NCCN Guidelines for Patients® | Non-Small Cell Lung Cancer - page 67

67
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 III invasive tumors
Other invasive tumors
Chemoradiation
Test results
T3, N1
T4, N0
T4, N1
T4, N0 or N1 that can’t
be treated with surgery;
N2 or N3 disease
Primary
treatment
Lung tumor
and lymph
node surgery
None (preferred)
Chemotherapy
Neoadjuvant
treatment
Chemoradiation
Adjuvant treatment
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
This chart maps the treatment for stage III invasive
tumors other than superior sulcus tumors. These tumors
have grown into the chest wall, bronchi, or mediastinum.
The cancer may or may not have spread to lymph
nodes. Surgery without neoadjuvant treatment is the
preferred option for these tumors. Other options start with
neoadjuvant chemoradiation or chemotherapy.
If you don’t have neoadjuvant treatment before surgery,
chemotherapy afterwards is recommended when the
surgical margins are cancer-free. When the margins
have cancer, treatment options are based on whether the
cancer can’t be seen with the naked eye (microscopic) or
can be seen (macroscopic). Microscopic cancer is found
with a microscope.
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