Non-Small Cell Lung Cancer - Treatment Options by Stages

Stage IV

In stage IV (any T, any N, M1), the cancer has spread (metastasized) to other parts of the body.

Treatment Options. 1. Combination of two- or three-drug chemotherapies that include platinum-based and newer agents. Best patient candidates are those in otherwise good health who have a limited number of distant metastasized sites. Chemotherapy not recommended for patients with poor performance scores. 2. External-beam radiation for symptoms. 3. Paclitaxel or gemcitabine as a single agent. 5. Other clinical trials. 6. If metastasized cancer involves only one or two areas in the brain, it may respond to surgical resection followed by radiation to the brain.

Recurring or Additional New Tumors

Recurring or additional new tumors occur in half of treated patients, usually again in the lung. Research indicates that a solitary tumor in the lung is more often a new tumor that, in many cases, may be operable.

Treatment Options. 1. Radiation for symptom control. 2. Chemotherapy. 3. If metastasized cancer strikes only one site and in the brain, it may be treated surgically and with postoperative whole-brain radiation. Prolonged disease-free survival is possible. If not operable, the brain tumor is treated with radiation. Even if cancer returns in the brain (in 50% of cases), retreatment is possible in many patients if the disease has not metastasized elsewhere. 4. Laser therapy or interstitial radiation for tumors within the airways. 5. Stereotactic radiosurgery (in a few selected patients).

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