Early-stage non-small cell lung cancer: surgery, stereotactic radiosurgery, and individualized adjuvant therapy.

Abstract:

:Despite cures in early stage (IA-IIB) non-small cell lung cancer (NSCLC), the 5-year survival rate is only 36%-73%. Surgical resection via lobectomy is the treatment of choice in early-stage NSCLC, with the goal being complete anatomic resection of the tumor and mediastinal lymph node evaluation. Newer technologies, including the minimally invasive thoracoscopic approach and the many techniques available to stage the mediastinum, have introduced advantages over traditional approaches in achieving this goal. The advent of stereotactic ablative radiotherapy (SABR) has changed how we treat those patients who cannot undergo surgery secondary to comorbidities or patient preference. SABR allows for precise radiation delivery in a short course and at high doses. Adjuvant cisplatin-based chemotherapy is the standard of care for completely resected high-risk stage IB and stage II NSCLC based on a ~5% improvement in 5-year overall survival. The concept of customized adjuvant chemotherapy is emerging, and we will explore the potential value of targeting tumor mutations with available drugs (ie, epidermal growth factor receptor [EGFR] mutations with erlotinib), a strategy that for the moment should be restricted to clinical trials.

journal_name

Semin Oncol

journal_title

Seminars in oncology

authors

Padda SK,Burt BM,Trakul N,Wakelee HA

doi

10.1053/j.seminoncol.2013.12.011

subject

Has Abstract

pub_date

2014-02-01 00:00:00

pages

40-56

issue

1

eissn

0093-7754

issn

1532-8708

pii

S0093-7754(13)00221-2

journal_volume

41

pub_type

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