Lung cancer

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Lung cancer
Cross section of a human lung. The white area in the upper lobe is cancer; the black areas indicate the patient was a smoker.
ICD-10 C33-C34
ICD-9 162
DiseasesDB 7616
MedlinePlus 007194
eMedicine med/1333  med/1336 emerg/335 radio/807 radio/405 radio/406
MeSH D002283

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Associate Editor-In-Chief: Kim-Son Nguyen, M.D., Beth Israel Deaconess Medical Center, Boston MA, Cafer Zorkun, M.D., Ph.D. [2]

Please Join in Editing This Page and Apply to be an Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [3] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

Lung cancer, or carcinoma of the lung, is a disease where epithelial (internal lining) tissue in the lung grows out of control. This leads to metastasis, invasion of adjacent tissue and infiltration beyond the lungs. Lung cancer, the most common cause of cancer-related death in men and the second most common in women,[1][2] is responsible for 1.3 million deaths worldwide annually.[3] The most common symptoms are shortness of breath, coughing (including coughing up blood), and weight loss.[4]

The main types of lung cancer are small cell lung carcinoma and non-small cell lung carcinoma. This distinction is important because the treatment varies; non-small cell lung carcinoma (NSCLC) is sometimes treated with surgery, while small cell lung carcinoma (SCLC) usually responds better to chemotherapy.[5]

The most common cause of lung cancer is exposure to tobacco smoke.[6] The occurrence of lung cancer in non-smokers, who account for fewer than 10% of cases, appears to be due to a combination of genetic factors.[7][8] Radon gas,[9] asbestos,[10] and air pollution[11][12][13] may also contribute to lung cancer.

Lung cancer may be seen on chest x-ray and computed tomography (CT scan). The diagnosis is confirmed with a biopsy. This is usually performed via bronchoscopy or CT-guided biopsy.

Treatment and prognosis depend upon the histological type of cancer, the stage (degree of spread), and the patient's performance status. Possible treatments include surgery, chemotherapy, and radiotherapy. With treatment, the five-year survival rate is 14%.[4]

Historical Background

Lung cancer was extremely rare before the advent of cigarette smoking. Malignant lung tumors made up only 1% of all cancers seen at autopsy in 1878, but had risen to 10–15% by the early 1900s.[14] Case reports in the medical literature numbered only 374 worldwide in 1912.[15] A review of autopsies showed that that the incidence of lung cancer had increased from 0.3% in 1852 to 5.66% in 1952.[16] In Germany, in 1929 physician Fritz Lickint recognized the link between smoking and lung cancer.[14] This led to an aggressive anti-smoking campaign.[17] The British Doctors Study, published in the 1950s, was the first solid epidemiological evidence of the link between lung cancer and smoking.[18] As a result, in 1964 the Surgeon General of the United States recommended that smokers should stop smoking.[19]

The connection with radon gas was first recognized among miners in the Ore Mountains near Schneeberg, Saxony. Silver has been mined there since 1470. However these mines are rich in uranium, with accompanying radium and radon gas. Miners developed a disproportionate amount of lung disease, eventually recognized as lung cancer in the 1870s. An estimated 75% of former miners died from lung cancer. Despite this discovery, mining continued into the 1950s due to the USSR's need for uranium.[20]

Epidemiology and Demographics

Worldwide, lung cancer is the most common cancer in terms of both incidence and mortality with 1.35 million new cases per year and 1.18 million deaths, with the highest rates in Europe and North America.[21] The population segment most likely to develop lung cancer is over-fifties who have a history of smoking. Lung cancer is the second most commonly occurring form of cancer in most western countries, and it is the leading cancer-related cause of death. Although the rate of men dying from lung cancer is declining in western countries, it is actually increasing for women due to the increased takeup of smoking by this group. Among lifetime non-smokers, men have higher age-standardized lung cancer death rates than women.

Not all cases of lung cancer are due to smoking, but the role of passive smoking is increasingly being recognized as a risk factor for lung cancer, leading to policy interventions to decrease undesired exposure of non-smokers to others' tobacco smoke. Emissions from automobiles, factories and power plants also pose potential risks.[11][13][22]

Eastern Europe has the highest lung cancer mortality among men, while northern Europe and the U.S. have the highest mortality among women. Lung cancer incidence is currently less common in developing countries.[23] With increased smoking in developing countries, the incidence is expected to increase in the next few years, notably in China[24] and India.[25]


  • Lung cancer distribution in the United States.

    Lung cancer distribution in the United States.

Pathophysiology and Etiology

Main article: Carcinogenesis

Similar to many other cancers, lung cancer is initiated by activation of oncogenes or inactivation of tumor suppressor genes.[26] Oncogenes are genes that are believed to make people more susceptible to cancer. Proto-oncogenes are believed to turn into oncogenes when exposed to particular carcinogens.[27] Mutations in the K-ras proto-oncogene are responsible for 20–30% of non-small cell lung cancers.[28] Chromosomal damage can lead to loss of heterozygosity. This can cause inactivation of tumor suppressor genes. Damage to chromosomes 3p, 5q, 13q and 17p are particularly common in small cell lung carcinoma. The TP53 tumor suppressor gene, located on chromosome 17p, is often affected.[29]

Several genetic polymorphisms are associated with lung cancer. These include polymorphisms in genes coding for interleukin-1,[30] cytochrome P450,[31] apoptosis promoters such as caspase-8,[32] and DNA repair molecules such as XRCC1.[33] People with these polymorphisms are more likely to develop lung cancer after exposure to carcinogens.

The main causes of lung cancer (and cancer in general) include carcinogens (such as those in tobacco smoke), ionizing radiation, and viral infection. This exposure causes cumulative changes to the DNA in the tissue lining the bronchi of the lungs (the bronchial epithelium). As more tissue becomes damaged, eventually a cancer develops.[5]

Smoking

Smoking, particularly of cigarettes, is by far the main contributor to lung cancer. In the United States, smoking is estimated to account for 87% of lung cancer cases (90% in men and 85% in women).[34] Among male smokers, the lifetime risk of developing lung cancer is 17.2%. Among female smokers, the risk is 11.6%. This risk is significantly lower in non-smokers: 1.3% in men and 1.4% in women.[35] Cigarette smoke contains over 60 known carcinogens[36] including radioisotopes from the radon decay sequence, nitrosamine, and benzopyrene. Additionally, nicotine appears to depress the immune response to malignant growths in exposed tissue. The length of time a person smokes as well as the amount smoked increases the person's chance of developing lung cancer. If a person stops smoking, this chance steadily decreases as damage to the lungs is repaired and contaminant particles are gradually removed. Across the developed world, almost 90% of lung cancer deaths are caused by smoking.[37] In addition, there is evidence that lung cancer in never-smokers has a better prognosis than in smokers,[38] and that patients who smoke at the time of diagnosis have shorter survival than those who have quit.[39]


  • The incidence of lung cancer is highly correlated with smoking. Source: NIH.

    The incidence of lung cancer is highly correlated with smoking. Source: NIH.


Passive smoking—the inhalation of smoke from another's smoking—is a cause of lung cancer in non-smokers. Studies from the U.S.,[40] Europe,[41] the UK,[42] and Australia[43] have consistently shown a significant increase in relative risk among those exposed to passive smoke. Recent investigation of sidestream smoke suggests it is more dangerous than direct smoke inhalation.[44]

Radon gas

Radon is a colorless and odorless gas generated by the breakdown of radioactive radium, which in turn is the decay product of uranium, found in the earth's crust. The radiation decay products ionize genetic material, causing mutations that sometimes turn cancerous. Radon exposure is the second major cause of lung cancer after smoking.[9]

Radon gas levels vary by locality and the composition of the underlying soil and rocks. For example, in areas such as Cornwall in the UK (which has granite as substrata), radon gas is a major problem, and buildings have to be force-ventilated with fans to lower radon gas concentrations. The United States Environmental Protection Agency (EPA) estimates that one in 15 homes in the U.S. has radon levels above the recommended guideline of 4 picoCuries per liter (pCi/L).[45] Iowa has the highest average radon concentration in the United States; studies performed there have demonstrated a 50% increased lung cancer risk with prolonged radon exposure above the EPA's action level of 4 pCi/L.[46][47]

Asbestos

Asbestos can cause a variety of lung diseases, including lung cancer. There is a synergistic effect between tobacco smoking and asbestos in the formation of lung cancer.[10] In the UK, asbestos accounts for 2–3% of male lung cancer deaths.[48] Asbestos can also cause cancer of the pleura, called mesothelioma (which is different from lung cancer).

Viruses

Viruses are known to cause lung cancer in animals[49][50] and recent evidence suggests similar potential in humans. Implicated viruses include human papillomavirus,[51] JC virus,[52] simian virus 40 (SV40), BK virus and cytomegalovirus.[53] These viruses may affect the cell cycle and inhibit apoptosis, allowing uncontrolled cell division.

Diagnosis

Symptoms

Symptoms that suggest lung cancer include:[54]

If the cancer grows in the airway, it may obstruct airflow, causing breathing difficulties. This can lead to accumulation of secretions behind the blockage, predisposing the patient to pneumonia.

Many lung cancers have a rich blood supply. The surface of the cancer may be fragile, leading to bleeding from the cancer into the airway. This blood may subsequently be coughed up.

Depending on the type of tumor, so-called paraneoplastic phenomena may initially attract attention to the disease.[55] In lung cancer, these phenomena may include Lambert-Eaton myasthenic syndrome (muscle weakness due to auto-antibodies), hypercalcemia or syndrome of inappropriate antidiuretic hormone (SIADH). Tumors in the top (apex) of the lung, known as Pancoast tumors,[56] may invade the local part of the sympathetic nervous system, leading to changed sweating patterns and eye muscle problems (a combination known as Horner's syndrome), as well as muscle weakness in the hands due to invasion of the brachial plexus.

