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Medicine - Radiology | Treatment of High-Risk Early Stage Lung Cancer

Treatment of High-Risk Early Stage Lung Cancer

Bogart, Jeffrey, Detterbeck, Frank C. (Eds.)

2015, Approx. 250 p. 100 illus., 50 illus. in color.

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ISBN 978-3-319-08539-5

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  • About this book

  • Detailed guide to the evaluation and management of high-risk patients with early stage NSCLC
  • Covers the full range of applicable surgical and radiotherapy treatment options plus other approaches
  • Highly relevant for radiation and medical oncologists, thoracic surgeons, interventional radiologists and pulmonologists

While the majority of patients with stage I non-small cell lung cancer (NSCLC) are treated surgically, approximately 30% are not considered candidates for lobectomy owing to pulmonary dysfunction and/or other co-morbidities. Under these circumstances, a nihilistic approach was commonly adopted in the past; however, the majority of untreated patients died not from their co-morbid disease but from their lung cancer, despite its early stage at diagnosis. Recent advances, including image-guided stereotactic radiotherapy, minimally invasive sublobar resection, and radiofrequency ablation, have altered the situation. A number of prospective studies have yielded promising results, and it is now widely recognized that definitive treatment should be considered in this population.


This book is a detailed guide to the evaluation and management of high-risk patients with early stage NSCLC. It first addresses issues such as pathologic considerations, assessment of co-morbidity, and the imaging and staging of NSCLC. Surgical and radiotherapy treatment options, including sublobar resection, minimally invasive surgery, brachytherapy, stereotactic body radiotherapy, and proton and charged particle therapy, are then discussed in detail. The role of radiofrequency ablation, salvage local therapy, and systemic chemotherapy is also considered. Treatment of High-Risk Early Stage Lung Cancer will be of great interest to radiation and medical oncologists, thoracic surgeons, interventional radiologists, and pulmonologists.

Content Level » Professional/practitioner

Keywords » Early Stage NSCLC - Lung cancer - Non-small Cell Lung Cancer - Proton Therapy in Lung Cancer - Radiofrequency ablation - Radiotherapy in Lung Cancer - Stereotactic Body Radiation Therapy - Sublobar resection - Synchronous primary NSCLC lesions

Related subjects » Internal Medicine - Oncology & Hematology - Radiology

Table of contents 

The spectrum of tumor aggressiveness in early stage Cancer.- The spectrum of patients with early cancer.- What is the appropriate evaluation for early stage NSCLC.- How do we assess outcomes in high risk patients.- Definition of high risk.- Which tumors are amenable to a lesion-only approach.- Technical consideration of minimally invasive surgery for stage I NSCLC.- Technical considerations of SBRT treatment planning and delivery.- Technical considerations of Ablative treatments (RFA).- Outcomes of surgical resection (VATS lobe, segment, wedge) in high risk patients.- Outcomes of SBRT in high risk patients.- Outcomes of RFA in high risk patients.- How should high-risk patients with peripheral stage I NSCLC be counseled regarding treatment alternatives (SLR vs SBRT vs RFA)?.- Synchronous primary NSCLC lesions / oligometastatic disease.- Considerations of salvage local therapy in previously treated stage I NSCLC.- Which patients with stage I NSCLC may benefit from systemic therapy.- Is there still a role for fractionated radiotherapy in medically inoperable peripheral early stage NSCLC.- Proton and charged particle therapy in the era of SBRT.

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