Adenocarcinoma of the lung medical therapy1

Multiple Lung Cancers

• The algorithm for the treatment of multiple non small cell lung cancers are based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.

Is there suspicion of multiple lung cancers?

Yes

No

Perform the following tests: If not previously done, PET scan or CT scan Contrast chest CT Brain MRI

Administer treatment according to the TNM stage of the tumor

Is the disease is confined to the chest or is there systemic proliferation?

Disease confined to the chest

Systemic proliferation

Assess the mediastinal lymph nodes in order to determine the N stage of the tumor

Click here for the treatment of systemic metastasis

What is the N stage of the tumor?

N0-1

N2-3

Is the patient symptomatic?

Click here for the treatment of systemic metastasis

Yes

No

Is the lesion a solitary nodule or are there multiple nodules?

Solitary nodule

Multiple nodules

What is the risk of turning into a symptomatic disease?

High

Low

Is definitive local therapy possible?

Observation

No

Yes

Consider palliative chemotherapy with or without local Radiation therapy

Administer one of the following treatments: Preferred option: Parenchymal sparing resection Radiation therapy Ablation therapy

Click here for the treatment of systemic metastasis

Go to the appropriate algorithm according to the characteristics of the disease: local or regional recurrence or metastasis