Many of the symptoms of lung cancer (bone pain, fever, weight loss) are nonspecific; in the elderly, these may be attributed to comorbid illness.[5] In many patients, the cancer has already spread beyond the original site by the time they have symptoms and seek medical attention. Common sites of metastasis include the bone, such as the spine (causing back pain and occasionally spinal cord compression), the liver and the brain. About 10% of people with lung cancer do not have symptoms at diagnosis; these cancers are incidentally found on routine chest x-rays.[4]

Chest X Ray

Performing a chest x-ray is the first step if a patient reports symptoms that may be suggestive of lung cancer. This may reveal an obvious mass, widening of the mediastinum (suggestive of spread to lymph nodes there), atelectasis (collapse), consolidation (pneumonia), or pleural effusion. If there are no x-ray findings but the suspicion is high (such as a heavy smoker with blood-stained sputum), bronchoscopy and/or a CT scan may provide the necessary information. Bronchoscopy or CT-guided biopsy is often used to identify the tumor type.[4]

The differential diagnosis for patients who present with abnormalities on chest x-ray includes lung cancer, as well as nonmalignant diseases. These include infectious causes such as tuberculosis or pneumonia, or inflammatory conditions such as sarcoidosis. These diseases can result in mediastinal lymphadenopathy or lung nodules, and sometimes mimic lung cancers.[5]


  • Chest x-ray showing a cancerous tumor in the left lung

    Chest x-ray showing a cancerous tumor in the left lung

Multi Sliced CT

  • CT: Bronchoalveolar carcinoma (Image courtesy of RadsWiki)

    CT: Bronchoalveolar carcinoma (Image courtesy of RadsWiki)

  • CT: Another patient with bronchoalveolar carcinoma (Image courtesy of RadsWiki)

    CT: Another patient with bronchoalveolar carcinoma (Image courtesy of RadsWiki)


  • CT: Another patient with bronchoalveolar carcinoma (Image courtesy of RadsWiki)

    CT: Another patient with bronchoalveolar carcinoma (Image courtesy of RadsWiki)

  • CT scan showing a cancerous tumor in the left lung

    CT scan showing a cancerous tumor in the left lung

Classification

Frequency of histological types of lung cancer[57]
Histological type Frequency (%)
Non-small cell lung carcinoma 80.4
Small cell lung carcinoma 16.8
Carcinoid[58] 0.8
Sarcoma[59] 0.1
Unspecified lung cancer 1.9

The vast majority of lung cancers are carcinomas—malignancies that arise from epithelial cells. There are two main types of lung carcinoma, categorized by the size and appearance of the malignant cells seen by a histopathologist under a microscope: non-small cell (80.4%) and small-cell (16.8%) lung carcinoma.[57] This classification, based on simple histological criteria, has important implications for clinical management and prognosis of the disease.

Non-small cell lung carcinoma (NSCLC)

The non-small cell lung carcinomas are grouped together because their prognosis and management are similar. There are three main sub-types: squamous cell lung carcinoma, adenocarcinoma and large cell lung carcinoma.

Sub-types of non-small cell lung cancer[57]
Histological sub-type Frequency of all lung cancers (%)
Squamous cell lung carcinoma 31.1
Adenocarcinoma Adenocarcinoma (not otherwise specified) 23.2
Bronchioloalveolar carcinoma 3.0
Adenosquamous carcinoma 1.2
Papillary adenocarcinoma 0.7
Mucoepidermoid carcinoma[60] 0.1
Adenoid cystic carcinoma[61] 0.04
Other specified adenocarcinoma 1.1
Large cell carcinoma 10.7
Giant cell and spindle cell carcinoma 0.4
Other/unspecified non-small cell lung carcinoma 8.9

Accounting for 31.1% of lung cancers,[57] squamous cell lung carcinoma usually starts near a central bronchus. Cavitation and necrosis within the center of the cancer is a common finding. Well-differentiated squamous cell lung cancers often grow more slowly than other cancer types.[5]

Adenocarcinoma accounts for 29.4% of lung cancers.[57] It usually originates in peripheral lung tissue. Most cases of adenocarcinoma are associated with smoking. However, among people who have never smoked ("never-smokers"), adenocarcinoma is the most common form of lung cancer.[62] A subtype of adenocarcinoma, the bronchioloalveolar carcinoma, is more common in female never-smokers, and may have different responses to treatment.[63]

Accounting for 10.7% of lung cancers,[57] large cell lung carcinoma is a fast-growing form that develops near the surface of the lung.[64] It is often poorly differentiated and tends to metastasize early.[5]

Small cell lung carcinoma (SCLC)

Small cell lung carcinoma (microscopic view of a core needle biopsy)

Small cell lung carcinoma (SCLC, also called "oat cell carcinoma") is less common. It tends to arise in the larger breathing tubes and grows rapidly, becoming quite large.[65]

The "oat" cell contains dense neurosecretory granules (vesicles containing neuroendocrine hormones) which give this an endocrine/paraneoplastic syndrome association.[66]

While initially more sensitive to chemotherapy, it ultimately carries a worse prognosis and is often metastatic at presentation. This type of lung cancer is strongly associated with smoking.[67]

Metastatic cancers

The lung is a common place for metastasis from tumors in other parts of the body. These cancers are identified by the site of origin, thus a breast cancer metastasis to the lung is still known as breast cancer. They often have a characteristic round appearance on chest x-ray.[68]

Primary lung cancers themselves most commonly metastasize to the adrenal glands, liver, brain, and bone.[5]

Staging

See also: Non-small cell lung carcinoma staging

Lung cancer staging is an assessment of the degree of spread of the cancer from its original source. It is an important factor affecting the prognosis and potential treatment of lung cancer.

Non-small cell lung carcinoma is staged from IA ("one A", best prognosis) to IV ("four", worst prognosis).[69] Small cell lung carcinoma is classified as limited stage if it is confined to one half of the chest and within the scope of a single radiotherapy field. Otherwise it is extensive stage.[65]

Primary tumor

  • Tis - Carcinoma in situ
  • TX - Positive malignant cytologic findings, no lesion observed
  • T1 - Diameter of 3 cm or smaller and surrounded by lung or visceral pleura or endobronchial tumor distal to the lobar bronchus
  • T2 - Diameter greater than 3 cm ; extension to the visceral pleura, atelectasis, or obstructive pneumopathy involving less than 1 lung; lobar endobronchial tumor; or tumor of a main bronchus more than 2 cm from the carina
  • T3 - Tumor at the apex; total atelectasis of 1 lung; endobronchial tumor of main bronchus within 2 cm of the carina but not invading it; or tumor of any size with direct extension to the adjacent structures (i.e. chest wall mediastinal pleura, diaphragm, pericardium parietal layer).
  • T4 - Invasion of the mediastinal organs (i.e esophagus, trachea, carina, great vessels, heart), obstruction of the superior vena cava; involvement of a vertebral body; recurrent nerve involvement; malignant pleural effusion, malignant pericardial effusion; or satellite pulmonary nodules within the same lobe as the primary tumor

Regional lymph node involvement

  • N0 - No lymph nodes involved
  • N1 - Ipsilateral hilar nodal involvement
  • N2 - Ipsilateral mediastinal involvement
  • N3 - Contralateral mediastinal or hilar nodal involvement or any scalene or supraclavicular nodal involvement

Metastatic involvement

  • M0 - No metastases
  • M1 - Metastases present

Stage groupings of Lung Cancer

  • IA - T1N0M0
  • IB - T2N0M0
  • IIA - T1N1M0
  • IIB - T2N1M0 or T3N0M0
  • IIIA - T1-3N2M0 or T3N1M0
  • IIIB - Any T4 or any N3M0
  • IV - Any M1

Treatment

Treatment for lung cancer depends on the cancer's specific cell type, how far it has spread, and the patient's performance status. Common treatments include surgery, chemotherapy, and radiation therapy.[4]

Surgery

Main article: Lung cancer surgery

If investigations confirm lung cancer, CT scan and often positron emission tomography (PET) are used to determine whether the disease is localised and amenable to surgery or whether it has spread to the point where it cannot be cured surgically.

Blood tests and spirometry (lung function testing) are also necessary to assess whether the patient is well enough to be operated on. If spirometry reveals poor respiratory reserve (often due to chronic obstructive pulmonary disease), surgery may be contraindicated.

Surgery itself has an operative death rate of about 4.4%, depending on the patient's lung function and other risk factors.[70] Surgery is usually only an option in non-small cell lung carcinoma limited to one lung, up to stage IIIA. This is assessed with medical imaging (computed tomography, positron emission tomography). A sufficient pre-operative respiratory reserve must be present to allow adequate lung function after the tissue is removed.

Procedures include wedge resection (removal of part of a lobe), lobectomy (one lobe), bilobectomy (two lobes) or pneumonectomy (whole lung). In patients with adequate respiratory reserve, lobectomy is the preferred option, as this minimizes the chance of local recurrence. If the patient does not have enough functional lung for this, wedge resection may be performed.[71] Radioactive iodine brachytherapy at the margins of wedge excision may reduce recurrence to that of lobectomy.[72]

Treatment

The first successful pneumonectomy for lung cancer was carried out in 1933.[73] Initially, pneumonectomy was the surgical treatment of choice.[74] However with improvements in cancer staging and surgical techniques, lobectomy with lymph node dissection has now become the treatment of choice.[75][76] [77] [78] [79] [80] [81] [82]

Palliative radiotherapy has been used since the 1940s.[74] Radical radiotherapy, initially used in the 1950s, was an attempt to use larger radiation doses in patients with relatively early stage lung cancer, but who were otherwise unfit for surgery.[83] In 1997, continuous hyperfractionated accelerated radiotherapy (CHART) was seen as an improvement over conventional radical radiotherapy.[84]

With small cell lung carcinoma, initial attempts in the 1960s at surgical resection[85] and radical radiotherapy[86] were unsuccessful. In the 1970s, successful chemotherapy regimens were developed.[87] [88] [89] [90] [91] [92] [93] [94] [95] [96] [97] [98] [99] [100] [101] [102] [103] [104] [105] [106] [107] [108] [109] [110] [111] [112] [113] [114] [115] [116] [117] [118] [119] [120] [121] [122] [123] [124] [125] [126] [127] [128] [129] [130] [131] [132] [133] [134] [135] [136] [137] [138] [139] [140] [141] [142] [143] [144] [145] [146] [147] [148] [149] [150] [151] [152] [153] [154] [155] [156] [157] [158] [159] [160] [161] [162] [163] [164] [165] [166] [167] [168] [169] [170] [171] [172] [173] [174] [175] [176] [177] [178] [179] [180] [181] [182] [183] [184] [185] [186] [187] [188] [189] [190] [191] [192] [193] [194] [195] [196] [197] [198] [199] [200] [201] [202] [203] [204] [205] [206] [207] [208] [209]

Chemotherapy

Small cell lung carcinoma is treated primarily with chemotherapy, as surgery has no demonstrable influence on survival. Primary chemotherapy is also given in metastatic non-small cell lung carcinoma.

The combination regimen depends on the tumor type. Non-small cell lung carcinoma is often treated with cisplatin or carboplatin, in combination with gemcitabine, paclitaxel, docetaxel, etoposide or vinorelbine.[210] In small cell lung carcinoma, cisplatin and etoposide are most commonly used.[211] Combinations with carboplatin, gemcitabine, paclitaxel, vinorelbine, topotecan and irinotecan are also used.[212][213]

Adjuvant chemotherapy for non-small cell lung carcinoma

Adjuvant chemotherapy refers to the use of chemotherapy after surgery to improve the outcome. During surgery, samples are taken from the lymph nodes. If these samples contain cancer, then the patient has stage II or III disease. In this situation, adjuvant chemotherapy may improve survival by up to 15%.[214][215] Standard practice is to offer platinum-based chemotherapy (including either cisplatin or carboplatin).[216]

Adjuvant chemotherapy for patients with stage IB cancer is controversial as clinical trials have not clearly demonstrated a survival benefit.[217][218] Trials of preoperative chemotherapy (neoadjuvant chemotherapy) in resectable non-small cell lung carcinoma have been inconclusive.[219]

Radiotherapy

Radiotherapy is often given together with chemotherapy, and may be used with curative intent in patients with non-small cell lung carcinoma who are not eligible for surgery. This form of high intensity radiotherapy is called radical radiotherapy. A refinement of this technique is continuous hyperfractionated accelerated radiotherapy (CHART), where a high dose of radiotherapy is given in a short time period.[84] For small cell lung carcinoma cases that are potentially curable, in addition to chemotherapy, chest radiation is often recommended.[220] The use of adjuvant thoracic radiotherapy following curative intent surgery for non-small cell lung carcinoma is not well established and controversial. Benefits, if any, may only be limited to those in whom the tumor has spread to the mediastinal lymph nodes.[221][222]

For both non-small cell lung carcinoma and small cell lung carcinoma patients, smaller doses of radiation to the chest may be used for symptom control (palliative radiotherapy). Unlike other treatments, it is possible to deliver palliative radiotherapy without confirming the histological diagnosis of lung cancer.

