Saturday, February, 11, 2012

Non-Small Cell Lung Cancer - Staging Systems

Table of Contents

Treatment for stage IA and IB lung cancer includes:

  • Lobectomy (removal of a whole lobe) or sometimes pneumonectomy (removal of one lung).
  • Wedge or segment removal, particularly in patients with poor lung function who cannot handle lobectomy.
  • Radiation in selected patients who would not tolerate having surgery or whose cancer is cannot be fully removed.
  • In general, chemotherapy is not done following surgery unless the tumor is not completely removed.

Stage II

In stage II the cancer cells have spread to nearby lymph nodes.

General Treatment Options. Surgery, usually removal of a lobe (lobectomy) or one lung (pneumonectomy), is the treatment of choice. Radiation treatment after surgery does not seem to improve survival.

If the tumor is completely removed, radiation therapy is usually not performed after surgery. Patients whose cancer is inoperable may consider radiation and chemotherapy treatments.

Patients who do well after surgical removal of the tumor often receive a platinum-based chemotherapy regimen.

In patients who can complete treatment, 5-year survival rates average around 45% for stage IIA and around 35% for stage IIB.

Stage III

In stage III, the cancer cells have spread beyond the lung to the chest wall, diaphragm, or further lymph nodes, such as those in the neck.

General Treatment Options. Generally, the treatment options for stage III tumors are:

  • Surgery, if the tumor and affected lympth nodes can be completely removed.
  • Consider chemotherapy or radiation therapy before or after surgery.
  • Consider clinical trials using advanced radiation techniques, including continuous hyperfractionated accelerated radiation, or 3-D conformal radiation (discussed below).
  • Consider other clinical trials, including those of various combination treatments, preventive radiation therapy to the brain and new drugs.

Combination approaches may be significantly more effective than single treatments.

Review Date: 07/01/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)