Small Cell and Non-Small Cell Lung Cancer
Authors: Wauters Isabelle , Robays Jo , Verleye Leen , Holdt Henningsen Kirsten , Hulstaert Frank , Berghmans Thierry , De Wever Walter , Lievens Yolande , Pauwels Patrick , Stroobants Sigrid , Van Houtte Paul , Van Meerbeeck Jan , Van Schil Paul , Weynand Birgit , De Greve Jacques 
Published: January 2025

LIST OF FIGURES 8 -- LIST OF TABLES 8 -- LIST OF ABBREVIATIONS 10 -- SCIENTIFIC REPORT 12 -- 1. INTRODUCTION 12 -- 1.1. BACKGROUND 13 -- 1.2. SCOPE AND TARGET PATIENT POPULATION 13 -- 1.3. REMIT OF THE GUIDELINE 13 -- 1.3.1. Overall objectives 13 -- 1.3.2. Target users of the guideline 13 -- 1.4. STATEMENT OF INTENT 13 -- 1.5. FUNDING AND DECLARATION OF INTEREST 14 -- 2. METHODOLOGY 14 -- 2.1. INTRODUCTION 14 -- 2.2. GENERAL APPROACH 14 -- 2.3. CLINICAL QUESTIONS 15 -- 2.4. LITERATURE SEARCH AND SELECTION CRITERIA 15 -- 2.4.1. Search strategy 15 -- 2.5. QUALITY APPRAISAL 17 -- 2.5.1. Clinical practice guidelines 17 -- 2.5.2. Systematic reviews and peer-reviewed articles 17 -- 2.6. DATA EXTRACTION AND EVIDENCE SUMMARY 17 -- 2.7. STATISTICAL ANALYSIS 17 -- 2.8. GRADING OF EVIDENCE 17 -- 2.9. FORMULATION OF RECOMMENDATIONS 21 -- 2.10. EXTERNAL REVIEW 21 -- 2.11. VALIDATION AND UPDATING OF THE GUIDELINE 22 -- 2.11.1. Validation process 22 -- 3. DEFINITIONS 22 -- 4. DIAGNOSIS AND STAGING 25 -- 4.1. GENERAL CONSIDERATIONS 25 -- 4.2. DIAGNOSIS AND STAGING OF LUNG CANCER 25 -- 4.2.1. Suspicion of lung cancer 25 -- 4.2.2. Pathological confirmation of the primary tumour 26 -- 4.2.3. Evaluation of distant metastasis 28 -- 4.2.4. Mediastinal staging for patients otherwise eligible for treatment with curative intent 29 -- 4.3. PATHOLOGY 36 -- 4.3.1. International Association for the Study of Lung Cancer/American -- Thoracic Society/European Respiratory Society International Multidisciplinary -- Classification of Lung Adenocarcinoma31 36 -- 4.3.2. Pathological sub-classification and molecular tests using Fine Needle Aspiration Cytology (FNAC) samples 36 -- 4.3.3. Pathological sub-classification: use of immunohistochemistry 37 -- 4.3.4. Molecular techniques to guide targeted treatment 38 -- 4.4. DIAGNOSIS AND EVALUATION OF SOLITARY PULMONARY NODULE (SPN) 40 -- 5. TREATMENT OF NSCLC 43 -- 5.1. TREATMENT OF EARLY STAGE NSCLC (STAGE CI-II SELECTED STAGE CIIIA CT3N1) 43 -- 5.1.1. Criteria for operability 43 -- 5.1.2. Primary surgery 49 -- 5.1.3. (Neo-)adjuvant chemotherapy and surgery 58 -- 5.1.4. Postoperative radiotherapy 61 -- 5.1.5. Primary radiotherapy 63 -- 5.2. TREATMENT OF LOCALLY ADVANCED NSCLC (STAGE CIIIA-CIIIB) 64 -- 5.2.1. Combined chemo-radiotherapy 64 -- 5.2.2. Neoadjuvant treatment followed by surgery for stage cIIIA-N2 disease 66 -- 5.2.3. Treatment of tumours involving the chest wall and sulcus superior tumours 69 -- 5.3. TREATMENT OF METASTATIC (STAGE CIV) AND RECURRENT NSCLC 71 -- 5.3.1. Use of chemotherapy in general versus best supportive care (BSC). 71 -- 5.3.2. What is the most effective first-line chemotherapy? 71 -- 5.3.3. Second and third line chemotherapy 74 -- 5.3.4. Crizotinib for the second line treatment of anaplastic lymphoma kinase (ALK) positive advanced non-small cell lung cancer 78 -- 5.3.5. Maintenance therapy 78 -- 5.4. FOLLOW-UP 82 -- 6. TREATMENT OF SCLC 85 -- 6.1. TREATMENT 85 -- 6.1.1. Limited stage disease (broadly corresponding to T1-4, N0-3,M0) 85 -- 6.1.2. Extensive stage disease small cell lung cancer (broadly staged as T1-4, N0-3, M1 a/b) 87 -- 6.1.3. Second line treatment for patients with SCLC who relapse after primary treatment. 88 -- 7. IMPLEMENTATION AND UPDATING OF THE GUIDELINE. 91 -- 7.1. IMPLEMENTATION 91 -- 7.2. MONITORING THE QUALITY OF CARE 91 -- 7.3. GUIDELINE UPDATE 91 -- APPENDICES 92