Management of Lung cancer

  • Sabita JiwnaniEmail author
  • George Karimundackal
  • C. S. Pramesh
Part of the Clinicians’ Guides to Radionuclide Hybrid Imaging book series (CGRHI)


Lung cancer is the leading cause of cancer-related mortality in both men and women throughout the world, accounting for more than a quarter of the deaths (27%) as per the cancer statistics report 2016 [1]. An estimated 2.2 million new lung cancer cases will be diagnosed in 2016 [1]. Lung cancers are generally divided into small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC).


  1. 1.
    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66:7–30.CrossRefPubMedGoogle Scholar
  2. 2.
    Swensen SJ, Brown LR. Conventional radiography of the hilum and mediastinum in bronchogenic carcinoma. Radiol Clin North Am. 1990;28:521–38, Review.PubMedGoogle Scholar
  3. 3.
    Swensen SJ, Brown LR, Colby TV. Lung nodule enhancement at CT: prospective findings. Radiology. 1996;201:447–55.CrossRefPubMedGoogle Scholar
  4. 4.
    Zwirewich CV, Vedal S, Miller RR, et al. Solitary pulmonary nodule: high resolution CT and radiologic-patho- logic correlation. Radiology. 1991;179:469–76.CrossRefPubMedGoogle Scholar
  5. 5.
    Vansteenkiste JF, Stroobants SG. The role of positron emission tomography with 18F-fluoro-2-deoxy-D-glucose in respiratory oncology. Eur Respir J. 2001;17:802–20.CrossRefPubMedGoogle Scholar
  6. 6.
    Bruzzi JF, Komaki R, Walsh GL, et al. Imaging of non-small cell lung cancer of the superior sulcus: part 1: anatomy, clinical manifestations, and management. Radiographics. 2008;28:551–60, Review.CrossRefPubMedGoogle Scholar
  7. 7.
    Yokoi K, Kamiya N, Matsuguma H, et al. Detection of brain metastasis in potentially operable non-small cell lung cancer: a comparison of CT and MRI. Chest. 1999;115:714–9.CrossRefPubMedGoogle Scholar
  8. 8.
    Schreiber G, McCrory DC. Performance characteristics of different modalities for diagnosis of suspected lung cancer: summary of published evidence. Chest. 2003;123:115S–28S, Review.CrossRefPubMedGoogle Scholar
  9. 9.
    Tsim S, O’Dowd CA, Milroy R, et al. Staging of non-small cell lung cancer(NSCLC): a review. Respir Med. 2010;104:1767–74.CrossRefPubMedGoogle Scholar
  10. 10.
    Howington JA, Blum MG, Chang AC, et al. Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143:e278S–313S.CrossRefPubMedGoogle Scholar
  11. 11.
    Ma Z, Dong A, Fan J, Cheng H. Does sleeve lobectomy concomitant with or without pulmonary artery reconstruction (double sleeve) have favorable results for non-small cell lung cancer compared with pneumonectomy? A meta-analysis. Eur J Cardiothorac Surg. 2007;32:20–8.CrossRefPubMedGoogle Scholar
  12. 12.
    Ginsberg RJ, Rubinstein LV. Lung Cancer Study Group randomized trial of lobectomy versus limited resection for T1 N0 non-small cell lung cancer. Ann Thorac Surg. 1995;60:615–23.CrossRefPubMedGoogle Scholar
  13. 13.
    Razi SS, John MM, Sainathan S, et al. Sublobar resection is equivalent to lobectomy for T1a non-small cell lung cancer in the elderly: a Surveillance, Epidemiology, and End Results database analysis. J Surg Res. 2016;200:683–9.CrossRefPubMedGoogle Scholar
  14. 14.
    Whitson BA, Groth SS, Duval SJ, et al. Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopic surgery versus thoracotomy approaches to lobectomy. Ann Thorac Surg. 2008;86:2008–16, Review.CrossRefPubMedGoogle Scholar
  15. 15.
    Cattaneo SM, Park BJ, Wilton AS, et al. Use of video-assisted thoracic surgery for lobectomy in the elderly results in fewer complications. Ann Thorac Surg. 2008;85:231–5.CrossRefPubMedGoogle Scholar
  16. 16.
