What is the treatment of choice for stage II non–small cell lung cancer (NSCLC)?

Updated: Jul 15, 2021
  • Author: Winston W Tan, MD, FACP; Chief Editor: Nagla Abdel Karim, MD, PhD  more...
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Answer

Surgical resection is the treatment of choice for stage II NSCLC, except for those patients who are not surgical candidates because of comorbid conditions or poor pulmonary reserve.

Long-term survival of 10-25% has been reported in patients with radiation therapy alone delivered with curative intent. In such cases, however, the dose of radiation therapy should be approximately 60 Gy, with careful planning to define tumor volume and avoid critical structures. Frequently a cone-down boost is used to enhance local control.

Patients with resected stage II disease are candidates for platinum-based adjuvant chemotherapy (see below) and should be offered four cycles of platinum-based adjuvant chemotherapy plus osimertinib if their tumor has an EGFR exon 19 deletion or exon 21 L858R mutation.


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