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

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

67 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 4 cm, after a wedge resection, or cancer cells barely look like normal cells. Some stage IIA tumors will be removed with cancer in the margins. In these cases, a second surgery is the option preferred by NCCN experts. Chemotherapy may be added. A second option is chemoradiation. These two types of treatment may be given at the same time or back-to-back. For stage IIB, chemotherapy is advised when the margins are cancer-free. When the margins have cancer, a second surgery followed by chemotherapy is an option. The second option is chemoradiation. These two types of treatment can be given at the same time. They may also be given back-to-back if cancer in the margins can only be seen with a microscope. After radiation therapy only . Chemotherapy may be received if cancer cells likely remain in your body. Cancer likely remains when tumors are larger than 4 cm or cancer cells barely look like normal cells. Chemotherapy may also be given if it is unknown whether cancer is in lymph nodes. Guide 10. Treatment for T2 or T3 without invasion Initial treatment Surgery status Cancer stage What are the options? You are approved and agree to surgery Any stage II • Surgery to remove lung tumor and lymph nodes You are not approved or decline surgery Stage II with N0 disease • Radiation therapy (including SABR) Stage II with N1 disease • Chemoradiation (at the same time) Adjuvant treatment after surgery Pathologic stage Margin status What are the options? Stage IIA No cancer in the margins • Start survivorship plan • Chemotherapy if cancer may still be in your body Cancer in the margins • Another surgery (preferred) • Chemoradiation (same time or back-to-back) Stage IIB No cancer in the margins • Chemotherapy Cancer in margins that is only seen with a microscope • Another surgery + chemotherapy • Chemoradiation (same time or back-to-back) Cancer in margins that is seen with the naked eye • Another surgery + chemotherapy • Chemoradiation (at the same time) Adjuvant treatment after radiation treatment Initial treatment What are the options? Radiation therapy only • Consider chemotherapy if cancer may still be in your body 6 Non-metastatic cancer One primary tumor – Stage II

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