Non small cell lung cancer medical therapy stage I
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alonso Alvarado, M.D. [2]Maria Fernanda Villarreal, M.D. [3]
Overview
Therapies for non-small cell lung cancer stage I, include: surgery, radiation therapy, or surgery and chemotherapy (if the tumor size is larger than 4cm).
Management Approach for Stage I Non-Small Cell Lung Cancer
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]
Is the tumor central o peripheral? | |||||||||||||||||||||||||||||||||||||||||||
Peripheral | Central | ||||||||||||||||||||||||||||||||||||||||||
Is the tumor T1 or T2a? | |||||||||||||||||||||||||||||||||||||||||||
T1ab, N0 | T2a, N0 | T1ab-2a, N0 | |||||||||||||||||||||||||||||||||||||||||
Perform a pretreatment evaluation
| Perform a pretreatment evaluation | ||||||||||||||||||||||||||||||||||||||||||
Does the pathological evaluation showed positive disease in the mediastinal lymph nodes? | 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 | ||||||||||||||||||||||||||||||||||||||||||