Surgery Surgical treatment— removal of the tumor—remains the mainstay of curative treatment for
non-small cell lung cancer. This will involve removing a lobe of the lung or, if appropriate, a wedge resection of the tumor. Sometimes the entire lung has to be removed.
Radiation If surgery is not considered feasible either because of the patient's condition or because
the lymph nodes are so involved that surgery could not remove all the cancer, then radiation therapy can be used as the primary treatment.
Chemotherapy The role of chemotherapy has not yet been completely defined, although it has
been found to be more successful since the advent of platinum compounds. Up through Stage II disease, the response rate has been reported to be in excess of 50 percent. In Stage IV disease, the response rate is lower.
When a platinum drug is combined with drugs such as vinblastine , vindesine or etoposide , response rates of about 30 percent have been observed in Stage IV cancer. Although there is no evidence of major survival improvement by the use of these agents in Stage IV disease, they may give palliative benefit by reducing the size of the tumors and relieving the symptoms. Recent trials using a cisplatin-based regimen showed a four- to five-month improvement in average survival. This exciting work has suggested that chemotherapy might be used earlier in treatment in hopes of improving survival.
