What are the most common methods for treating lung cancer? What are the most effective methods for treating lung cancer?

At present, the treatment of lung cancer is still mainly surgical resection, which is the only means to cure lung cancer. Surgery is often suitable for patients in the early stage of the disease. However, lung cancer is generally discovered in the middle and late stages. During this period, the effect of surgery is lost, and even surgery cannot be used for treatment. The following is an introduction to the methods of treating lung cancer:

Treatments for lung cancer:

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.

(I) 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.

(II) Chemotherapy for non-small cell lung cancer Although there are many effective drugs for non-small cell lung cancer, the 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 residual lesions; ② intrathoracic lymph node metastasis; ③ cancer thrombi in lymphatic vessels or thrombi; ④ poorly differentiated cancer;

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

2. Contraindications: Same as small cell carcinoma.

Radiation therapy

(I) 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 therapy. 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.

(ii) There are many radiation complications, which may 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.

(III) Indications for radiotherapy are divided into radical treatment, palliative treatment, preoperative radiotherapy, postoperative radiotherapy and intracavitary radiotherapy according to the purpose of treatment.

Radical treatment

(1) Early cases with surgical contraindications or refusal to undergo surgery, or IIIa cases with lesions limited to 150 cm; (2) Patients with basically normal heart, lung, liver, and kidney functions, blood white blood cell count greater than 3×10^9/L, and hemoglobin greater than 100g/L; (3) KS ≥ 60 points. A careful plan should be made in advance and strictly implemented. Do not change the treatment plan easily. Even if there is a radiation reaction, the goal should be to cure the tumor. 2. Palliative treatment: Its purpose varies greatly. There is palliative treatment that is close to radical treatment to relieve the patient's pain, prolong life, and improve the quality of life; there is also palliative treatment that only relieves the symptoms of advanced patients and even causes a placebo effect, such as pain, paralysis, coma, shortness of breath, and bleeding. The number of irradiation times for palliative treatment can range from several times to dozens of times, depending on the specific situation and equipment conditions. However, the principle must be not to increase the patient's pain. If there is a large radiation reaction or a decrease in the KS score during treatment, the treatment plan can be modified as appropriate. 3. Preoperative radiotherapy: It aims to improve the surgical resection rate and reduce the risk of tumor dissemination during surgery. For patients who are estimated to have no difficulty in surgical resection, high-dose, less-fractionated radiotherapy can be used before surgery; if the tumor is huge or has external invasion, and it is estimated that surgical resection will be difficult, conventional fractionated radiotherapy can be used. The time between radiotherapy and surgery is generally about 50 days, and the longest time should not exceed three months. 4. Postoperative radiotherapy: It is used for cases with insufficient preoperative estimation and incomplete surgical resection of the tumor. Silver clips should be placed on local residual lesions to facilitate accurate positioning during radiotherapy. 5. Intracavitary short-distance radiotherapy: It is suitable for cancer lesions confined to large bronchi. Afterloading technology can be used to place the catheter at the bronchial lesion through a fiberoptic bronchoscope. Iridium (192Ir) can be used for close-range radiotherapy and combined with external irradiation to improve the treatment effect.

Surgical treatment of lung cancer

In the treatment of lung cancer, except for stage IIIb and IV, surgery should be the main treatment or strive for surgery, and radiotherapy, chemotherapy and immunotherapy should be added according to different stages and pathological tissue types. Regarding the survival period after lung cancer surgery, it has been reported in China 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%.

It can be clearly said that the most critical treatment for malignant tumors is early surgical resection, and the same is true for lung cancer. However, the early symptoms of lung cancer are not easy to be discovered by people, which not only requires people and the high-risk groups for lung cancer to promptly grasp the symptoms of lung cancer, but also to do a good job of physical examination.