Patients with limited stage small cell lung carcinoma are usually given prophylactic cranial irradiation (PCI). This is a type of radiotherapy to the brain, used to reduce the risk of metastasis.[223] More recently, PCI has also been shown to be beneficial in those with extensive small cell lung cancer. In patients whose cancer has improved following a course of chemotherapy, PCI has been shown to reduce the cumulative risk of brain metastases within one year from 40.4% to 14.6%.[224]

Interventional radiology

Radiofrequency ablation is more frequently used for this condition as it is nontoxic and causes little pain. It is especially effective when combined with chemotherapy as it catches the cells deeper inside a tumor—the ones difficult to reach with chemotherapy due to reduced blood supply to the center of the tumor. It is done by inserting a small heat probe into the tumor to kill the tumor cells.[225]

Targeted therapy

In recent years, various molecular targeted therapies have been developed for the treatment of advanced lung cancer. Gefitinib (Iressa) is one such drug, which targets the tyrosine kinase domain of the epidermal growth factor receptor (EGF-R) which is expressed in many cases of non-small cell lung carcinoma. It was not shown to increase survival, although females, Asians, non-smokers and those with bronchioloalveolar carcinoma appear to derive the most benefit from gefitinib.[63]

Erlotinib (Tarceva), another tyrosine kinase inhibitor, has been shown to increase survival in lung cancer patients[226] and has recently been approved by the FDA for second-line treatment of advanced non-small cell lung carcinoma. Similar to gefitinib, it appeared to work best in females, Asians, non-smokers and those with bronchioloalveolar carcinoma.[227]

The angiogenesis inhibitor bevacizumab (in combination with paclitaxel and carboplatin) improves the survival of patients with advanced non-small cell lung carcinoma.[228] However this increases the risk of lung bleeding, particularly in patients with squamous cell carcinoma.

Advances in cytotoxic drugs,[229] pharmacogenetics[230] and targeted drug design[231] show promise. A number of targeted agents are at the early stages of clinical research, such as cyclo-oxygenase-2 inhibitors,[232] the apoptosis promoter exisulind,[233] proteasome inhibitors,[234] bexarotene[235] and vaccines.[236]

Prevention

Prevention is the most cost-effective means of fighting lung cancer. While in most countries industrial and domestic carcinogens have been identified and banned, tobacco smoking is still widespread. Eliminating tobacco smoking is a primary goal in the prevention of lung cancer, and smoking cessation is an important preventative tool in this process.[237]

Policy interventions to decrease passive smoking in public areas such as restaurants and workplaces have become more common in many Western countries, with California taking a lead in banning smoking in public establishments in 1998. Ireland played a similar role in Europe in 2004, followed by Italy and Norway in 2005, Scotland as well as several others in 2006, and England in 2007. New Zealand has also banned smoking in public places as of 2004.

The state of Bhutan has had a complete smoking ban since 2005.[238] In many countries, pressure groups are campaigning for similar bans. Arguments cited against such bans are criminalisation of smoking, increased risk of smuggling and the risk that such a ban cannot be enforced.[239]

Screening

Main article: Lung cancer screening

Screening refers to the use of medical tests to detect disease in asymptomatic people. Possible screening tests for lung cancer include chest x-ray or computed tomography (CT) of the chest. So far, screening programs for lung cancer have not demonstrated any clear benefit. Randomized controlled trials are underway in this area to see if decreased long-term mortality can be directly observed from CT screening.[240]

Prognosis

Main articles: Non-small cell lung carcinoma staging and Manchester score

Prognosis depends on the cell type (histology), stage (degree of spread), and the patient's performance status. Overall 5 year survival rates vary from 8.9% in developing countries to 15% in the United States.[21]

For non-small cell lung carcinoma, prognosis is poor. Following complete surgical resection of stage IA disease, five-year survival is 67%. With stage IB disease, five-year survival is 57%.[241] The 5-year survival rate of patients with stage IV NSCLC is about 1%.[6]

For small cell lung carcinoma, prognosis is also poor. The overall five-year survival for patients with SCLC is about 5%.[4] Patients with extensive-stage SCLC have an average five-year survival rate of less than 1%. The median survival time for limited-stage disease is 20 months, with a five-year survival rate of 20%.[6]

5 Year Survival

  • Stage IA - 75%
  • Stage IB - 55%
  • Stage IIA - 50%
  • Stage IIB - 40%
  • Stage IIIA - 10-35% (surgical)
  • Stage IIIB - 5% (medical treatment)
  • Stage IV - Less than 5%

Case Examples

Case #1

Clinical Summary

This 55-year-old white male had a long history of emphysema and a 60-70 pack-year smoking history. He was in his usual state of health until about one month before admission, at which time he developed increasing dyspnea on exertion. At the same time, his sputum increased from two tablespoons to half a cup of yellow blood-streaked sputum a day. Chest x-ray showed a right hilar mass. Sputum cytology revealed abnormal cells that were "positive for malignancy." He later developed pneumonia and fever. The patient expired soon thereafter.

Autopsy Findings

Significant findings included advanced carcinoma of the right main stem bronchus with extension across the carina to produce obstruction of the left main stem bronchus. There was left lower lobe pneumonia and left upper lobe atelectasis. Extensive metastases were present in regional lymph nodes as well as the pericardium, left atrium, and right kidney.

Histopathological Findings

Images courtesy of Professor Peter Anderson DVM PhD and published with permission © PEIR, University of Alabama at Birmingham, Department of Pathology

This is a gross photograph of bronchogenic carcinoma. The large tumor mass can be seen adjacent to the bronchus (1). Note that the epithelial surface of the bronchus is rough and irregular (2). The first branch off the right main stem bronchus is partially occluded by the thickened mucosa and submucosa (3).


This is a low-power photomicrograph of bronchus showing normal mucosa (1) with transition to carcinoma (2). Note the bronchial cartilage (3) and the invasion of tumor through the entire wall of the bronchus with tumor extending to the serosal surface (4).


This is a photomicrograph of bronchus with ulcerated mucosal surface on the right (1). The submucosa is completely filled with tumor down to the cartilage (2).


This is a higher-power photomicrograph of bronchus with the ulcerated mucosal surface on the right and tumor underneath.


This is a higher-power photomicrograph of the mucosal surface (right) with an area of hemorrhage (arrow) and underlying tumor (left).


This is a photomicrograph of tumor from an area of invasion with compression of fibrous stroma and focal necrosis.


This is a high-power photomicrograph showing cytologic detail of the tumor with an area of necrosis (1) and a more differentiated area with keratin pearl formation (2).


This is a high power photomicrograph of tumor with an area of central necrosis (arrow).


This high-power photomicrograph of tumor shows the cytologic detail of a less-differentiated area of neoplasm with cellular anaplasia.