    Cheng D, Downey RJ, Kernstine K, et al. Video-assisted thoracic surgery in lung cancer resection: a meta-analysis and systematic review of controlled trials. Innovations. 2007;2:261–92.PubMedGoogle Scholar
  17. 17.
    Wu Y, Huang ZF, Wang SY, et al. A randomized trial of systematic nodal dissection in resectable non-small cell lung cancer. Lung Cancer. 2002;36:1–6.CrossRefPubMedGoogle Scholar
  18. 18.
    Allen MS, Darling GE, Pechet TTV, et al. The ACOSOG Z0030 Study Group. Morbidity and mortality of major pulmonary resection in patients with early-stage lung cancer: initial results of the randomised prospective ACOSOG Z0030 trial. Ann Thorac Surg. 2006;81:1013–20.CrossRefPubMedGoogle Scholar
  19. 19.
    Darling GE, Allen MS, Decker PA, et al. Randomized trial of mediastinal lymph node sampling versus complete lymphadenectomy during pulmonary resection in the patient with N0 or N1 (less than hilar) non-small cell carcinoma: results of the American College of Surgery Oncology Group Z0030 Trial. J Thorac Cardiovasc Surg. 2011;141:662–70.CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Huang X, Wang J, Chen Q, et al. Mediastinal lymph node dissection versus mediastinal lymph node sampling for early stage non-small cell lung cancer: a systematic review and meta-analysis. PLoS One. 2014;9(10):e109979, eCollection 2014, Review.
  21. 21.
    Dosoretz DE, Katin MJ, Blitzer PH, et al. Radiation therapy in the management of medically inoperable carcinoma of the lung: results and implications for future treatment strategies. Int J Radiat Oncol Biol Phys. 1992;24:3–9.CrossRefPubMedGoogle Scholar
  22. 22.
    Onishi H, Shirato H, Nagata Y, et al. Hypofractionated stereotactic radiotherapy (HypoFXSRT) for stage I non-small cell lung cancer: updated results of 257 patients in a Japanese multi-institutional study. J Thorac Oncol. 2007;2:S94–100.CrossRefPubMedGoogle Scholar
  23. 23.
    Lencioni R, Crocetti L, Cioni R, et al. Response to radiofrequency ablation of pulmonary tumours: a prospective, intention-to-treat, multicentre clinical trial (the RAPTURE study). Lancet Oncol. 2008;9:621–8.CrossRefPubMedGoogle Scholar
  24. 24.
    Pignon JP, Tribodet H, Scagliotti GV, et al. Lung adjuvant cisplatin evaluation: a pooled analysis by the LACE Collaborative Group. J Clin Oncol. 2008;26:3552–9.CrossRefPubMedGoogle Scholar
  25. 25.
    PORT Meta-analysis Trialists Group: postoperative radiotherapy for non-small cell lung cancer. Cochrane Database Syst Rev. 2005;(2):CD002142.Google Scholar
  26. 26.
    Lally BE, Zelterman D, Colasanto JM, et al. Postoperative radiotherapy for stage II or III non-small-cell lung cancer using the surveillance, epidemiology, and end results database. J Clin Oncol. 2006;24:2998–3006.CrossRefPubMedGoogle Scholar
  27. 27.
    Roth JA, Fossella F, Komaki R, et al. A randomized trial comparing perioperative chemotherapy and surgery with surgery alone in respectable stage IIIA non small cell lung cancer. J Natl Cancer Inst. 1994;86:673–80.CrossRefPubMedGoogle Scholar
  28. 28.
    Rosell R, Gomez-Codina J, Camps C, et al. A randomized trial comparing pre-operative chemotherapy plus surgery with surgery alone in patients with non-small cell lung cancer. N Engl J Med. 1994;330:153–8.CrossRefPubMedGoogle Scholar
  29. 29.
    Roth JA, Atkinson EN, Fossella F, et al. Long-term follow-up of patients enrolled in a randomized trial comparing perioperative chemotherapy and surgery with surgery alone in resectable stage IIIA non-small-cell lung cancer. Lung Cancer. 1998;21:1–6.CrossRefPubMedGoogle Scholar
  30. 30.
