Surgical Management of Early-Stage Non-small Cell Lung Carcinoma and the Present and Future Roles of Adjuvant Therapy: A Review for the Radiation Oncologist

• Published in: International journal of radiation oncology, biology, physics Vol. 84; no. 5; pp. 1048 - 1057
• Main Authors: Medford-Davis, Laura, MD, DeCamp, Malcom, MD, Recht, Abram, MD, Flickinger, John, MD, Belani, Chandra P., MD, Varlotto, John, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-12-2012; Elsevier
• Subjects: Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - pathology; Carcinoma, Non-Small-Cell Lung - therapy; CARCINOMAS; CHEMOTHERAPY; Chemotherapy, Adjuvant - methods; Chemotherapy, Adjuvant - mortality; Chemotherapy, Adjuvant - trends; CLINICAL TRIALS; Early Detection of Cancer; Forecasting; HEALTH HAZARDS; Hematology, Oncology and Palliative Medicine; Humans; Lung - surgery; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - therapy; LUNGS; Lymph Node Excision - methods; Lymph Node Excision - mortality; LYMPH NODES; Lymphatic Metastasis; Mediastinum; MEDICAL PERSONNEL; Medical sciences; Neoadjuvant Therapy - methods; Neoadjuvant Therapy - mortality; Neoadjuvant Therapy - trends; Neoplasm Recurrence, Local - therapy; Neoplasm Staging; Neoplasm, Residual; PATIENTS; Pneumology; Pneumonectomy - adverse effects; Pneumonectomy - methods; Pneumonectomy - mortality; Practice Guidelines as Topic; Radiation Oncology; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; RADIOTHERAPY; Radiotherapy, Adjuvant - methods; Radiotherapy, Adjuvant - mortality; Radiotherapy, Adjuvant - trends; Randomized Controlled Trials as Topic; Risk Factors; SURGERY; Tumor Burden; Tumors of the respiratory system and mediastinum; Lung disease; Respiratory disease; Lung cancer; Adjuvant treatment; Early stage; Malignant tumor; Review; non-small cell lung carcinoma; Cancerology; Clinical management; Surgery; Bronchus disease; Bibliographic review; Cancer
• ISSN: 0360-3016; 1879-355X
• DOI: 10.1016/j.ijrobp.2012.03.018

We review the evidence for optimal surgical management and adjuvant therapy for patients with stages I and II non-small cell lung cancer (NSCLC) along with factors associated with increased risks of recurrence. Based on the current evidence, we recommend optimal use of mediastinal lymph node dissection, adjuvant chemotherapy, and post-operative radiation therapy, and make suggestions for areas to explore in future prospective randomized clinical trials.