References

  1. ↑ WHO (2004). "Deaths by cause, sex and mortality stratum" (PDF). World Health Organization. Retrieved 2007-06-01.
  2. ↑ "Lung Cancer Facts (Women)". National Lung Cancer Partnership. 2006. Retrieved 2007-05-26.
  3. ↑ WHO (February 2006). "Cancer". World Health Organization. Retrieved 2007-06-25.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 Minna, JD (2004). Harrison's Principle's of Internal Medicine. McGraw-Hill. pp. 506–516. doi:10.1036/0071402357. ISBN 0071391401.
  5. ↑ 5.0 5.1 5.2 5.3 5.4 5.5 5.6 Vaporciyan, AA (2000). Cancer Medicine. B C Decker Inc. pp. 1227–1292. ISBN 1-55009-113-1. Unknown parameter |coauthors= ignored (help)
  6. ↑ 6.0 6.1 6.2 "Lung Carcinoma: Tumors of the Lungs". Merck Manual Professional Edition, Online edition. Retrieved 2007-08-15.
  7. ↑ Gorlova, OY (Jul 2007). "Aggregation of cancer among relatives of never-smoking lung cancer patients". International Journal of Cancer. 121 (1): 111–118. PMID 17304511. Unknown parameter |coauthors= ignored (help)
  8. ↑ Hackshaw, AK (Oct 1997). "The accumulated evidence on lung cancer and environmental tobacco smoke". British Medical Journal. 315 (7114): 980–988. PMID 9365295. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  9. ↑ 9.0 9.1 Catelinois, O (May 2006). "Lung Cancer Attributable to Indoor Radon Exposure in France: Impact of the Risk Models and Uncertainty Analysis". Environmental Health Perspectives. National Institute of Environmental Health Science. 114 (9): 1361–1366. doi:10.1289/ehp.9070. PMID 16966089. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  10. ↑ 10.0 10.1 O'Reilly, KM (Mar 2007). "Asbestos-related lung disease". American Family Physician. 75 (5): 683–688. PMID 17375514. Retrieved 2007-08-18. Unknown parameter |coauthors= ignored (help)
  11. ↑ 11.0 11.1 Kabir, Z (Feb 2007). "Lung cancer and urban air-pollution in dublin: a temporal association?". Irish Medical Journal. 100 (2): 367–369. PMID 17432813. Unknown parameter |coauthors= ignored (help)
  12. ↑ Coyle, YM (Sep 2006). "An ecological study of the association of metal air pollutants with lung cancer incidence in Texas". Journal of Thoracic Oncology. 1 (7): 654–661. PMID 17409932. Unknown parameter |coauthors= ignored (help)
  13. ↑ 13.0 13.1 Chiu, HF (Dec 2006). "Outdoor air pollution and female lung cancer in Taiwan". Inhalation Toxicology. 18 (13): 1025–1031. PMID 16966302. Unknown parameter |coauthors= ignored (help)
  14. ↑ 14.0 14.1 Witschi, H (Nov 2001). "A short history of lung cancer". Toxicological Sciences. 64 (1): 4–6. PMID 11606795.
  15. ↑ Adler I (1912). Primary Malignant Growths of the Lungs and Bronchi. New York: Longmans, Green, and Company. Template:OCLC, cited in Spiro SG, Silvestri GA (2005). "One hundred years of lung cancer". Am. J. Respir. Crit. Care Med. 172 (5): 523–9. doi:10.1164/rccm.200504-531OE. PMID 15961694.
  16. ↑ Grannis, FW. "History of cigarette smoking and lung cancer". smokinglungs.com. Retrieved 2007-08-06.
  17. ↑ Proctor, R (2000). The Nazi War on Cancer. Princeton University Press. pp. 173–246. ISBN 0-691-00196-0.
  18. ↑ Doll, R (Nov 1956). "Lung cancer and other causes of death in relation to smoking; a second report on the mortality of British doctors". British Medical Journal. 2 (5001): 1071–1081. PMID 13364389. Unknown parameter |coauthors= ignored (help)
  19. ↑ US Department of Health Education and Welfare (1964), Smoking and health: report of the advisory committee to the Surgeon General of the Public Health Service, Washington, DC: US Government Printing Office
  20. ↑ Greaves, M (2000). Cancer: the Evolutionary Legacy. Oxford University Press. pp. 196–197. ISBN 0-19-262835-6.
  21. ↑ 21.0 21.1 Parkin, DM (Mar–Apr 2005). "Global cancer statistics, 2002". CA: A Cancer Journal for Clinicians. 55 (2): 74–108. PMID 15761078. Retrieved 2007-09-12. Unknown parameter |coauthors= ignored (help)
  22. ↑ Parent, ME (Jan 2007). "Exposure to diesel and gasoline engine emissions and the risk of lung cancer". American Journal of Epidemiology. 165 (1): 53–62. PMID 17062632. Unknown parameter |coauthors= ignored (help)
  23. ↑ "Gender in lung cancer and smoking research" (PDF). World Health Organization. 2004. Retrieved 2007-05-26.
  24. ↑ Liu, BQ (Nov 1998). "Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths". British Medical Journal. 317 (7170): 1411–1422. PMID 9822393. Retrieved 2007-09-27. Unknown parameter |coauthors= ignored (help)
  25. ↑ Behera, D (2004). "Lung cancer in India". Indian Journal of Chest Diseases and Allied Sciences. 46 (4): 269–281. PMID 15515828. Unknown parameter |coauthors= ignored (help)
  26. ↑ Fong, KM (Oct 2003). "Lung cancer. 9: Molecular biology of lung cancer: clinical implications". Thorax. BMJ Publishing Group Ltd. 58 (10): 892–900. PMID 14514947. Unknown parameter |coauthors= ignored (help)
  27. ↑ Salgia, R (Mar 1998). "Molecular abnormalities in lung cancer". Journal of Clinical Oncology. 16 (3): 1207–1217. PMID 9508209. Unknown parameter |coauthors= ignored (help)
  28. ↑ Aviel-Ronen, S (Jul 2006). "K-ras mutations in non-small-cell lung carcinoma: a review". Clinical Lung Cancer. Cancer Information Group. 8 (1): 30–38. PMID 16870043. Unknown parameter |coauthors= ignored (help)
  29. ↑ Devereux, TR (Mar 1996). "Molecular mechanisms of lung cancer. Interaction of environmental and genetic factors". Chest. American College of Chest Physicians. 109 (Suppl. 3): 14S–19S. PMID 8598134. Retrieved 2007-08-11. Unknown parameter |coauthors= ignored (help)
  30. ↑ Engels, EA (Jul 2007). "Systematic evaluation of genetic variants in the inflammation pathway and risk of lung cancer". Cancer Research. American Association for Cancer Research. 67 (13): 6520–6527. PMID 17596594. Unknown parameter |coauthors= ignored (help)
  31. ↑ Wenzlaff, AS (Dec 2005). "CYP1A1 and CYP1B1 polymorphisms and risk of lung cancer among never smokers: a population-based study". Carcinogenesis. Oxford University Press. 26 (12): 2207–2212. PMID 16051642. Unknown parameter |coauthors= ignored (help)
  32. ↑ Son, JW (Sep 2006). "Polymorphisms in the caspase-8 gene and the risk of lung cancer". Cancer Genetics and Cytogenetics. 169 (2): 121–127. PMID 16938569. Unknown parameter |coauthors= ignored (help)
  33. ↑ Yin, J (May 2007). "The DNA repair gene XRCC1 and genetic susceptibility of lung cancer in a northeastern Chinese population". Lung Cancer. 56 (2): 153–160. PMID 17316890. Unknown parameter |coauthors= ignored (help)
  34. ↑ Samet, JM (May 1988). "Cigarette smoking and lung cancer in New Mexico". American Review of Respiratory Disease. 137 (5): 1110–1113. PMID 3264122. Unknown parameter |coauthors= ignored (help)
  35. ↑ Villeneuve, PJ (Nov 1994). "Lifetime probability of developing lung cancer, by smoking status, Canada". Canadian Journal of Public Health. 85 (6): 385–388. PMID 7895211. Unknown parameter |coauthors= ignored (help)
  36. ↑ Hecht, S (Oct 2003). "Tobacco carcinogens, their biomarkers and tobacco-induced cancer". Nature Reviews. Cancer. Nature Publishing Group. 3 (10): 733–744. doi:10.1038/nrc1190. PMID 14570033. Retrieved 2007-08-10.
  37. ↑ Peto R, R (2006). Mortality from smoking in developed countries 1950–2000: Indirect estimates from National Vital Statistics. Oxford University Press. ISBN 0-19-262535-7. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  38. ↑ Nordquist, LT (Aug 2004). "Improved survival in never-smokers vs current smokers with primary adenocarcinoma of the lung". Chest. American College of Chest Physicians. 126 (2): 347–351. PMID 15302716. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  39. ↑ Tammemagi, CM (Jan 2004). "Smoking and lung cancer survival: the role of comorbidity and treatment". Chest. American College of Chest Physicians. 125 (1): 27–37. PMID 14718417. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  40. ↑ CDC (Dec 1986). "1986 Surgeon General's report: the health consequences of involuntary smoking". CDC. PMID 3097495. Retrieved 2007-08-10.
    * National Research Council (1986). Environmental tobacco smoke: measuring exposures and assessing health effects. National Academy Press. ISBN 0-309-07456-8.
    * Template:Cite paper
    * California Environmental Protection Agency (1997). "Health effects of exposure to environmental tobacco smoke". Tobacco Control. 6 (4): 346–353. PMID 9583639. Retrieved 2007-08-10.
    * CDC (Dec 2001). "State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke—United States, 2000". Morbidity and Mortality Weekly Report. CDC. 50 (49): 1101–1106. PMID 11794619. Retrieved 2007-08-10.
    * Alberg, AJ (Jan 2003). "Epidemiology of lung cancer". Chest. American College of Chest Physicians. 123 (S1): 21S–49S. PMID 12527563. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  41. ↑ Boffetta, P (Oct 1998). "Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe". Journal of the National Cancer Institute. Oxford University Press. 90 (19): 1440–1450. PMID 9776409. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  42. ↑ "Report of the Scientific Committee on Tobacco and Health". Department of Health. Mar 1998. Retrieved 2007-07-09.
    * Hackshaw, AK (Jun 1998). "Lung cancer and passive smoking". Statistical Methods in Medical Research. 7 (2): 119–136. PMID 9654638.
  43. ↑ Template:Cite paper
  44. ↑ Schick, S (Dec 2005). "Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke". Tobacco Control. 14 (6): 396–404. PMID 16319363. Unknown parameter |coauthors= ignored (help)
  45. ↑ EPA (Oct 2006). "Radiation information: radon". EPA. Retrieved 2007-08-11.
  46. ↑ Field, RW (Jun 2000). "Residential radon gas exposure and lung cancer: the Iowa Radon Lung Cancer Study". American Journal of Epidemiology. Oxford Journals. 151 (11): 1091–1102. PMID 10873134. Retrieved 2007-08-11. Unknown parameter |coauthors= ignored (help)
  47. ↑ EPA (Jun 2000). "Iowa Radon Lung Cancer Study". EPA. Retrieved 2007-08-11.
  48. ↑ Darnton, AJ (Jan 2006). "Estimating the number of asbestos-related lung cancer deaths in Great Britain from 1980 to 2000". Annals of Occupational Hygiene. 50 (1): 29–38. PMID 16126764. Retrieved 2007-09-07. Unknown parameter |coauthors= ignored (help)