    Song WA, Zhou NK, Wang W, et al. Survival benefit of neoadjuvant chemotherapy in non-small cell lung cancer: an updated meta-analysis of 13 randomized control trials. J Thorac Oncol. 2010;5:510–6.CrossRefPubMedGoogle Scholar
  31. 31.
    Martins RG, D’Amico TA, Loo BW Jr, et al. The management of patients with stage IIIA non-small cell lung cancer with N2 mediastinal node involvement. J Natl Compr Canc Netw. 2012;10:599–613, Review.CrossRefPubMedGoogle Scholar
  32. 32.
    O’Rourke N, Roqué I Figuls M, et al. Concurrent chemoradiotherapy in non-small cell lung cancer. Cochrane Database Syst Rev. 2010;(16):CD002140.Google Scholar
  33. 33.
    NSCLC Meta-Analyses Collaborative Group. Chemotherapy in addition to supportive care improves survival in advanced non-small-cell lung cancer: a systematic review and meta-analysis of individual patient data from 16 randomized controlled trials. J Clin Oncol. 2008;26:4617–25, Review.CrossRefPubMedCentralGoogle Scholar
  34. 34.
    Delbaldo C, Michiels S, Syz N, et al. Benefits of adding a drug to a single-agent or a 2-agent chemotherapy regimen in advanced non-small-cell lung cancer: a meta-analysis. JAMA. 2004;292:470–84.CrossRefPubMedGoogle Scholar
  35. 35.
    The Elderly Lung Cancer Vinorelbine Italian Study Group. Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell lung cancer. J Natl Cancer Inst. 1999;91:66–72.CrossRefGoogle Scholar
  36. 36.
    Scagliotti GV, Parikh P, von Pawel J, et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol. 2008;26:3543–51.CrossRefPubMedGoogle Scholar
  37. 37.
    Sandler A, Gray R, Perry MC, et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006;355:2542–50.CrossRefPubMedGoogle Scholar
  38. 38.
    Forde PM, Ettinger DS. Targeted therapy for non-small-cell lung cancer: past, present and future. Expert Rev Anticancer Ther. 2013;13:745–58.CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Mok TS, Wu YL, Thongprasert S, et al. Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 2009;361:947–57.CrossRefPubMedGoogle Scholar
  40. 40.
    Shepherd FA, Rodrigues Pereira J, Ciuleanu T, et al. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med. 2005;353:123–32.CrossRefPubMedGoogle Scholar
  41. 41.
    Seetharamu N, Budman DR, Sullivan KM. Immune checkpoint inhibitors in lung cancer: past, present and future. Future Oncol. 2016;12:1151–63.CrossRefPubMedGoogle Scholar
  42. 42.
    Micke P, Faldum A, Metz T, et al. Staging small cell lung cancer: Veterans Administration Lung Study Group versus International Association for the Study of Lung Cancer–what limits limited disease? Lung Cancer. 2002;37:271–6.CrossRefPubMedGoogle Scholar
  43. 43.
    Veronesi G, Bottoni E, Finocchiaro G, Alloisio M. When is surgery indicated for small-cell lung cancer? Lung Cancer. 2015;90:582–9.CrossRefPubMedGoogle Scholar
  44. 44.
    Takada M, Fukuoka M, Kawahara M, et al. Phase III randomized study of concurrent versus sequential thoracic radiotherapy in combination with cisplatin and etoposide for limited-stage small-cell lung cancer: results of the Japan Clinical Oncology Group Study 9104. J Clin Oncol. 2002;20:3054–60.CrossRefPubMedGoogle Scholar
  45. 45.
    Aupérin A, Arriagada R, Pignon JP, et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group. N Engl J Med. 1999;341:476–84.CrossRefPubMedGoogle Scholar
  46. 46.
    Noda K, Nishiwaki Y, Kawahara M, et al. Irinotecan plus cisplatin compared with etoposide plus cisplatin for extensive small-cell lung cancer. N Engl J Med. 2002;346:85–91.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Sabita Jiwnani
    • 1
    Email author
  • George Karimundackal
    • 1
  • C. S. Pramesh
    • 1
  1. 1.Department of Surgical OncologyTata Memorial HospitalMumbaiIndia

Personalised recommendations