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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