Non small cell lung cancer medical therapy stage IV
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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]
Overview
Medical Therapy for Stage IV Non-Small Cell Lung Cancer
The algorithms for the treatment of stage IV non small cell carcinoma of the lung are based on the 2014 NCCN Non-Small Cell Lung Cancer guidelines.[1]
Is pleural or pericardial effusion present (suggestive of M1a) or are findings suggestive of systemic metastasis (M1b) present? | |||||||||||||||||||||||||||||||||||||||||||||
M1a | M1b: solitary site systemic metastasis | ||||||||||||||||||||||||||||||||||||||||||||
Perform the following tests:
| Perform the following tests:
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Is the liquid extracted positive for malignant cells? | Are findings suggestive of adrenal metastasis or brain metastasis? | ||||||||||||||||||||||||||||||||||||||||||||
Yes | No | Adrenal | Brain | ||||||||||||||||||||||||||||||||||||||||||
Local therapy
PLUS | Perform a needle aspiration biopsy for metastasis confirmation | Surgical resection + adjuvant radiation therapy Radiation therapy alone:
| {{{Whole brain radiation therapy]] OR PLUS | ||||||||||||||||||||||||||||||||||||||||||
If the lung disease is curable, administer local therapy for the adrenal lesion:
OR | What is the TN stage of the lung tumor? | ||||||||||||||||||||||||||||||||||||||||||||
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| Administer therapy for metastatic disease in case of not curable lung lesions (click here for the treatment of metastatic cancer) | ||||||||||||||||||||||||||||||||||||||||||||