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Clinical year in review I.
Non-small cell lung cancer
Jean-Paul SCULIERDepartment of Intensive Care & Thoracic Oncology
Institut Jules BordetUniversité Libre de Bruxelles (ULB)
www.pneumocancero.com
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No conflict of interest
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EPIDEMIOLOGY
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SCREENING
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NPS to avoid by CT one death by lung cancer in comparison to chest XR : 265
NSS to diagnose one lung cancer by CT : 40
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DIAGNOSIS
Thorax 66: 294-300; 2011
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TREATMENT
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Surgery
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Overall survival
Cancer-specific survival
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Tumour < 2.1 cm
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Chemotherapy for advanced disease
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Tyrosine kinase inhibitors
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overall mutation
No mutation ?
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Mutation No mutation
High copy number
Low copy number
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Exon 19 L858R
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Oligometastatic disease
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62 patients with metastatic sites other than brain or adrenals
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PROGNOSIS
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PALLIATIVE CARE AND END OF LIFE
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Main conclusions1. Antismoking policy has resulted in a significant
decrease in the rate of deaths by lung cancer in Europe.
2. For screening, CT scan detects significantly more lung cancers than chest X-Ray.
3. Single agent switch maintenance chemotherapy is associated with survival advantage.
4. In case of active EGFr mutation in advanced NSCLC, the therapeutic project should include TKI and chemotherapy.
5. More attention should be given to the announce of the diagnosis and the introduction of palliative care.