"China Primary Lung Cancer Diagnosis and Treatment Practice Guidelines 2015" Key points Interpretation

"China Primary Lung Cancer Diagnosis and Treatment Practice Guidelines 2015" was released on Jan. 28, 2015, and many expert interpretation events have been organized to promote the acceptance of the new lung cancer practice norms in the nation.

Here are some excerpts of the key points in the "Lung Cancer 2015".

Xiuyi Zhi, MD Professor
Director, Thoracic Surgery Department
Xuanwu Hospital of Beijing
Photo：Oncology Frontier

Surgical oncology: Xiuyi Zhi MD 

Anatomical lung resection is the main treatment for early lung cancer.

In the premise of accurate TNM staging, molecular pathology classification should be strived to achieve. In addition, Dr. Zhi also introduced minimally invasive thoracic surgery technology - VATS in the significance of early surgical treatment for lung cancer.

Caicun Zhou, MD PhD Professor
Director, Medical Oncology
Shanghai Pulmonary Hospital
Tongji University
Photo: Oncology Frontier

Medical Oncology: Caicun Zhou, MD 

Compared to 2011 version,  "Lung Cancer 2015" specifically highlights the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) gene mutation test in the late-stage NSCLC diagnosis and treatment.

Specifically, EGFR gene mutation (+) or ALK fusion gene (+) patients in advanced NSCLC, can choose EGFR - TKI target therapy treatment, and ALK inhibitor such as crizotinib for treatment.

Jingming Yu, MD Academician
Director, Radiation Therapy
Cancer Hospital of Shandong Province
Photo: Oncology Frontier

Radiation therapey: Jin-ming Yu MD 

"Lung Cancer 2015" version first recommends specifically stereotactic radiotherapy (SBRT) for stage I unresectable NSCLC.

SBRT for residual primary tumors and small numbers of metastasis locales can be considered, when systemic benefic is expected for  Stage IV NSCLC patients with extensive metastasis.

Baishen Pan, MD Professor
Director, Laboratory Departemnt
Zhongshan Hospital, Fudan University
Photo:Zs-hospital

Auxiliary biomarkers: Drs Baishen Pan, Jie Zhang, Hong Shang

Enzyme (NSE) and neuron specific enolization gastrin-releasing peptideprecursor (ProGRP) are helpful to the diagnosis of small cell lung cancer (SCLC).

Cell keratin fragments (CYFRA21 1), carcinoembryonic antigen (CEA) and squamous cell carcinoma antigen (SCC) are helpful to the diagnosis of non-small cell lung cancer (NSCLC).

Tumor markers combination test is generally recommended, to improve sensitivity and accuracy of diagnosis in primary SCLC and NSCLC.

At the same time, two or more tumor markers combination test, could be used for treatment efficacy monitoring, as well as in post treatment for prognosis monitoring.

References:

1. "China Primary Lung Cancer Diagnosis and Treatment Practice Guidelines-2015" Chin J of Oncol. 2015,37(01): 67-1. DOI: 10.3760/cma.j.issn.0253-3766.2015.01.014

2. "'China Primary Lung Cancer Diagnosis and Treatment Practice Guidelines-2015' and experts commentary" Feb. 28, Oncology frontier, Imedtimes.com

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