What are the treatments for lung cancer? The most effective treatments for lung cancer

In recent years, more and more people have been diagnosed with lung cancer. There are many reasons for lung cancer, many of which are caused by long-term smoking and long-term exposure to harsh environments. Lung cancer is extremely harmful to our bodies, so it is very important to understand the treatment methods for lung cancer:

There are three main types of treatment for lung cancer:

1. Chemotherapy

In the past two decades, tumor chemotherapy has developed rapidly and has been widely used. The efficacy of chemotherapy on small cell lung cancer is relatively certain, whether in the early or late stages, and there are even a few reports of radical cure; it also has a certain effect on non-small cell lung cancer, but it is only palliative and the effect needs to be further improved. In recent years, the role of chemotherapy in lung cancer is no longer limited to patients with advanced lung cancer who cannot undergo surgery, but is often included in the comprehensive treatment plan for lung cancer as a systemic treatment. Chemotherapy will inhibit the bone marrow hematopoietic system, mainly the decrease of white blood cells and platelets. It is best to combine it with traditional Chinese medicine and immunotherapy.

1. Chemotherapy for small cell lung cancer

Due to the biological characteristics of small cell lung cancer, it is generally recognized that chemotherapy should be the first choice except for a few patients with sufficient evidence showing no intrathoracic lymph node metastasis.

1. Indications

(1) Patients with small cell lung cancer confirmed by pathology or cytology;

(2) KS score is 50-60 points or above;

(3) Those with an expected survival time of more than one month;

(4) Persons aged ≤70 years.

2. Contraindications

(1) Elderly or cachectic patients;

(2) Those with severe heart, liver and kidney dysfunction;

(3) Poor bone marrow function with white blood cells below 3×10^9/L and platelets below 80×10^9/L (direct count);

(4) There are complications and infection, fever, bleeding tendency, etc.

2. Chemotherapy for non-small cell lung cancer

Although there are many effective drugs for non-small cell lung cancer, their efficacy is low and complete remission is rarely achieved.

1. Indications:

(1) Patients with stage III disease confirmed by pathology or cytology to have squamous cell carcinoma, adenocarcinoma or large cell carcinoma who are not suitable for surgery, and patients with postoperative recurrence and metastasis or stage III disease who are not suitable for surgery for other reasons;

(2) Patients with the following conditions after surgical exploration and pathological examination:

① There are residual lesions;

② There is lymph node metastasis in the chest;

③ Cancer thrombi in lymphatic vessels or blood clots;

④Poorly differentiated carcinoma;

(3) Patients with pleural or pericardial effusion require local chemotherapy.

2. Contraindications:

Same as small cell carcinoma.

2. Radiation therapy

Treatment principles

Radiotherapy is the best for small cell carcinoma, followed by squamous cell carcinoma, and the worst for adenocarcinoma. However, small cell carcinoma is prone to metastasis, so large-area irregular irradiation is often used. The irradiation area should include the primary lesion, the supraclavicular area on both sides of the mediastinum, and even the liver and brain, and should be supplemented with drug treatment. Squamous cell carcinoma is moderately sensitive to radiation, and the lesions are mainly local invasions, and metastasis is relatively slow, so radical treatment is often used. Adenocarcinoma is less sensitive to radiation and is prone to blood metastasis, so simple radiotherapy is rarely used.

There are many radiation complications, and even cause partial functional loss; for patients with advanced tumors, the effect of radiotherapy is not perfect. At the same time, patients with poor physical condition and older age are not suitable for radiotherapy.

Indications for radiotherapy

According to the purpose of treatment, it is divided into radical treatment, palliative treatment, preoperative radiotherapy, postoperative radiotherapy and intracavitary radiotherapy.

3. Surgical treatment of lung cancer

The treatment of lung cancer should be based on surgery or strive for surgery except for stages IIIb and IV, and combined treatment with radiotherapy, chemotherapy and immunotherapy should be added according to different stages and pathological tissue types.

Regarding the survival period after lung cancer surgery, domestic reports have shown that the three-year survival rate is about 40% to 60%; the five-year survival rate is about 22% to 44%; and the surgical mortality rate is below 3%.

Indications for surgery

People with the following conditions can generally undergo surgical treatment:

1. No distant metastasis, including solid organs such as liver, brain, adrenal glands, bones, extrathoracic lymph nodes, etc.;

2. The cancerous tissue has not invaded or spread to adjacent organs or tissues in the chest, such as the aorta, superior vena cava, esophagus, and cancerous pleural effusion;

3. Those without severe cardiopulmonary dysfunction or recent onset of angina;

4. Those without severe liver or kidney diseases and severe diabetes.

Patients with the following conditions should generally undergo surgery with caution or require further examination and treatment:

(1) Elderly people with poor cardiopulmonary function;

(2) Except for stage I, small cell lung cancer should be treated with chemotherapy or radiotherapy first, and then determine whether it can be treated surgically;

(3) In addition to the primary lesion, X-ray findings also reveal several suspicious metastases in the mediastinum.