Lung cancer

Grundy, Seamus; Barton, Rachael; Campbell, Anne; Cowen, Michael; Lind, Michael

Abstract

The accurate diagnosis, staging and management of lung cancer occupies a large part of modern adult respiratory practice. Although smoking is less prevalent, the incidence and mortality of this condition remain high, and earlier detection through screening programmes is currently being evaluated. Widely available techniques, including endoscopic ultrasound and positron emission tomography scanning, have changed diagnostic strategies and now have an established role in the staging pathway where they have largely replaced surgical staging of the mediastinum. Minimally invasive techniques and lung-sparing resections have allowed potentially curative operations in patients whose comorbidities would have prevented traditional surgical approaches. Although the role of chemotherapy in small cell lung cancer (SCLC) has been well established, recent data have identified benefits of chemotherapy in non-small cell lung cancer (NSCLC) in both primary and adjuvant settings or when combined with radiotherapy. A particularly exciting development has been the recognition of subsets of NSCLC tumours exhibiting driver mutations or expressing programmed cell death receptors which predict response to a rapidly emerging therapeutic armamentarium and which appear more effective and better tolerated than conventional combination chemotherapy. Increasingly sophisticated techniques of irradiation have expanded the hitherto largely palliative role of radiotherapy (RT). Patients with T1–2 tumours who are unfit for surgery can be treated with radical intent using stereotactic ablative body radiotherapy (SABR) or in some centres hyperfractionation. The roles of thoracic and cranial RT in SCLC and NSCLC can now be approached with a firmer evidence base and are discussed in this chapter.

Citation

Grundy, S., Barton, R., Campbell, A., Cowen, M., & Lind, M. (2018). Lung cancer. In S. Hart, & M. Greenstone (Eds.), Foundations of Respiratory Medicine (87-118). Springer. https://doi.org/10.1007/978-3-319-94127-1_6

• Online Publication Date: Sep 5, 2018
• Publication Date: Sep 4, 2018
• Deposit Date: May 30, 2022
• Publisher: Springer
• Pages: 87-118
• Book Title: Foundations of Respiratory Medicine
• ISBN: 9783319941257
• DOI: https://doi.org/10.1007/978-3-319-94127-1_6
• Keywords: Lung cancer; Small-cell; Non-small cell; Staging; Surgery; Radiotherapy; Chemotherapy; Transcription kinase inhibitors; Immuotherapy
• Public URL: https://hull-repository.worktribe.com/output/3597045