Term
| Which type is more aggressive: Small cell lung cancer or Non-small cell lung cancer? |
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Definition
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Term
| Which type is more common: Small cell lung cancer or Non-small cell lung cancer? |
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Definition
| NSCLC, more specifically adenocarcinoma |
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Term
| Screening Methods for Lung Cancer |
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Definition
Chest X-Ray
More sensitive for adenocarcinoma
Sputum Cytology
More sensitive for squamous cell
Spiral CT
More sensitive in general |
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Term
| Positive Prognostic Factors for NSCLC |
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Definition
- Early stage disease
- Good performance status
- No significant weight loss
- Female gender
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Term
| NSCLC treatment is a triad that involves: |
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Definition
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Term
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Definition
- Carboplatin + paclitaxel
- Cisplatin + paclitaxel
- Cisplatin + gemcitabine
- Cisplatin + docetaxel
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Term
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Definition
| Surgery treatment of choice |
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Term
| NSCLC Treatment: Stage II |
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Definition
- Surgery
- Chemotherapy
- Radiation
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Term
| NSCLC Treatment: Stage IIIa |
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Definition
- Neoadjuvant chemotherapy + radiation, THEN
- Surgery
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Term
| NSCLC Treatment: Stage IIIb |
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Definition
- Chemotherapy (carboplatin/paclitaxel) + radiation
- Surgery generally not possible due to size of tumor
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Term
| NSCLC Treatment: Stage IV |
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Definition
- Patients who are bed-ridden and cannot take care of themselves DO NOT benefit from therapy
- Only treat those with good performance status
- Young, relatively good health status -- combo therapy + bevacizumab
- Radiation for symptom palliation
- Surgery for palliation (adrenal mets, brain mets)
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Term
| Bevacizumab should not be given to: |
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Definition
- Patients with squamous cell cancer of the lung
- Results in life-threatening bleeding
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Term
| NSCLC Treatment: Recurrent cancer |
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Definition
- 1st relapse: Single agent chemotherapy with bevacizumab if pt has not already received and if not squamous cell cancer
- 2nd relapse: Erlotinib -- reserved for ppl that have failed 2 types of chemo
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Term
| Erlotinib is reserved for: |
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Definition
| Patients that have failed 2 types of chemo |
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Term
| Carboplatin/Paclitaxel ADRs |
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Definition
Quick
Hypersensitivity
Short term
- NV
- Myelosuppression
- Mucositis
- Alopecia
- Neuropathies
- Nephrotoxicity
Long Term
Hepatotoxicity |
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Term
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Definition
- Maculopapular rash
- NVD
- VTE
- Hepatotoxicity
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Term
| Small Cell Lung Cancer Staging: Extensive Tumor |
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Definition
Not confined to one lung (hemithorax)
Distant metastasis |
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Term
| Small Cell Lung Cancer Staging: Limited Tumor |
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Definition
| Confined to one lung (hemithorax) and/or the mediastinum and supraclavicular nodes |
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Term
| SCLC Paraneoplastic Syndromes |
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Definition
- Hyponatremia of malignancy -- results from SIADH
- Cushing's Syndrome
- Hypercalcemia
- Superior vena cava syndrome
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Term
| Positive Prognostic factors for SCLC |
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Definition
- Good performance status
- Limited stage disease
- Female gender
- Normal LDH
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Term
| General Principles of Limited SCLC Treatment |
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Definition
- Surgery is very seldom possible because patients frequently have multiple tumors
- Concurrent thoracic XRT + Chemo improves survival
- Prophylactic cranial XRT for pts with CR
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Term
| Commonly Used Chemo Regimens for Limited SCLC |
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Definition
- Cisplatin/Etoposide (EP)
- Carboplatin/Etoposide (EC)
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Term
| General Principles of Extensive SCLC Treatment |
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Definition
- Surgery has minimal to no role
- Combination chemotherapy x 4-6 cycles is standard therapy
- Radiation used for palliation of symptomatic sites (including brain)
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Term
| Commonly Used Chemo Regimens for Extensive SCLC |
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Definition
- Cisplatin/Etoposide (EP) -- most commonly used
- Carboplatin/Etoposide (EC) -- slightly less toxic
- Irinotecan/Cisplatin (IP) -- more expensive, more toxic, no better
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Term
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Definition
- Pts generally relapse after initial treatment
- Use single agent (topotecan, irinotecan, docetaxel, paclitaxel, vinorelbine, carboplatin)
- Combo therapy may increase survival but also increases toxicity
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Term
| Etoposide/Cisplatin (EC): ADRs |
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Definition
Quick
- Hypersensitivity
- Hypotension
Short Term
- NV
- Myelosuppression
- Mucositis
- Alopecia
- Neuropathies
- Nephrotoxicity
- Ototoxicity
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