  49. ↑ Leroux, C (Mar–Apr 2007). "Jaagsiekte Sheep Retrovirus (JSRV): from virus to lung cancer in sheep". Veterinary Research. 38 (2): 211–228. PMID 17257570. Unknown parameter |coauthors= ignored (help)
  50. ↑ Palmarini, M (November 2001). "Retrovirus-induced ovine pulmonary adenocarcinoma, an animal model for lung cancer". Journal of the National Cancer Institute. Oxford University Press. 93 (21): 1603–1614. PMID 11698564. Retrieved 2007-08-11. Unknown parameter |coauthors= ignored (help)
  51. ↑ Cheng, YW (Apr 2001). "The association of human papillomavirus 16/18 infection with lung cancer among nonsmoking Taiwanese women". Cancer Research. American Association for Cancer Research. 61 (7): 2799–2803. PMID 11306446. Retrieved 2007-08-11. Unknown parameter |coauthors= ignored (help)
  52. ↑ Zheng, H (May 2007). "Oncogenic role of JC virus in lung cancer". Journal of Pathology. 212 (3): 306–315. PMID 17534844. Unknown parameter |coauthors= ignored (help)
  53. ↑ Giuliani, L (Sep 2007). "Detection of oncogenic viruses (SV40, BKV, JCV, HCMV, HPV) and p53 codon 72 polymorphism in lung carcinoma". Lung Cancer. 57 (3): 273–281. PMID 17400331. Unknown parameter |coauthors= ignored (help)
  54. ↑ Hamilton, W (Dec 2005). "What are the clinical features of lung cancer before the diagnosis is made? A population based case-control study". Thorax. BMJ Publishing Group Ltd. 60 (12): 1059–1065. PMID 16227326. Unknown parameter |coauthors= ignored (help)
  55. ↑ Honnorat, J (May 2007). "Paraneoplastic neurological syndromes". Orphanet Journal of Rare Diseases. BioMed Central Ltd. 2: 22. doi:10.1186/1750-1172-2-22. PMID 17480225. Retrieved 2007-09-05. Unknown parameter |coauthors= ignored (help)
  56. ↑ Jones, DR (Jul 1998). "Pancoast tumors of the lung". Current Opinion in Pulmonary Medicine. 4 (4): 191–197. PMID 10813231. Unknown parameter |coauthors= ignored (help)
  57. ↑ 57.0 57.1 57.2 57.3 57.4 57.5 Travis, WD (Jan 1995). "Lung cancer". Cancer. 75 (Suppl. 1): 191–202. PMID 8000996. Unknown parameter |coauthors= ignored (help)
  58. ↑ Morandi, U (2006). "Bronchial typical carcinoid tumors". Seminars in Thoracic and Cardiovascular Surgery. 18 (3): 191–198. PMID 17185178. Unknown parameter |coauthors= ignored (help)
  59. ↑ Etienne-Mastroianni, B (Dec 2002). "Primary sarcomas of the lung: a clinicopathologic study of 12 cases". Lung Cancer. 38 (3): 283–289. PMID 12445750. Unknown parameter |coauthors= ignored (help)
  60. ↑ Sánchez-Mora, N (Jan 2007). "Mucoepidermoid tumors of the bronchus. Ultrastructural and immunohistochemical study". Histology and Histopathology. 22 (1): 9–13. PMID 17128406. Unknown parameter |coauthors= ignored (help)
  61. ↑ Moran, CA (Mar 1994). "Primary adenoid cystic carcinoma of the lung. A clinicopathologic and immunohistochemical study of 16 cases". Cancer. 73 (5): 1390–1397. PMID 7509254. Unknown parameter |coauthors= ignored (help)
  62. ↑ Subramanian, J (February 2007). "Lung cancer in never smokers: a review". Journal of Clinical Oncology. American Society of Clinical Oncology. 25 (5): 561–570. PMID 17290066. Unknown parameter |coauthors= ignored (help)
  63. ↑ 63.0 63.1 Raz, DJ (Mar 2006). "Bronchioloalveolar carcinoma: a review". Clinical Lung Cancer. Cancer Information Group. 7 (5): 313–322. PMID 16640802. Unknown parameter |coauthors= ignored (help)
  64. ↑ Veronesi G (Jul 2006). "Large cell neuroendocrine carcinoma of the lung: a retrospective analysis of 144 surgical cases". Lung Cancer. 53 (1): 111–115. doi:10.1016/j.lungcan.2006.03.007. PMID 16697073. Unknown parameter |coauthors= ignored (help)
  65. ↑ 65.0 65.1 Collins, LG (Jan 2007). "Lung cancer: diagnosis and management". American Family Physician. American Academy of Family Physicians. 75 (1): 56–63. PMID 17225705. Retrieved 2007-08-10. Unknown parameter |coauthors= ignored (help)
  66. ↑ Rosti, G (Mar 2006). "Small cell lung cancer". Annals of Oncology. 17 (Suppl. 2): 5–10. doi:10.1093/annonc/mdj910. PMID 16608983. Retrieved 2007-09-06. Unknown parameter |coauthors= ignored (help)
  67. ↑ Barbone, F (Dec 1997). "Cigarette smoking and histologic type of lung cancer in men" (PDF). Chest. American College of Chest Physicians. 112 (6): 1474–1479. PMID 9404741. Retrieved 2007-09-07. Unknown parameter |coauthors= ignored (help)
  68. ↑ Seo, JB (2001). "Atypical pulmonary metastases: spectrum of radiologic findings". Radiographics. 21 (2): 403–417. PMID 11259704. Retrieved 2007-09-10. Unknown parameter |coauthors= ignored (help)
  69. ↑ Mountain, CF (2003). A Handbook for Staging, Imaging, and Lymph Node Classification. Charles P Young Company. Retrieved 2007-09-01. Unknown parameter |coauthors= ignored (help)
  70. ↑ Strand, TE (Jun 2007). "Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude". Thorax. BMJ Publishing Group Ltd. PMID 17573442. Unknown parameter |coauthors= ignored (help)
  71. ↑ El-Sherif, A (Aug 2006). "Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis". Annals of Thoracic Surgery. 82 (2): 408–415. PMID 16863738. Unknown parameter |coauthors= ignored (help)
  72. ↑ Fernando, HC (Feb 2005). "Lobar and sublobar resection with and without brachytherapy for small stage IA non-small cell lung cancer". Journal of Thoracic and Cardiovascular Surgery. 129 (2): 261–267. PMID 15678034. Unknown parameter |coauthors= ignored (help)
  73. ↑ Office of the Home Secretary (1976). Biographical Memoirs. National Academy of Sciences. ISBN 0-309-02349-1.
  74. ↑ 74.0 74.1 Edwards, AT (1946). "Carcinoma of the bronchus". Thorax. 1: 1–25.
  75. ↑ Scott, WJ (Jan 2003). "Treatment of stage II non-small cell lung cancer". Chest. American College of Chest Physicians. 123 (Suppl. 1): 188S–201S. PMID 12527579. Retrieved 2007-10-01. Unknown parameter |coauthors= ignored (help)
  76. ↑ Smythe, WJ (Jan 2003). "Treatment of stage I non-small cell lung carcinoma". Chest. American College of Chest Physicians. 123 (Suppl. 1): 181S–187S. PMID 12527578. Retrieved 2007-10-01.
  77. ↑ Scott, WJ; Howington J, Movsas B (January 2003). "Treatment of stage II non-small cell lung cancer". Chest 123 (Suppl. 1): 188S–201S. American College of Chest Physicians. PMID 12527579. Retrieved on 2007-10-01.
  78. ↑ Smythe, WJ (January 2003). "Treatment of stage I non-small cell lung carcinoma". Chest 123 (Suppl. 1): 181S–187S. American College of Chest Physicians. PMID 12527578. Retrieved on 2007-10-01
  79. ↑ Kabela, M (1956). "Experience with radical irradiation of bronchial cancer". Ceskoslovenská Onkológia 3 (2): 109–115. PMID 13383622.
  80. ↑ Lennox, SC; Flavell G, Pollock DJ et al. (November 1968). "Results of resection for oat-cell carcinoma of the lung". Lancet 2 (7575): 925–927. Elsevier. PMID 4176258
  81. ↑ Miller, AB; Fox W, Tall R (September 1969). "Five-year follow-up of the Medical Research Council comparative trial of surgery and radiotherapy for the primary treatment of small-celled or oat-celled carcinoma of the bronchus". Lancet 2 (7619): 501–505. Elsevier. PMID 4184834.
  82. ↑ Cohen, M; Creaven PJ, Fossieck BE Jr et al. (1977). "Intensive chemotherapy of small cell bronchogenic carcinoma". Cancer Treatment Reports 61 (3): 349–354. PMID 194691.
  83. ↑ Kabela, M (1956). "Experience with radical irradiation of bronchial cancer". Ceskoslovenská Onkológia. 3 (2): 109–115. PMID 13383622.
  84. ↑ 84.0 84.1 Saunders, M (Jul 1997). "Continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small-cell lung cancer: a randomised multicentre trial". Lancet. Elsevier. 350 (9072): 161–165. PMID 9250182. Unknown parameter |coauthors= ignored (help)
  85. ↑ Lennox, SC (Nov 1968). "Results of resection for oat-cell carcinoma of the lung". Lancet. Elsevier. 2 (7575): 925–927. PMID 4176258. Unknown parameter |coauthors= ignored (help)
  86. ↑ Miller, AB (Sep 1969). "Five-year follow-up of the Medical Research Council comparative trial of surgery and radiotherapy for the primary treatment of small-celled or oat-celled carcinoma of the bronchus". Lancet. Elsevier. 2 (7619): 501–505. PMID 4184834. Unknown parameter |coauthors= ignored (help)
  87. ↑ Cohen, M (1977). "Intensive chemotherapy of small cell bronchogenic carcinoma". Cancer Treatment Reports. 61 (3): 349–354. PMID 194691. Unknown parameter |coauthors= ignored (help)
  88. ↑ WHO (2004). Deaths by cause, sex and mortality stratum (PDF). World Health Organization. Retrieved on 2007-06-01.
  89. ↑ Lung Cancer Facts (Women). National Lung Cancer Partnership (2006). Retrieved on 2007-05-26.
  90. ↑ WHO (February 2006). Cancer. World Health Organization. Retrieved on 2007-06-25.
  91. ↑ Minna, JD (2004). Harrison's Principles of Internal Medicine. McGraw-Hill, 506–516. DOI:10.1036/0071402357. ISBN 0071391401.
  92. ↑ Vaporciyan, AA; Nesbitt JC, Lee JS et al. (2000). Cancer Medicine. B C Decker Inc., 1227–1292. ISBN 1-55009-113-1.
  93. ↑ Lung Carcinoma: Tumors of the Lungs. Merck Manual Professional Edition, Online edition. Retrieved on 2007-08-15.
  94. ↑ Gorlova, OY; Weng SF, Zhang Y et al. (July 2007). "Aggregation of cancer among relatives of never-smoking lung cancer patients". International Journal of Cancer 121 (1): 111–118. PMID 17304511.
  95. ↑ Hackshaw, AK; Law MR, Wald NJ (October 1997). "The accumulated evidence on lung cancer and environmental tobacco smoke". British Medical Journal 315 (7114): 980–988. PMID 9365295. Retrieved on 2007-08-10.
  96. ↑ Catelinois, O; Rogel A, Laurier D et al. (May 2006). "Lung Cancer Attributable to Indoor Radon Exposure in France: Impact of the Risk Models and Uncertainty Analysis". Environmental Health Perspectives 114 (9): 1361–1366. National Institute of Environmental Health Science. doi:10.1289/ehp.9070. PMID 16966089. Retrieved on 2007-08-10.
  97. ↑ O'Reilly, KM; Mclaughlin AM, Beckett WS, Sime PJ (March 2007). "Asbestos-related lung disease". American Family Physician 75 (5): 683–688. PMID 17375514. Retrieved on 2007-08-18.
