Non-Operative Management of Lung Cancer

Question 1

Describe the principle management of inoperable NSCLC

Answer 1

• Surgery
• Radiotherapy: palliative or curable?
• Chemotherapy
• Combination?
• Targeted therapy

Question 2

Describe the prognosis of non-operative management of NSCLC

Answer 2

Stage III;

• Radical RT: 5YS = 20%
• Chemo: 2YS = 27%

Stage IV;

• Incurable
• Palliation essential
• Median survival >12 months with mono therapy

Stages III and IV chemo;

• 3 cycles as good as 6
• 1YS >40%

Question 3

Describe the principle management of SCLC

Answer 3

• Chemo of choice
• 4 cycles of combined drugs
• Early RT better
• ## Prophylactic cranial radiation recommended

Question 4

Describe other treatment strategies which are important in the palliation of lune cancer

Answer 4

a

Question 5

Describe the ECOG performance status

Answer 5

0 = asymptomatic
1 = symptomatic, light work
2 = rest <50% of the day
3 = rest >50% of the day
4 = bedboound
5 = dead

Question 6

Describe NSCLC adjuvant therapy

Answer 6

• Given post-operatively
• Chemo to increase survival
• RT detrimental in stages I and II
• Preoperative chemo shown to increase stage III survival
• Use induction chemo prior to RT

Question 7

Describe the prognosis of non-operative management of SCLC

Answer 7

• Response rate 90%
• Complete remission 60%
• MS doubled with treatment: 16 months
• 2YS = 15%
• ED: response rate 80%
• CR in 30%
• MS 10x with treatment: 8 months