Lung cancer

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Treatment of stage IIIB non–small cell lung cancer

The following are treatment options for stage IIIB non–small cell lung cancer. The types of treatments given are based on the unique needs of the person with cancer.

Chemotherapy

Chemotherapy is the primary treatment for stage IIIB non–small cell lung cancer. It is often given at the same time as radiation therapy (concurrent therapy).

The most common chemotherapy combinations used for stage IIIB non–small cell lung cancer use cisplatin (Platinol AQ) and another drug:

  • cisplatin and etoposide (Vepesid)
  • cisplatin and vinorelbine (Navelbine)
  • cisplatin and gemcitabine (Gemzar)
  • cisplatin and docetaxel (Taxotere)
  • cisplatin and pemetrexed (Alimta)

If a person cannot take cisplatin, a related drug called carboplatin (Paraplatin, Paraplatin AQ) may be used with the above drugs.

Single chemotherapy drugs may be given if a person with non–small cell lung cancer cannot have combination chemotherapy because of poor health or other medical problems:

  • gemcitabine
  • vinorelbine
  • docetaxel
  • pemetrexed

Targeted chemotherapy

Targeted chemotherapy may be offered for stage IIIB non–small cell lung cancer. The types of targeted chemotherapy used for non–small cell lung cancer are:

  • gefitinib (Iressa) for EGFR-positive tumours
  • crizotinib (Xalkori) for ALK-positive tumours

Maintenance chemotherapy

Maintenance chemotherapy may be offered to people with stage IIIB non–small cell lung cancer that has responded to chemotherapy. The drug used is pemetrexed.

  • Pemetrexed is not used for squamous cell carcinomas.

Radiation therapy

Radiation therapy may be offered for stage IIIB non–small cell lung cancer:

  • at the same time as chemotherapy (concurrent therapy) or after chemotherapy (sequential therapy)
  • alone in people who cannot have chemotherapy

The type of radiation therapy is external beam radiation therapy.

Endobronchial therapies

Endobronchial therapies for stage IIIB non–small cell lung cancer may be used to relieve symptoms caused by a tumour that is blocking the airway(s). The types of endobronchial therapies are:

  • photodynamic therapy
  • laser surgery
  • electrocoagulation
  • stent placement

Surgery

Surgery is not done to remove stage IIIB non–small cell lung cancer. At this stage, the cancer has spread too far for surgery to be effective. Surgery may be used to relieve symptoms (palliative surgery), such as difficulty breathing. The types of surgery that may be used are:

  • chest tube placement
  • thoracentesis

Clinical trials

People with non–small cell lung cancer may be offered the opportunity to participate in clinical trials. For more information, go to clinical trials.

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