Diagnosis and management of patients with stage III non‑small cell lung cancer: A joint statement by the Lebanese Society of Medical Oncology and the Lebanese Pulmonary Society (Review)

Abstract

Proper management of stage III non‑small cell lung cancer (NSCLC) might result in a cure or patient long‑term survival. Management should therefore be preceded by adequate and accurate diagnosis and staging, which will inform therapeutic decisions. A panel of oncolo‑ gists, surgeons and pulmonologists in Lebanon convened to establish a set of recommendations to guide and unify clinical practice, in alignment with international standards of care. Whilst chest computerized tomography (CT) scan‑ ning remains a cornerstone in the discovery of a lung lesion, a positron‑emission tomography (PET)/CT scan and a tumor biopsy allows for staging of the cancer and defining the resectability of the tumor(s). A multidisciplinary discussion meeting is currently widely advised for evaluating patients on a case‑by‑case basis, and should include at least the treating oncologist, a thoracic surgeon, a radiation oncolo‑ gist and a pulmonologist, in addition to physicians from other specialties as needed. The standard of care for unre‑ sectable stage III NSCLC is concurrent chemotherapy and radiation therapy, followed by consolidation therapy with durvalumab, which should be initiated within 42 days of the last radiation dose; for resectable tumors, neoadjuvant therapy followed by surgical resection is recommended. This joint statement is based on the expertise of the physi‑ cian panel, available literature and evidence governing the treatment, management and follow‑up of patients with stage III NSCLC. © 2023 Spandidos Publications. All rights reserved.

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Keywords

Joint statement, Locally advanced lung cancer, Non‑small cell lung cancer, Practical guidance, Trimodal therapy, Carboplatin, Cisplatin, Docetaxel, Durvalumab, Epidermal growth factor receptor, Etoposide, Fluorodeoxyglucose f 18, Gemcitabine, Osimertinib, Paclitaxel, Pembrolizumab, Pemetrexed, Programmed death 1 ligand 1, Protein bcl 2, Protein p53, Protein tyrosine kinase inhibitor, Vasculotropin, Vinorelbine tartrate, Apoptosis, Cancer adjuvant therapy, Cancer chemotherapy, Cancer screening, Cancer staging, Cancer survival, Clinical evaluation, Clinical practice, Clinical target volume, Computer assisted tomography, Disease free survival, Ecog performance status, Endobronchial ultrasonography, Endoscopic ultrasonography, Fine needle aspiration biopsy, Forced expiratory volume, Glucose transport, Human, Karnofsky performance status, Lung adenocarcinoma, Lung cancer, Lung lesion, Lymph node dissection, Non small cell lung cancer, Nuclear magnetic resonance imaging, Overall survival, Positron emission tomography-computed tomography, Progression free survival, Pulmonologist, Review, Thoracoscopy, Thoracotomy, Tumor biopsy

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