NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 61

61
NCCN Guidelines for Patients
®
: Non-Small Cell Lung Cancer
Version 1.2014
Part 7: Treatment by cancer stage
Par t 1
Par t 2
Par t 3
Par t 4
Par t 5
Par t 6
Par t 7
Par t 8
Par t 9
Stage IIB invasive tumors
This chart maps the treatment for stage IIB invasive tumors.
These tumors have grown into the chest wall or bronchi, but
the cancer hasn’t spread to lymph nodes. Treatment options
depend on into which tissues the primary tumor has grown.
A superior sulcus tumor starts at the top of the lung
and easily grows into the chest wall. For these tumors,
chemoradiation is used to shrink the tumor to make surgery
easier. After surgery, chemotherapy is recommended.
No neoadjuvant treatment before surgery is the preferred
option for other tumors that have grown into the chest
wall or bronchi. Other options are chemoradiation or
chemotherapy followed by surgery. Adjuvant treatment is
based on the surgical results.
If you have no neoadjuvant treatment before surgery,
chemotherapy is recommended when the surgical
margins are cancer-free. When cancer is in the margins,
treatment options are based on whether the cancer can’t
Primary
treatment
Test results
Superior
sulcus tumor
Growth into
chest wall
or bronchi
Lung tumor
and lymph
node surgery
Chemoradiation
Lung tumor
and lymph
node surgery
None (preferred)
Chemotherapy
Neoadjuvant
treatment
Chemoradiation
Adjuvant treatment
Chemotherapy
Margin status
No cancer
in margins
Chemotherapy
Cancer not seen
with naked eye
Cancer seen
with naked eye
Surgery + chemotherapy, or
Concurrent or sequential chemoradiation
Surgery + chemotherapy, or
Concurrent chemoradiation
No cancer
in margins
Observe
Cancer in
margins
Surgery
Lung tumor
and lymph
node surgery
1...,51,52,53,54,55,56,57,58,59,60 62,63,64,65,66,67,68,69,70,71,...108
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