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30 Cards in this Set
- Front
- Back
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most common lung cancer for non-smokers
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NSCLC- adenocarcinoma
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location: adenocarcinoma (nonsquamous), squamous, large cell, SCLC
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adeno, large cell= periphery,
squamous, SCLC= tracheobronchial tree |
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most common lung symptom
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cough- especially in squamous and SCLC due to location in central airways
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common paraneoplastic syndrome w/SCLC
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SIADH- syndrome of inappropriate secretion of antidiuretic hormone= buildup of fluid and hyponatremia
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SCLC- surgery
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surgery has no role, sensitive to chemo and rad
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SCLC limited stage- treatment
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EP x 4-6 cycles + rad
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SCLC extensive stage- treatment
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cisplatin or carbo combination therapy x 4-6 cycles
cisplatin + etoposide or irinotecan 3 drug regimen NOT superior to 2 |
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CSFs w/ SCLC?
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CSFs to maintain dose intensity not beneficial and should also be avoide in pts receiving thoracic RT
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dose intensity in SCLC
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does not improve outcomes
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surgery in NSCLC?
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surgery is treatment of choice in resectable tumors
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adjuvant chemo in NSCLC?
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cisplatin-based chemo in resected stage II and IIIA is standard and improves OS. Alkylating agents are not used.
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NSCLC treatment stage I
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adjuvant chemo is not indicated
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NSCLC treatment- stage 3B
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EP +RT or cisplatin+vinblastine + RT
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NSCLC treatment stage 4
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cisplatin-based doublets. Adding bev to carbo/paclitaxel prolongs survival.
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NSCLC stage 4 PS
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PS 3-4 = no benefit from chemo
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NSCLC second line agents
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docetaxel or pemetrexed
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NSCLC third line
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erlotinib 150mg PO qd
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histology for pemetrexed and bevacizumab
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non-squamous only
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predictors of response for erlotinib (4)
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female, adenocarcinoma, never smoker, asian ethnicity
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NCCN category 1 agent for relapsed disease
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topotecan
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Regimen in SCLC to use if relapse >6 months from initial tx
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repeat same regimen used in prior tx
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SCLC- Cranial RT if no brain mets?
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Increased 1 yr survival by irradiating brain even if no mets if there was a positive response to chest RT
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topotecan dose for SCLC
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1.5mg/m2 qd x 5 days every 21 days
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1st line NSCLC tx for non-squamous in healthy patients
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platinum based doublets + bevacizumab in select patients OR cisplatin + pemetrexed
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1st line NSCLC tx for squamous in healthy patients
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platinum based doublets
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1st line NSCLC tx for poor health patients
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cisplatin, vinorelbine, consider single agent or carboplatin based doublet
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NSCLC maintainence
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pemetrexed (nonsquamous only), erlotinib, docetaxel
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NSCLC 2nd line agents
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erlotinib, docetaxel, pemetrexed
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NSCLC 3rd line
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erlotinib
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Preventing NSCLC recurrence following surgery is best obtained by:
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Adjuvant chemo. Adjuvant RT has been shown to decrease survival.
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