  98. ↑ Kabir, Z; Bennett K, Clancy L (February 2007). "Lung cancer and urban air-pollution in dublin: a temporal association?". Irish Medical Journal 100 (2): 367–369. PMID 17432813
  99. ↑ Coyle, YM; Minahjuddin AT, Hynan LS, Minna JD (September 2006). "An ecological study of the association of metal air pollutants with lung cancer incidence in Texas.". Journal of Thoracic Oncology 1 (7): 654–661. PMID 17409932.
  100. ↑ Chiu, HF; Cheng MH, Tsai SS et al. (December 2006). "Outdoor air pollution and female lung cancer in Taiwan.". Inhalation Toxicology 18 (13): 1025–1031. PMID 16966302.
  101. ↑ U.S. Department of Health and Human Services. "The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General", 2006; One of the major conclusions of the Surgeon General Report is: "Secondhand smoke exposure causes disease and premature death in children and adults who do not smoke."
  102. ↑ WHO International Agency for Research on Cancer "Tobacco Smoke and Involuntary Smoking" IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, Vol. 83, 2002; the evaluation of the Monograph is: "There is sufficient evidence that involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) causes lung cancer in humans. [...] Involuntary smoking (exposure to secondhand or 'environmental' tobacco smoke) is carcinogenic to humans (Group 1)."
  103. ↑ Travis, WD; Travis LB, Devesa SS (January 1995). "Lung cancer". Cancer 75 (Suppl. 1): 191–202. PMID 8000996.
  104. ↑ Morandi, U; Casali C, Rossi G (2006). "Bronchial typical carcinoid tumors". Seminars in Thoracic and Cardiovascular Surgery 18 (3): 191–198. PMID 17185178.
  105. ↑ Etienne-Mastroianni, B; Falchero L, Chalabreysse L et al. (December 2002). "Primary sarcomas of the lung: a clinicopathologic study of 12 cases". Lung Cancer 38 (3): 283–289. PMID 12445750.
  106. ↑ Sánchez-Mora, N; Parra-Blanco V, Cebollero-Presmanes M et al. (January 2007). "Mucoepidermoid tumors of the bronchus. Ultrastructural and immunohistochemical study". Histology and Histopathology 22 (1): 9–13. PMID 17128406.
  107. ↑ Moran, CA; Suster S, Koss MN (March 1994). "Primary adenoid cystic carcinoma of the lung. A clinicopathologic and immunohistochemical study of 16 cases". Cancer 73 (5): 1390–1397. PMID 7509254.
  108. ↑ Subramanian, J; Govindan R (February 2007). "Lung cancer in never smokers: a review". Journal of Clinical Oncology 25 (5): 561–570. American Society of Clinical Oncology. PMID 17290066.
  109. ↑ Raz, DJ; He B, Rosell R, Jablons DM (March 2006). "Bronchioloalveolar carcinoma: a review". Clinical Lung Cancer 7 (5): 313–322. Cancer Information Group. PMID 16640802.
  110. ↑ Veronesi G; Morandi U, Alloisio M et al. (July 2006). "Large cell neuroendocrine carcinoma of the lung: a retrospective analysis of 144 surgical cases". Lung Cancer 53 (1): 111–115. doi:10.1016/j.lungcan.2006.03.007. PMID 16697073.
  111. ↑ Collins, LG; Haines C, Perkel R, Enck RE (January 2007). "Lung cancer: diagnosis and management". American Family Physician 75 (1): 56–63. American Academy of Family Physicians. PMID 17225705. Retrieved on 2007-08-10.
  112. ↑ Rosti, G; Bevilacqua G, Bidoli P et al. (March 2006). "Small cell lung cancer". Annals of Oncology 17 (Suppl. 2): 5–10. doi:10.1093/annonc/mdj910. PMID 16608983. Retrieved on 2007-09-06.
  113. ↑ Barbone, F; Bovenzi M, Cavallieri F, Stanta G (December 1997). "Cigarette smoking and histologic type of lung cancer in men" (PDF). Chest 112 (6): 1474–1479. American College of Chest Physicians. PMID 9404741. Retrieved on 2007-09-07.
  114. ↑ Seo, JB; Im JG, Goo JM et al. (2001). "Atypical pulmonary metastases: spectrum of radiologic findings". Radiographics 21 (2): 403–417. PMID 11259704. Retrieved on 2007-09-10.
  115. ↑ Mountain, CF; Libshitz HI, Hermes KE (2003). A Handbook for Staging, Imaging, and Lymph Node Classification. Charles P Young Company. Retrieved on 2007-09-01.
  116. ↑ Hamilton, W; Peters TJ, Round A, Sharp D (December 2005). "What are the clinical features of lung cancer before the diagnosis is made? A population based case-control study". Thorax 60 (12): 1059–1065. BMJ Publishing Group Ltd.. PMID 16227326.
  117. ↑ Honnorat, J; Antoine JC (May 2007). "Paraneoplastic neurological syndromes". Orphanet Journal of Rare Diseases 2: 22. BioMed Central Ltd.. doi:10.1186/1750-1172-2-22. PMID 17480225. Retrieved on 2007-09-05.
  118. ↑ Jones, DR; Detterbeck FC (July 1998). "Pancoast tumors of the lung". Current Opinion in Pulmonary Medicine 4 (4): 191–197. PMID 10813231.
  119. ↑ Samet, JM; Wiggins CL, Humble CG, Pathak DR (May 1988). "Cigarette smoking and lung cancer in New Mexico". American Review of Respiratory Disease 137 (5): 1110–1113. PMID 3264122.
  120. ↑ Villeneuve, PJ; Mao Y (November 1994). "Lifetime probability of developing lung cancer, by smoking status, Canada". Canadian Journal of Public Health 85 (6): 385–388. PMID 7895211.
  121. ↑ Hecht, S (October 2003). "Tobacco carcinogens, their biomarkers and tobacco-induced cancer". Nature Reviews. Cancer 3 (10): 733–744. Nature Publishing Group. doi:10.1038/nrc1190. PMID 14570033. Retrieved on 2007-08-10.
  122. ↑ US Department of Health and Human Services (1990), The Health Benefits of Smoking Cessation: a Report of the Surgeon General, Centers for Disease Control (CDC), Office on Smoking and Health., pp. vi, 130, 148, 152, 155, 164, 166, <http://profiles.nlm.nih.gov/NN/B/B/C/T/_/nnbbct.pdf>. Retrieved on 18 November 2007
  123. ↑ Peto R, R; Lopez AD, Boreham J et al. (2006). Mortality from smoking in developed countries 1950–2000: Indirect estimates from National Vital Statistics. Oxford University Press. ISBN 0-19-262535-7. Retrieved on 2007-08-10.
  124. ↑ Nordquist, LT; Simon GR, Cantor A et al. (August 2004). "Improved survival in never-smokers vs current smokers with primary adenocarcinoma of the lung". Chest 126 (2): 347–351. American College of Chest Physicians. PMID 15302716. Retrieved on 2007-08-10.
  125. ↑ Tammemagi, CM; Neslund-Dudas C, Simoff M, Kvale P (January 2004). "Smoking and lung cancer survival: the role of comorbidity and treatment". Chest 125 (1): 27–37. American College of Chest Physicians. PMID 14718417. Retrieved on 2007-08-10.
  126. ↑ CDC (December 1986). 1986 Surgeon General's report: the health consequences of involuntary smoking. CDC. Retrieved on 2007-08-10.
  127. ↑ National Research Council (1986). Environmental tobacco smoke: measuring exposures and assessing health effects. National Academy Press. ISBN 0-309-07456-8.
  128. ↑ EPA (1992). "Respiratory health effects of passive smoking: lung cancer and other disorders". EPA. Retrieved on 2007-08-10.
  129. ↑ California Environmental Protection Agency (1997). "Health effects of exposure to environmental tobacco smoke". Tobacco Control 6 (4): 346–353. PMID 9583639. Retrieved on 2007-08-10.
  130. ↑ CDC (December 2001). "State-specific prevalence of current cigarette smoking among adults, and policies and attitudes about secondhand smoke—United States, 2000". Morbidity and Mortality Weekly Report 50 (49): 1101–1106. CDC. PMID 11794619. Retrieved on 2007-08-10.
  131. ↑ Alberg, AJ; Samet JM (January 2003). "Epidemiology of lung cancer". Chest 123 (S1): 21S-49S. American College of Chest Physicians. PMID 12527563. Retrieved on 2007-08-10.
  132. ↑ Boffetta, P; Agudo A, Ahrens W et al. (October 1998). "Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe". Journal of the National Cancer Institute 90 (19): 1440–1450. Oxford University Press. PMID 9776409. Retrieved on 2007-08-10.
  133. ↑ Report of the Scientific Committee on Tobacco and Health. Department of Health (March 1998). Retrieved on 2007-07-09
  134. ↑ Hackshaw, AK (June 1998). "Lung cancer and passive smoking". Statistical Methods in Medical Research 7 (2): 119–136. PMID 9654638.
  135. ↑ National Health and Medical Research Council (April 1994). "The health effects and regulation of passive smoking". Australian Government Publishing Service. Retrieved on 2007-08-10.
  136. ↑ Schick, S; Glantz S (December 2005). "Philip Morris toxicological experiments with fresh sidestream smoke: more toxic than mainstream smoke". Tobacco Control 14 (6): 396–404. PMID 16319363.
  137. ↑ EPA (October 2006). Radiation information: radon. EPA. Retrieved on 2007-08-11.
  138. ↑ Field, RW; Steck DJ, Smith BJ et al. (June 2000). "Residential radon gas exposure and lung cancer: the Iowa Radon Lung Cancer Study". American Journal of Epidemiology 151 (11): 1091–1102. Oxford Journals. PMID 10873134. Retrieved on 2007-08-11.
  139. ↑ EPA (June 2000). Iowa Radon Lung Cancer Study. EPA. Retrieved on 2007-08-11.
  140. ↑ Darnton, AJ; McElvenny DM, Hodgson JT (January 2006). "Estimating the number of asbestos-related lung cancer deaths in Great Britain from 1980 to 2000". Annals of Occupational Hygiene 50 (1): 29–38. PMID 16126764. Retrieved on 2007-09-07.
  141. ↑ Leroux, C; Girard N, Cottin V et al. (Mar-April 2007). "Jaagsiekte Sheep Retrovirus (JSRV): from virus to lung cancer in sheep". Veterinary Research 38 (2): 211–228. PMID 17257570.
  142. ↑ Palmarini, M; Fan H (November 2001). "Retrovirus-induced ovine pulmonary adenocarcinoma, an animal model for lung cancer". Journal of the National Cancer Institute 93 (21): 1603–1614. Oxford University Press. PMID 11698564. Retrieved on 2007-08-11.
  143. ↑ Cheng, YW; Chiou HL, Sheu GT et al. (April 2001). "The association of human papillomavirus 16/18 infection with lung cancer among non smoking Taiwanese women". Cancer Research 61 (7): 2799–2803. American Association for Cancer Research. PMID 11306446. Retrieved on 2007-08-11.
  144. ↑ Zheng, H; Aziz HA, Nakanishi Y et al. (May 2007). "Oncogenic role of JC virus in lung cancer". Journal of Pathology 212 (3): 306–315. PMID 17534844.
  145. ↑ Giuliani, L; Jaxmar T, Casadio C et al. (September 2007). "Detection of oncogenic viruses (SV40, BKV, JCV, HCMV, HPV) and p53 codon 72 polymorphism in lung carcinoma". Lung Cancer 57 (3): 273–281. PMID 17400331.
  146. ↑ Fong, KM; Sekido Y, Gazdar AF, Minna JD (October 2003). "Lung cancer. 9: Molecular biology of lung cancer: clinical implications". Thorax 58 (10): 892–900. BMJ Publishing Group Ltd.. PMID 14514947.
