Optimization of diagnostic and therapeutic management in patients with stage III non-small cell lung cancer — experience of the centers in Poznań

Abstract

Lung cancer is one of the most frequently diagnosed malignancies, with one of the worst progno-ses. Non-small cell lung cancer (NSCLC) is the dominant histological type, accounting for 85% of cases. In Poland, in more than one-third of patients, NSCLC is diagnosed at stage III. One of the most effective methods of radical treatment in such cases is concurrent radiochemotherapy. However, in Poland the percentage of patients eligible for this type of therapy is quite low, due to delayed diagnosis, lack of reference centers, long qualification process for treatment, and ineffective treatment organization. This article discusses the optimization of therapeutic management in patients with stage III NSCLC based on the experience of centers in Poznań (the Greater Poland Cancer Center and Greater Poland Center for Pulmonology and Thoracic Surgery). Some modifications include introduction of a surgery qualification form, urgent early evaluation using combined positron emission tomography (PET)/computed tomography (CT) and invasive mediastinum evaluation, and initial qualification for radiochemotherapy (with the setting of dates) already during diagnostics. These activities led to the multiplication of the number of patients qualified for concurrent radiochemotherapy.