Adenocarcinoma of the lung medical therapy: Difference between revisions

	Adenocarcinoma of the Lung Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Adenocarcinoma of the Lung from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Electrocardiogram
X Ray
Echocardiography and Ultrasound
CT
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Intervention
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Adenocarcinoma of the lung medical therapy On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Adenocarcinoma of the lung medical therapy All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Adenocarcinoma of the lung medical therapy
CDC on Adenocarcinoma of the lung medical therapy
Adenocarcinoma of the lung medical therapy in the news
Blogs on Adenocarcinoma of the lung medical therapy
Directions to Hospitals Treating Adenocarcinoma of the lung
Risk calculators and risk factors for Adenocarcinoma of the lung medical therapy

← Older edit Newer edit →

VisualWikitext

Revision as of 18:45, 5 January 2016

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2]

Overview

Medical Therapy

Stage I

Shown below is the algorithm on the treatment of the stage I non-small cell lung cancer based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.^[1]

In the tumor central o peripheral?

Peripheral

Central

Is the tumor T1 or T2a?

T1ab, N0

T2a, N0

T1ab-2a, N0

Perform a pretreatment evaluation

If not done, perform pulmonary function tests
Perform bronchoscopy (if possible intraoperative)
Perform a pathological lymph node evaluation
If not done, order PET scan or CT scan

Perform a pretreatment evaluation

If not done, perform pulmonary function tests

Perform bronchoscopy (if possible intraoperative)

Perform a pathological lymph node evaluation

If not done, order PET scan or CT scan

Does the pathological evaluation showed positive disease in the mediastinal lymph nodes?

Yes

No

Yes

No

Click here for the stage III treatment

Is the tumor operable?

Click here for the stage III treatment

Is the tumor operable?

Yes

No

Yes

No

Surgical resection + lymph node dissection

stereotactic ablative radiation therapy

Surgical resection + lymph node dissection

Does the patient presents metastasis to ipsilateral peribronchial and/or hiliar nodesand intrapulmonar nodes (N1)?

Yes

No

chemotherapy + radiation therapy

stereotactic ablative radiation therapy
Adjuvant chemotherapy should be added for high-risk stages

References

↑ http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf

Template:WikiDoc Sources

[NCCN-1] ttp://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf

[1]

@@ Line 3: / Line 3: @@
 {{CMG}}; {{AE}} {{SC}}
 ==Overview==
-==Management==
+==Medical Therapy==
-[[Targeted therapy]] is available for lung adenocarcinomas with certain mutations. [[Crizotinib]] is effective in tumors with fusions involving ALK or ROS1, whereas [[gefitinib]], [[erlotinib]], and [[afatinib]] are used in patients whose tumors have mutations in EGFR.<ref name=WCR20145.1/>
+===Stage I===
+Shown below is the algorithm on the treatment of the stage I non-small cell lung cancer based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.<ref name="NCCN">http://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf</ref>
+{{familytree/start}}
-Targeted therapies: ALK and ROS1 fusions proteins are both sensitive to treatment with the new ALK tyrosine kinase inhibitors (see the [[Atlas of Genetics and Cytogenetics in Oncology and Haematology]],<ref>{{cite web|url=http://Atlasgeneticsoncology.org|title=Atlas of Genetics and Cytogenetics in Oncology and Haematology|work=atlasgeneticsoncology.org}}</ref>).
+{{familytree | | | | | | | | | | A01 | | |A01=In the [[tumor]] central o peripheral?}}
+{{familytree | | | | | | |,|-|-|-|^|-|-|.| | | | |}}
+{{familytree | | | | | | B01 | | | | | B02 | | | B01=Peripheral|B02=Central}}
+{{familytree | | | | | | |!| | | | | | |!| | |}}
+{{familytree | | | | | | C01 | | | | | |!| | | C01=Is the [[tumor]] T1 or T2a?}}
+{{familytree | | | |,|-|-|^|-|-|.| | | |!| | | |}}
+{{familytree | | | D01 | | | | D02 | | D03 | | | D01=T1ab, N0|D02=T2a, N0|D03=T1ab-2a, N0}}
+{{familytree | | | |!| | | | | |`|-|v|-|'| | | |}}
+{{familytree | | | E01 | | | | | | E02 | | | | E01='''Perform a pretreatment evaluation'''<br>
+* If not done, perform [[pulmonary function tests]]<br>
+* Perform [[bronchoscopy]] (if possible intraoperative)<br>
+* Perform a pathological [[lymph node evaluation]]<br>
+* If not done, order [[PET]] scan or [[CT scan]]
+|E02='''Perform a pretreatment evaluation'''<br>
+* If not done, perform [[pulmonary function tests]]<br>
+* Perform [[bronchoscopy]] (if possible intraoperative)<br>
+* Perform a pathological [[lymph node]] evaluation<br>
+* If not done, order [[PET]] scan or [[CT scan]]}}
+{{familytree | | | |!| | | | | | | |!| | | | |}}
+{{familytree | | | F01 | | | | | | F02 | | | | | F01=Does the pathological evaluation showed positive disease in the mediastinal [[lymph nodes]]?|F02=Does the pathological evaluation showed positive disease in the mediastinal [[lymph nodes]]?}}
+{{familytree | |,|-|^|-|.| | | |,|-|^|-|.| | |}}
+{{familytree | G01 | | G02 | | G03 | | G04 | | G01=Yes|G02=No|G03=Yes|G04=No}}
+{{familytree | |!| | | |!| | | |!| | | |!| | | |}}
+{{familytree | H01 | | H02 | | H03 | | H04 | | | | H01=[[Non small cell carcinoma of the lung medical therapy stage III|Click here for the stage III treatment]]|H02=Is the [[tumor]] operable?|H03=[[Non small cell carcinoma of the lung medical therapy stage III|Click here for the stage III treatment]]|H04=Is the tumor operable?}}
+{{familytree | | | |,|-|^|-|.| | | |,|-|^|-|.| | |}}
+{{familytree | | | I01 | | I02 | | I03 | | I04 | | | I01=Yes|I02=No|I03=Yes|I04=No}}
+{{familytree | | | |!| | | |!| | | |!| | | |!| | | |}}
+{{familytree | | | J01 | | J02 | | J03 | | J04 | | | J01=Surgical resection + [[lymph node]] dissection|J02=[[Non small cell carcinoma of the lung radiation therapy#Stereotactic Ablative Radiotherapy Usual Dosage|stereotactic ablative radiation therapy]]|J03=Surgical resection + [[lymph node]] dissection|J04=Does the patient presents metastasis to ipsilateral peribronchial and/or hiliar nodesand intrapulmonar nodes (N1)?}}
+{{familytree | | | | | | | | | | | | | |,|-|^|-|.| | |}}
+{{familytree | | | | | | | | | | | | | K01 | | K02 | | |K01=Yes|K02=No}}
+{{familytree | | | | | | | | | | | | | |!| | | |!| | | |}}
+{{familytree | | | | | | | | | | | | | L01 | | L02 | | | L01=[[Non small cell carcinoma of the lung chemotherapy#Chemotherapy plus radiation therapy|chemotherapy + radiation therapy]]|L02=[[Non small cell carcinoma of the lung radiation therapy#Stereotactic Ablative Radiotherapy Usual Dosage|stereotactic ablative radiation therapy]]<br>Adjuvant [[Non small cell carcinoma of the lung chemotherapy|chemotherapy]] should be added for high-risk stages}}
+{{familytree/end}}
 ==References==
 {{reflist|2}}