  147. ↑ Salgia, R; Skarin AT (March 1998). "Molecular abnormalities in lung cancer". Journal of Clinical Oncology 16 (3): 1207–1217. PMID 9508209.
  148. ↑ Aviel-Ronen, S; Blackhall FH, Shepherd FA, Tsao MS (July 2006). "K-ras mutations in non-small-cell lung carcinoma: a review". Clinical Lung Cancer 8 (1): 30–38. Cancer Information Group. PMID 16870043.
  149. ↑ Devereux, TR; Taylor JA, Barrett JC (March 1996). "Molecular mechanisms of lung cancer. Interaction of environmental and genetic factors". Chest 109 (Suppl. 3): 14S-19S. American College of Chest Physicians. PMID 8598134. Retrieved on 2007-08-11.
  150. ↑ Engels, EA; Wu X, Gu J et al. (July 2007). "Systematic evaluation of genetic variants in the inflammation pathway and risk of lung cancer". Cancer Research 67 (13): 6520–6527. American Association for Cancer Research. PMID 17596594.
  151. ↑ Wenzlaff, AS; Cote ML, Bock CH et al. (December 2005). "CYP1A1 and CYP1B1 polymorphisms and risk of lung cancer among never smokers: a population-based study". Carcinogenesis 26 (12): 2207–2212. Oxford University Press. PMID 16051642.
  152. ↑ Son, JW; Kang HK, Chae MH et al. (September 2006). "Polymorphisms in the caspase-8 gene and the risk of lung cancer". Cancer Genetics and Cytogenetics 169 (2): 121–127. PMID 16938569.
  153. ↑ Yin, J; Vogel U, Ma Y et al. (May 2007). "The DNA repair gene XRCC1 and genetic susceptibility of lung cancer in a northeastern Chinese population". Lung Cancer 56 (2): 153–160. PMID 17316890.
  154. ↑ Vineis, P; Hoek G, Krzyzanowski M et al. (February 2007). "Lung cancers attributable to environmental tobacco smoke and air pollution in non-smokers in different European countries: a prospective study". Environmental Health 6: 7. BioMed Central. doi:10.1186/1476-069X-6-7. PMID 17302981. Retrieved on 2007-08-11.
  155. ↑ Pandey, G (February 2005). Bhutan's smokers face public ban. BBC. Retrieved on 2007-09-07.
  156. ↑ Gray, N (February 2003). "A global approach to tobacco policy". Lung Cancer 39 (2): 113–117. BioMed Central. PMID 12581561.
  157. ↑ Gohagan, JK; Marcus PM, Fagerstrom RM et al. (January 2005). "Final results of the Lung Screening Study, a randomized feasibility study of spiral CT versus chest X-ray screening for lung cancer". Lung Cancer 47 (1): 9–15. doi: 10.1016/j.lungcan. 2004.06.007. PMID 15603850.
  158. ↑ Strand, TE; Rostad H, Damhuis RA, Norstein J (June 2007). "Risk factors for 30-day mortality after resection of lung cancer and prediction of their magnitude". Thorax. BMJ Publishing Group Ltd.. PMID 17573442.
  159. ↑ El-Sherif, A; Gooding WE, Santos R et al. (August 2006). "Outcomes of sublobar resection versus lobectomy for stage I non-small cell lung cancer: a 13-year analysis". Annals of Thoracic Surgery 82 (2): 408–415. PMID 16863738.
  160. ↑ Fernando, HC; Santos RS, Benfield JR et al. (February 2005). "Lobar and sublobar resection with and without brachytherapy for small stage IA non-small cell lung cancer". Journal of Thoracic and Cardiovascular Surgery 129 (2): 261–267. PMID 15678034.
  161. ↑ Clegg, A; Scott DA, Hewitson P et al. (January 2002). "Clinical and cost effectiveness of paclitaxel, docetaxel, gemcitabine, and vinorelbine in non-small cell lung cancer: a systematic review". Thorax 57 (1): 20–28. BMJ Publishing Group Ltd. PMID 11809985.
  162. ↑ Murray, N; Turrisi AT (March 2006). "A review of first-line treatment for small-cell lung cancer". Journal of Thoracic Oncology 1 (3): 270–278. PMID 17409868.
  163. ↑ Azim, HA; Ganti AK (March 2007). "Treatment options for relapsed small-cell lung cancer". Anticancer drugs 18 (3): 255–261. PMID 17264756.
  164. ↑ MacCallum, C; Gillenwater HH (July 2006). "Second-line treatment of small-cell lung cancer". Current Oncology Reports 8 (4): 258–264. PMID 17254525.
  165. ↑ Winton, T; Livingston R, Johnson D et al. (June 2005). "Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer". New England Journal of Medicine 352 (25): 2589–2597. Massachusetts Medical Society. PMID 15972865.
  166. ↑ Douillard, JY; Rosell R, De Lena M et al. (September 2006). "Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant #Navelbine International Trialist Association [ANITA]): a randomised controlled trial". Lancet Oncology 7 (9): 719–727. Elsevier. PMID 16945766.
  167. ↑ Tsuboi, M; Ohira T, Saji H et al. (April 2007). "The present status of postoperative adjuvant chemotherapy for completely resected non-small cell lung cancer" (PDF). Ann Thorac Cardiovasc Surg 13 (2): 73–77. PMID 17505412. Retrieved on 2007-08-14.
  168. ↑ Horn, L; Sandler AB, Putnam JB Jr, Johnson DH (May 2007). "The rationale for adjuvant chemotherapy in stage I non-small cell lung cancer". Journal of Thoracic Oncology 2 (5): 377–383. PMID 17473651.
  169. ↑ Wakelee, HA; Schiller JH, Gandara DR (July 2006). "Current status of adjuvant chemotherapy for stage IB non-small-cell lung cancer: implications for the New Intergroup Trial". Clinical Lung Cancer 8 (1): 18–21. Cancer Information Group. PMID 16870041.
  170. ↑ BMJ (December 2005). Clinical Evidence Concise. BMJ Publishing Group, 486–488. ISBN 1-905545-00-2.
  171. ↑ Saunders, M; Dische S, Barrett A et al. (July 1997). "Continuous hyperfractionated accelerated radiotherapy (CHART) versus conventional radiotherapy in non-small-cell lung cancer: a randomised multicentre trial". Lancet 350 (9072): 161–165. Elsevier. PMID 9250182.
  172. ↑ Wagner, H (January 1998). "Radiation therapy in the management of limited small cell lung cancer: when, where, and how much?". Chest 113 (Suppl. 1): 92S–100S. American College of Chest Physicians. PMID 9438697. Retrieved on 2007-08-14.
  173. ↑ (2005) "Postoperative radiotherapy for non-small cell lung cancer". Cochrane database of systematic reviews (Online) (2): CD002142. doi:10.1002/14651858.CD002142.pub2. PMID 15846628.
  174. ↑ Lally, BE; Zelterman D, Colasanto JM et al. (July 2006). "Postoperative Radiotherapy for Stage II or III Non–Small-Cell Lung Cancer Using the Surveillance, Epidemiology, and End Results Database". Journal of Clinical Oncology 24 (19): 2998–3006. John Wiley & Sons, Ltd.. PMID 16769986.
  175. ↑ Ng, M; Chong J, Milner A et al. (June 2007). "Tolerability of accelerated chest irradiation and impact on survival of prophylactic cranial irradiation in patients with limited-stage small cell lung cancer: review of a single institution's experience". Journal of Thoracic Oncology 2 (6): 506–513. International Association for the Study of Lung Cancer. PMID 17545845.
  176. ↑ Slotman, B; Faivre-Finn C, Kramer G et al. (August 2007). "Prophylactic cranial irradiation in extensive small-cell lung cancer". New England Journal of Medicine 357 (7): 664–672. PMID 17699816.
  177. ↑ Simon, CJ; Dupuy DE, DiPetrillo TA et al. (April 2007). "Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients". Radiology 243 (1): 268–275. PMID 17392258.
  178. ↑ Feld, R; Sridhar SS, Shepherd FA et al. (May 2006). "Use of the epidermal growth factor receptor inhibitors gefitinib and erlotinib in the treatment of non-small cell lung cancer: a systematic review". Journal of Thoracic Oncology 1 (4): 367–376. International Association for the Study of Lung Cancer. PMID 17409886.
  179. ↑ Bencardino, K; Manzoni M, Delfanti S et al. (March 2007). "Epidermal growth factor receptor tyrosine kinase inhibitors for the treatment of non-small-cell lung cancer: results and open issues". Internal and Emergency Medicine 2 (1): 3–12. PMID 17551677.
  180. ↑ Sandler, A; Gray R, Perry M et al. (December 2006). "Paclitaxel–carboplatin alone or with bevacizumab for non–small cell lung cancer". New England Journal of Medicine 355 (24): 2542–2550. Massachusetts Medical Society. PMID 17167137.
  181. ↑ Edelman, MJ (September 2006). "Novel cytotoxic agents for non-small cell lung cancer". Journal of Thoracic Oncology 1 (7): 752–755. PMID 17409954.
  182. ↑ Danesi, R; Pasqualetti G, Giovannetti E, Del Tacca M (May 2007). "The role of pharmacogenetics in adjuvant treatment of non-small cell lung cancer". Journal of Thoracic Oncology 2 (5 Suppl.): S27–S30. PMID 17457227.
  183. ↑ Blackhall, FH; Shepherd FA (March 2007). "Small cell lung cancer and targeted therapies". Current Opinion in Oncology 19 (2): 103–108. PMID 17272981.
  184. ↑ Lee, JM; Mao JT, Krysan K, Dubinett SM (April 2007). "Significance of cyclooxygenase-2 in prognosis, targeted therapy and chemoprevention of NSCLC". Future Oncology 2 (2): 149–153. PMID 17381414.
  185. ↑ Whitehead, CM; Earle KA, Fetter J et al. (May 2003). "Exisulind-induced Apoptosis in a Non-Small Cell Lung Cancer Orthotopic Lung Tumor Model Augments Docetaxel Treatment and Contributes to Increased Survival". Molecular Cancer Therapeutics 2: 479–488. American Association for Cancer Research. PMID 12748310. Retrieved on 2007-09-01.
  186. ↑ Scagliotti, G (June 2006). "Proteasome inhibitors in lung cancer". Critical Reviews in Oncology/Haematology 58 (3): 177–189. PMID 16427303.
  187. ↑ Dragnev, KH; Petty WJ, Shah SJ et al. (March 2007). "A proof-of-principle clinical trial of bexarotene in patients with non-small cell lung cancer". Clinical Cancer Research 13 (6): 1794–1800. American Association for Cancer Research. PMID 17363535.
  188. ↑ Albright, C; Garst J (July 2007). "Vaccine therapy in non-small cell lung cancer". Current Oncology Reports 9 (4): 241–246. PMID 17588347.
  189. ↑ Sun, S; Schiller JH, Spinola M, Minna JD (October 2007). "New molecularly targeted therapies for lung cancer". Journal of Clinical Investigation 117 (10): 2740–2750. American Society for Clinical Investigation. PMID 17909619. Retrieved on 2007-10-15.
  190. ↑ National Cancer Institute PDQ for Professionals. National Cancer Institute PDQ for Professionals.
  191. ↑ Mountain, CF (1997). "Revisions in the international system for staging lung cancer" (PDF). Chest 111: 1710–1717. American College of Chest Physicians. PMID 9187198. Retrieved on 2007-08-09.
  192. ↑ SEER Cancer Statistics Review 1975-2002 - Search. Retrieved on 2007-11-18.
