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

68 NCCN Guidelines for Patients ® : Lung Cancer – Non-Small Cell, 2018 T3 Superior sulcus tumors Guide 11 lists treatment options for stage IIB superior sulcus tumors. These tumors start at the top of the lung and easily grow into the chest wall. They are invasive cancers. Options are based on if you can have surgery. If surgery is an option, preoperative treatment is advised. Chemoradiation may shrink the tumor and make surgery easier. After surgery, chemotherapy is advised. Chemotherapy will reduce the chances of the cancer returning. You may be unable or refuse to have surgery. In this case, chemoradiation is an option. These two types of treatment should be received at the same time. The goal is to try to cure the cancer. T3 Other invasive tumors Other stage IIB tumors can be invasive like superior sulcus tumors. These tumors may have grown into the chest wall or bronchi. The cancer hasn’t spread to lymph nodes. Guide 12 lists treatment options for invasive T3 tumors. For initial treatment, options depend on if you are able to have surgery. Initial treatment If surgery is an option, surgery alone is the option preferred by NCCN experts. Other options are chemoradiation or chemotherapy before surgery. These treatments may shrink the cancer and make surgery easier. You may be unable or refuse to have surgery. In this case, chemoradiation is an option. These two types of treatment should be received at the same time. Adjuvant treatment Adjuvant treatment is given to reduce the chances of the cancer returning. Treatment options differ by type of initial treatment. Cancer in the surgical margins also affects treatment options. No preoperative treatment . 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. Preoperative treatment . You may start your survivorship plan if the margins are cancer-free. Otherwise, a second surgery to remove the cancer is advised. 6 Non-metastatic cancer One primary tumor – Stage II

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