Treatment of lung cancer refers to the use of medical therapies, such as surgery, radiation, chemotherapy, immunotherapy, percutaneous ablation, and palliative care,[1][2][3][4] alone or in combination, in an attempt to cure or lessen the adverse impact of malignant neoplasms originating in lung tissue.
Lung cancer is an extremely heterogeneous family of malignant neoplasms,[5] and well over 50 different histopathological variants are currently recognized under the most widely used typing system.[6] Because these variants have differing genetic, biological, and clinical properties, including response to treatment, correct classification of lung cancer cases are necessary to assure that lung cancer patients receive optimum management.[6][7][8]
Approximately 95% of lung cancers are carcinoma, or tumors derived from transformed cells of epithelial lineage.[9] Currently, nearly four dozen different histopathological variants of lung carcinoma are recognized.[6] For clinical and treatment purposes, however, most oncologists tend to classify lung carcinomas into two major groups, namely small cell carcinoma (SCLC) and non-small cell lung cancer (NSCLC). This is done because of differing responses to treatment—NSCLC is comparatively less sensitive to chemotherapy and/or radiation, so surgery is the treatment of choice in these tumors. SCLC, in contrast, usually initially responds well to chemotherapy and/or radiation, but has usually metastasized widely by the time it is discovered, making surgery ineffective.
In a 2010 study of patients with metastatic non–small-cell lung cancer, "early palliative care led to significant improvements in both quality of life and mood. As compared with patients receiving standard care, patients receiving early palliative care had less aggressive care at the end of life but longer survival" which was increased by approximately three months.[1]
There are typically three objectives applied to the treatment of lung cancer and can vary by patient or individual diagnosis: (1) curing lung cancer, (2) controlling lung cancer, and (3) being comfortable.[10]
^ abTemel JS, Greer JA, Muzikansky A, et al. (August 2010). "Early palliative care for patients with metastatic non-small-cell lung cancer". N. Engl. J. Med. 363 (8): 733–42. doi:10.1056/NEJMoa1000678. PMID 20818875. S2CID 1128078.
^Kelley AS, Meier DE (August 2010). "Palliative care--a shifting paradigm". N. Engl. J. Med. 363 (8): 781–2. doi:10.1056/NEJMe1004139. PMID 20818881.
^Prince-Paul M (April 2009). "When hospice is the best option: an opportunity to redefine goals". Oncology (Williston Park, N.Y.). 23 (4 Suppl Nurse Ed): 13–7. PMID 19856592.
^Syn, Nicholas L; Teng, Michele W L; Mok, Tony S K; Soo, Ross A (2017). "De-novo and acquired resistance to immune checkpoint targeting". The Lancet Oncology. 18 (12): e731–e741. doi:10.1016/s1470-2045(17)30607-1. PMID 29208439.
^Roggli VL, Vollmer RT, Greenberg SD, McGavran MH, Spjut HJ, Yesner R (June 1985). "Lung cancer heterogeneity: a blinded and randomized study of 100 consecutive cases". Hum. Pathol. 16 (6): 569–79. doi:10.1016/S0046-8177(85)80106-4. PMID 2987102.
^ abcTravis, William D; Brambilla, Elizabeth; Muller-Hermelink, H Konrad; et al., eds. (2004). Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart(PDF). World Health Organization Classification of Tumours. Lyon: IARC Press. ISBN 92-832-2418-3.
^Rossi G, Marchioni A, Sartori G, Longo L, Piccinini S, Cavazza A (2007). "Histotype in non-small cell lung cancer therapy and staging: The emerging role of an old and underrated factor". Curr Respir Med Rev. 3: 69–77. doi:10.2174/157339807779941820.
^Vincent MD (August 2009). "Optimizing the management of advanced non-small-cell lung cancer: a personal view". Curr Oncol. 16 (4): 9–21. doi:10.3747/co.v16i4.465. PMC 2722061. PMID 19672420.
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