  193. ↑ Commonly diagnosed cancers worldwide. Cancer Research UK (Apr 2005). Retrieved on 2008-01-11.
  194. ↑ Parent, ME; Rousseau MC, Boffetta P et al. (January 2007). "Exposure to diesel and gasoline engine emissions and the risk of lung cancer". American Journal of Epidemiology 165 (1): 53–62. PMID 17062632.
  195. ↑ Gender in lung cancer and smoking research (PDF). World Health Organization (2004). Retrieved on 2007-05-26.
  196. ↑ Liu, BQ; Peto R, Chen ZM et al. (November 1998). "Emerging tobacco hazards in China: 1. Retrospective proportional mortality study of one million deaths". British Medical Journal 317 (7170): 1411–1422. PMID 9822393. Retrieved on 2007-09-27.
  197. ↑ Behera, D; Balamugesh T (2004). "Lung cancer in India". Indian Journal of Chest Diseases and Allied Sciences 46 (4): 269-281. PMID 15515828.
  198. ↑ Mohr SB, Garland CF, Gorham ED, Grant WB, Garland FC (2008). "Could ultraviolet B irradiance and vitamin D be associated with lower incidence rates of lung cancer?". J Epidemiol Community Health 62 (1): 69–74. doi:10.1136/jech.2006.052571. PMID 18079336.
  199. ↑ Morgagni, GB (1761). De sedibus et causis morborum per antomen indagatis.
  200. ↑ Bayle, GL (1810). Recherches sur la phtisie pulmonaire.
  201. ↑ Witschi, H (November 2001). "A short history of lung cancer". Toxicological Sciences 64 (1): 4–6. PMID 11606795.
  202. ↑ Adler, I (1912). Primary Malignant Growths of the Lungs and Bronchi. New York: Longmans, Green, and Company. OCLC 14783544, cited in Spiro SG, Silvestri GA (2005). "One hundred years of lung cancer". Am. J. Respir. Crit. Care Med. 172 (5): 523–9. doi:10.1164/rccm.200504-531OE. PMID 15961694.
  203. ↑ Grannis, FW. History of cigarette smoking and lung cancer. smokinglungs.com. Retrieved on 2007-08-06.
  204. ↑ Proctor, R (2000). The Nazi War on Cancer. Princeton University Press, 173–246. ISBN 0-691-00196-0.
  205. ↑ Doll, R; Hill AB (November 1956). "Lung cancer and other causes of death in relation to smoking; a second report on the mortality of British doctors". British Medical Journal 2 (5001): 1071–1081. PMID 13364389.
  206. ↑ US Department of Health Education and Welfare (1964), Smoking and health: report of the advisory committee to the Surgeon General of the Public Health Service, Washington, DC: US Government Printing Office
  207. ↑ Greaves, M (2000). Cancer: the Evolutionary Legacy. Oxford University Press, 196–197. ISBN 0-19-262835-6.
  208. ↑ Office of the Home Secretary (1976). Biographical Memoirs. National Academy of Sciences. ISBN 0-309-02349-1.
  209. ↑ Edwards, AT (1946). "Carcinoma of the bronchus". Thorax 1: 1–25.
  210. ↑ Clegg, A (Jan 2002). "Clinical and cost effectiveness of paclitaxel, docetaxel, gemcitabine, and vinorelbine in non-small cell lung cancer: a systematic review". Thorax. BMJ Publishing Group Ltd. 57 (1): 20–28. PMID 11809985. Unknown parameter |coauthors= ignored (help)
  211. ↑ Murray, N (Mar 2006). "A review of first-line treatment for small-cell lung cancer". Journal of Thoracic Oncology. 1 (3): 270–278. PMID 17409868. Unknown parameter |coauthors= ignored (help)
  212. ↑ Azim, HA (Mar 2007). "Treatment options for relapsed small-cell lung cancer". Anticancer drugs. 18 (3): 255–261. PMID 17264756. Unknown parameter |coauthors= ignored (help)
  213. ↑ MacCallum, C (Jul 2006). "Second-line treatment of small-cell lung cancer". Current Oncology Reports. 8 (4): 258–264. PMID 17254525. Unknown parameter |coauthors= ignored (help)
  214. ↑ Winton, T (Jun 2005). "Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer". New England Journal of Medicine. Massachusetts Medical Society. 352 (25): 2589–2597. PMID 15972865. Unknown parameter |coauthors= ignored (help)
  215. ↑ Douillard, JY (Sep 2006). "Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial". Lancet Oncology. Elsevier. 7 (9): 719–727. PMID 16945766. Unknown parameter |coauthors= ignored (help)
  216. ↑ Tsuboi, M (Apr 2007). "The present status of postoperative adjuvant chemotherapy for completely resected non-small cell lung cancer" (PDF). Ann Thorac Cardiovasc Surg. 13 (2): 73–77. PMID 17505412. Retrieved 2007-08-14. Unknown parameter |coauthors= ignored (help)
  217. ↑ Horn, L (May 2007). "The rationale for adjuvant chemotherapy in stage I non-small cell lung cancer". Journal of Thoracic Oncology. 2 (5): 377–383. PMID 17473651. Unknown parameter |coauthors= ignored (help)
  218. ↑ Wakelee, HA (Jul 2006). "Current status of adjuvant chemotherapy for stage IB non-small-cell lung cancer: implications for the New Intergroup Trial". Clinical Lung Cancer. Cancer Information Group. 8 (1): 18–21. PMID 16870041. Unknown parameter |coauthors= ignored (help)
  219. ↑ BMJ (Dec 2005). Clinical Evidence Concise. BMJ Publishing Group. pp. 486–488. ISBN 1-905545-00-2. ISSN 1475-9225.
  220. ↑ Wagner, H (Jan 1998). "Radiation therapy in the management of limited small cell lung cancer: when, where, and how much?". Chest. American College of Chest Physicians. 113 (Suppl. 1): 92S–100S. PMID 9438697. Retrieved 2007-08-14.
  221. ↑ "Postoperative radiotherapy for non-small cell lung cancer". Cochrane database of systematic reviews (Online) (2): CD002142. 2005. doi:10.1002/14651858.CD002142.pub2. PMID 15846628.
  222. ↑ Lally, BE (Jul 2006). "Postoperative Radiotherapy for Stage II or III Non–Small-Cell Lung Cancer Using the Surveillance, Epidemiology, and End Results Database". Journal of Clinical Oncology. John Wiley & Sons, Ltd. 24 (19): 2998–3006. PMID 16769986. Unknown parameter |coauthors= ignored (help)
  223. ↑ Ng, M (Jun 2007). "Tolerability of accelerated chest irradiation and impact on survival of prophylactic cranial irradiation in patients with limited-stage small cell lung cancer: review of a single institution's experience". Journal of Thoracic Oncology. International Association for the Study of Lung Cancer. 2 (6): 506–513. PMID 17545845. Unknown parameter |coauthors= ignored (help)
  224. ↑ Slotman, B (Aug 2007). "Prophylactic cranial irradiation in extensive small-cell lung cancer". New England Journal of Medicine. 357 (7): 664–672. PMID 17699816. Unknown parameter |coauthors= ignored (help)
  225. ↑ Simon, CJ (Apr 2007). "Pulmonary radiofrequency ablation: long-term safety and efficacy in 153 patients". Radiology. 243 (1): 268–275. PMID 17392258. Unknown parameter |coauthors= ignored (help)
  226. ↑ Feld, R (May 2006). "Use of the epidermal growth factor receptor inhibitors gefitinib and erlotinib in the treatment of non-small cell lung cancer: a systematic review". Journal of Thoracic Oncology. International Association for the Study of Lung Cancer. 1 (4): 367–376. PMID 17409886. Unknown parameter |coauthors= ignored (help)
  227. ↑ Bencardino, K (Mar 2007). "Epidermal growth factor receptor tyrosine kinase inhibitors for the treatment of non-small-cell lung cancer: results and open issues". Internal and Emergency Medicine. 2 (1): 3–12. PMID 17551677. Unknown parameter |coauthors= ignored (help)
  228. ↑ Sandler, A (Dec 2006). "Paclitaxel–Carboplatin Alone or with Bevacizumab for Non–Small-Cell Lung Cancer". New England Journal of Medicine. Massachusetts Medical Society. 355 (24): 2542–2550. PMID 17167137. Unknown parameter |coauthors= ignored (help)
  229. ↑ Edelman, MJ (Sep 2006). "Novel cytotoxic agents for non-small cell lung cancer". Journal of Thoracic Oncology. 1 (7): 752–755. PMID 17409954.
  230. ↑ Danesi, R (May 2007). "The role of pharmacogenetics in adjuvant treatment of non-small cell lung cancer". Journal of Thoracic Oncology. 2 (5 Suppl.): S27–S30. PMID 17457227. Unknown parameter |coauthors= ignored (help)
  231. ↑ Blackhall, FH (Mar 2007). "Small cell lung cancer and targeted therapies". Current Opinion in Oncology. 19 (2): 103–108. PMID 17272981. Unknown parameter |coauthors= ignored (help)
  232. ↑ Lee, JM (Apr 2007). "Significance of cyclooxygenase-2 in prognosis, targeted therapy and chemoprevention of NSCLC". Future Oncology. 2 (2): 149–153. PMID 17381414. Unknown parameter |coauthors= ignored (help)
  233. ↑ Whitehead, Clark M (May 2003). "Exisulind-induced Apoptosis in a Non-Small Cell Lung Cancer Orthotopic Lung Tumor Model Augments Docetaxel Treatment and Contributes to Increased Survival". Molecular Cancer Therapeutics. American Association for Cancer Research. 2: 479–488. PMID 12748310. Retrieved 2007-09-01. Unknown parameter |coauthors= ignored (help)
  234. ↑ Scagliotti, G (Jun 2006). "Proteasome inhibitors in lung cancer". Critical Reviews in Oncology/Haematology. 58 (3): 177–189. PMID 16427303.
  235. ↑ Dragnev, KH (Mar 2007). "A proof-of-principle clinical trial of bexarotene in patients with non-small cell lung cancer". Clinical Cancer Research. American Association for Cancer Research. 13 (6): 1794–1800. PMID 17363535. Unknown parameter |coauthors= ignored (help)
  236. ↑ Albright, C (Jul 2007). "Vaccine therapy in non-small cell lung cancer". Current Oncology Reports. 9 (4): 241–246. PMID 17588347. Unknown parameter |coauthors= ignored (help)
  237. ↑ Vineis, P (Feb 2007). "Lung cancers attributable to environmental tobacco smoke and air pollution in non-smokers in different European countries: a prospective study". Environmental Health. BioMed Central. 6: 7. doi:10.1186/1476-069X-6-7. PMID 17302981. Retrieved 2007-08-11. Unknown parameter |coauthors= ignored (help)
  238. ↑ Pandey, G (Feb 2005). "Bhutan's smokers face public ban". BBC. Retrieved 2007-09-07.
  239. ↑ Gray, N (Feb 2003). "A global approach to tobacco policy". Lung Cancer. BioMed Central. 39 (2): 113&ndash, 117. PMID 12581561.
  240. ↑ Gohagan, JK (Jan 2005). "Final results of the Lung Screening Study, a randomized feasibility study of spiral CT versus chest X-ray screening for lung cancer". Lung Cancer. 47 (1): 9–15. doi:10.1016/j.lungcan.2004.06.007. PMID 15603850. Unknown parameter |coauthors= ignored (help)
  241. ↑ Mountain, CF (1997). "Revisions in the international system for staging lung cancer" (PDF). Chest. American College of Chest Physicians. 111: 1710–1717. PMID 9187198. Retrieved 2007-08-09.

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