. 2024 Feb 29;32(1):200788. doi: 10.1016/j.omton.2024.200788

Table 1.

Treatment modality for different stages of lung cancer

Modality	Process	Stage of disease	Reference
Non-small cell lung cancer

Surgery	Patients with entirely resectable tumors and in a good position for resection should consider surgery. When the cancer is small enough to ensure that resection will be possible, there has been little or no dissemination to nearby lymph nodes, and the patient and other tumor variables are favorable, surgical resection is advised. Thoracotomy surgery is the most popular type of surgery. The less-invasive surgery, a limited anterior thoracotomy, requires a small opening through the front of the chest. On the other hand, lung cancer patients frequently undergo a lobectomy. Segmentectomy or wedge resection may be an option for individuals with exceedingly small, early-stage lung tumors or those who cannot tolerate having a lobe removed because of compromised lung function.	Surgery is the preferred and most effective treatment for stage I and II diseases. Up to 60% of patients with stage I illness survive for 5 years. Although surgery is still the preferred treatment option, 5-year survival rates for stage II tumors are typically 30%. Resection may be viable for some stage III tumors; this should be determined individually. Regrettably, many of these patients experience recurrence despite resection. Due to its variability, it is challenging to specify specific therapy choices for cancer in stage III. Since the survival benefits of surgery have not been established, it is not recommended for individuals with stage IV illness.	Herbst et al.⁴^,⁵^,⁶; Alexander et al.⁵; Duma et al.⁴^,⁵^,⁶
Radiotherapy	Radiation therapy (RT) is used to treat cancer to raise the likelihood of curing the disease, improve local tumor control, and provide palliative care (e.g., improve symptoms and quality of life). Brachytherapy and external beam radiation therapy are RT’s two basic delivery systems. The therapeutic ratio is determined by comparing the maximum damage that the surrounding healthy tissue can withstand to the total damage that radiation is intended to cause to the malignant cells.	At any stage, RT can be used as the first-line, curative, adjuvant, or palliative treatment for lung cancer. Even though they have stage I and stage II disease, patients judged inoperable typically receive RT (e.g., due to age). The current "gold standard" therapy for patients with stage III illness consists of RT and chemotherapy. Combining chemotherapy and radiotherapy can be considered a curative therapy for stage IIIB illness.	Herbst et al.⁴^,⁵^,⁶; Alexander et al.⁵; Duma et al.⁴^,⁵^,⁶
Chemotherapy	These conditions may all be treated with chemotherapy: • as the primary treatment for those who are unable to undergo surgery • to relieve the pain of advanced cancer • to reduce the size of a tumor before surgery or radiation • to kill cancer cells that were not removed during surgery to lower the risk of recurrence • to relieve advanced cancer pain and as maintenance therapy in those with advanced cancer that is responsive to chemotherapy.	According to studies, postoperative adjuvant therapy improved 5-year survival rates for patients with stage IB to stage III illness. At the same time, chemotherapy appeared to harm patients with stage IA disease. Adjuvant cisplatin-based chemotherapy is the gold standard of care for some stage I and the majority of stage II and III patients with completely resected NSCLC. Since surgery is typically not an option for patients in the stage IIIB, chemo-radiation is the only treatment method used. Despite meager survival rates, chemotherapy is the primary treatment for people with stage IV illness.	Herbst et al.⁴^,⁵^,⁶; Alexander et al.⁴^,⁵

Small cell lung cancer

Chemotherapy	Chemotherapy agent mixtures are typically used to treat SCLC. One drug, topotecan, a topoisomerase I inhibitor, has been FDA approved for use in SCLC as a second-line treatment. In addition, the National Comprehensive Cancer Network has approved immunotherapy drugs such as nivolumab and nivolumab plus ipilimumab as a course of treatment for SCLC patients who have progressed after receiving one or more prior regimens or who have relapsed within 6 months of receiving initial therapy.	Both mild and severe SCLC are mostly treated with chemotherapy.	van Meerbeeck et al.⁷; Zugazagoitia and Paz-Ares⁷^,⁸^,⁹Yang et al.⁷^,⁸^,⁹
Radiotherapy	Radiation treatment and chemotherapy boost median survival to about 1.5 years for limited-stage diseases. Patients with early-stage illness are also advised to have radiation therapy to the brain. This is administered when there is no indication that cancer has progressed to the brain and chest therapy is the only treatment.	Mortality was reduced when radiation was used with chemotherapy for both extensive-stage and limited-stage illnesses.	Zugazagoitia et al.⁸^,⁹^,¹⁰; Yang et al.⁸^,⁹^,¹⁰; Wang et al.⁸^,⁹^,¹⁰
Surgery	Most cases of SCLC cannot be treated with surgery.	Surgery, in addition to chemotherapy, may be an option for patients with stage I SCLC and no nodal involvement.	Zugazagoitia et al.⁸^,⁹^,¹⁰; Yang et al.⁸^,⁹^,¹⁰; Wang et al.⁸^,⁹^,¹⁰