Non-operative Management of Lung Cancer

Question 1

Describe the principles of management of inoperable, non- small cell lung cancer with radiotherapy and/or chemotherapy, the side effects of these treatments and their likely outcomes.

Answer 1

Doubling time of 129 days(more common), staging using TNM and around 25% operable
Chemotherapy/ radiotherapy but patient must be reviewed for fitness
side effects: SOB due to pneumonitis, lethargy, oesophagitis, pulmonary fibrosis

Question 2

Describe the principles of management of small cell lung cancer.

Answer 2

Not as common and doubling time of 29 days
Use chemo/ radio/ immunotherapy

Question 3

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

Answer 3

chemotherapy, immunotherapy, TKI, (tyrosine kinase inhibitors), palliative radiotherapy
Palliative immunotherapy- don’t need to be as fit

Question 4

what is SABR

Answer 4

stereotactic ablative radiotherapy can have similar outcomes to surgery. Can give a similar dose over three fractions rather than 20. Can be used if masses 2 cm away from central structures

Question 5

side effects of chemotherapy

Answer 5

marrow surpression, nausea, vomiting, GI upset, increased risk of stroke, renal impairment, hair loss

Question 6

side effects of radiotherapy

Answer 6

lethargy, risk to surrounding organs, acute pneumotisi, dysphagia (swallowing problems)