v.20, no.10 Primary Care & Cancer (November/December 2000)
Provides a general overview of the standard of care for stage IIIA NSCLC. Registration required for free access to cancernetwork.com. [12/00]

A Randomized Trial of Postoperative Adjuvant Therapy in Patients with Completely Resected Stage II or IIIA NSCLC (New England Journal of Medicine)
Abstract of a study published in the October 26, 2000 issue of the New England Journal of Medicine that found when compared with radiotherapy alone, adjuvant radiotherapy and chemotherapy with cisplatin and etoposide does not decrease the risk of intrathoracic recurrence or prolong survival in patients with completely resected stage II or IIIA NSCLC. [10/00]

Neoadjuvant Docetaxel (Taxotere) Improves Life Expectancy in Locally Advanced Lung Cancer
(Doctor's Guide)
Reports research presented at the 9th World Congress on Lung Cancer that showed docetaxel (Taxotere) used as neoadjuvant therapy improves survival over local treatment alone in patients with locally advanced NSCLC. [9/00]

Mediastinal Lymph Node Dissection Improves Survival In Patients with Stages II and IIIA NSCLC. Eastern Cooperative Oncology Group (PubMed)
Abstract of a nonrandomized study published in the August 2000 issue of the Annals of Thoracic Surgery that compared the impact of systematic sampling (SS) vs. complete mediastinal lymph node dissection (MLND) on the identification of mediastinal lymph node metastases and survival in patients with NSCLC. SS was found to be as efficacious as complete MLND in staging patients with NSCLC. However, complete MLND identified significantly more levels of N2 disease. Furthermore, complete MLND was associated with improved survival with right NSCLC when compared with SS. [8/00]

"Current Management of Lung Cancer with Preoperatively-Identified Mediastinal Nodal Disease (N2 and N3)" (CTSNet)
by Robert J. Ginsberg, MD - General Thoracic Surgery FAQ Addresses issues related to the treatment and management of NSCLC patients with N2 and N3 staged nodal disease. Intended for physicians. [n.b., undated]

Treatment of Stage II NSCLC - Recent MEDLINE Abstracts

Treatment of Stage IIIA NSCLC - Recent MEDLINE Abstracts



Stage IIIB & IV

First-line Chemotherapy Options for Patients with Advanced NSCLC (Medscape)
by Konstantin Dragnev, MD and James Rigas, MD
This article examines the first-line chemotherapy options for patients with advanced NSCLC and reviews the major trials supporting the use of platinum-based regimens. Aimed at physicians. Registration required for free access to Medscape. [2/05]

ASCO Treatment of Unresectable NSCLC Lung Cancer Guideline: Update 2003 (Journal of Clinical Oncology)
by David G. Pfister, et al
v.22, no.2, Journal of Clinical Oncology (January 15, 2004): 330-346
Clinical practice guidelines from the American Society for Clinical Oncology (ASCO) for the diagnostic evaluation, treatment and follow-up care of patients with surgically unresectable stage III and IV NSCLC. These guidelines are intended for use by oncologists in the care of patients outside of clinical trials. Recommendations from the 1997 guidelines are listed, followed by an updated (2003) recommendation. [1/04]

Treatment of Stage IIIB NSCLC (CHEST)
Abstract of the evidence-based lung cancer treatment guideline published by the American College of Chest Physicians (ACCP) in the supplement to the January 2003 issue of CHEST. Notes that surgery may be indicated only for carefully selected Stage IIIB patients. Patients with N3 lymph node involvement are not considered as surgical candidates. For patients with unresectable disease, good performance score, and minimal weight loss, treatment with combined chemotherapy and radiotherapy has resulted in better survival than treatment with radiotherapy alone. Multiple daily fractions of radiotherapy have not resulted in improved survival compared with standard fractionation once daily. Concurrent chemoradiotherapy appears to be associated with improved survival compared with sequential chemotherapy and radiotherapy. Treatment of stage IIIB due to malignant pleural effusion is addressed. Additional recommendations and assessments are included. Aimed at physicians. [1/03]

Treatment of Stage IV NSCLC (CHEST)
Abstract of the evidence-based lung cancer treatment guideline published by the American College of Chest Physicians (ACCP) in the supplement to the January 2003 issue of CHEST. Notes that Stage IV non-small cell lung cancer (NSCLC) denotes the presence of metastatic disease and is largely incurable using present-day therapies. Discusses the use of chemotherapy and the issues surrounding its use in patients with stage IV NSCLC, including the identification of prognostic factors in selecting patients for chemotherapy and a critical analysis of the survival benefit provided by chemotherapy. Given the fact that chemotherapy does not represent a curative option, other issues are addressed, including the optimal duration of treatment as well as its impact on symptom relief and quality of life, the role of second-line therapy, and the outcomes expectations from both first-line and second-line chemotherapy. Notes that there are several regimens that can be considered "standard-of-care" options in the first line setting. Additional recommendations and assessments are included. Aimed at physicians. [1/03]

Chemotherapy in Advanced NSCLC (Medscape)
Summary, by Tracey L. Evans, MD, of results of chemotherapy trials for NSCLC presented at ASCO 2001. Aimed at physicians. Registration required for free access to Medscape. [5/01]

New Investigations Question Need for Cisplatin in Advanced NSCLC (cancernetwork.com)
v.9, no.11, Suppl.6 Oncology News (November 2000)
Discusses the results of the European Organization for Research and Treatment of Cancer trial (EORTC 08975) which compared the non-platinum doublet gemcitabine (Gemzar) and paclitaxel (Taxol) with gemcitabine/cisplatin and paclitaxel/cisplatin in patients with advanced NSCLC. Discusses the ultimate goal of finding chemotherapeutic strategies that are as effective as platinum- based therapy, but are better tolerated and more cost effective [11/00].

Consolidation Docetaxel After Chemoradiotherapy Encouraging in NSCLC (Doctor's Guide)
Reports on a study published in the May 15, 2003 issue of the Journal of Clinical Oncology that found the use of docetaxel (Taxotere) after cisplatin/etoposide plus radiotherapy produces high survival rates in patients with Stage IIIB NSCLC. [5/03]

Benefit of Surgery after Chemoradiotherapy in Stage IIIB (T4 and/or N3) NSCLC (PubMed)
Abstract of an article in the October 2001 issue of the Journal of Thoracic and Cardiovascular Surgery indicating that surgery in stage IIIB NSCLC patients, when feasible, is associated with 28% long-term survival for patients in whom chemoradiotherapy alone fails to control disease. [10/01]

Endobronchial Management of Advanced Lung Cancer (Medscape)
by Michael J. Simoff, MD
8(4) Cancer Control (2001):337-343
Reviews the use of several endobronchial treatment modalities, including rigid and flexible bronchoscopy, laser therapy, endobronchial prosthesis, and photodynamic therapy. Recommends that these modalities be used to supplement traditional therapies for advanced lung cancer to provide symptom palliation and improved quality of life. Aimed at physicians. Registration required for free access to Medscape. [2001]

Treatment of Stage IIIB NSCLC - Recent MEDLINE Abstracts

Treatment of Stage IV NSCLC - Recent MEDLINE Abstracts



 

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Last modified: 27-Apr-2011
Karen Parles, MLS Editor