|
|
Non-Small Cell Lung Cancer |
Lung cancer is the leading cause of cancer death in the world, accounting for 32% of cancer deaths in males and 25% in females, affecting approximately 171,000 people annually in the U.S. (Parker 1997, Sandler 2006) and more than 200,000 people in Europe (Rossi, Maione, and Gridelli 2006). Of all these patients, approximately 85% have non-small cell lung cancer (NSCLC) (Sandler, et al 2006).
Non-Small Cell Lung Cancer (NSCLC) is a heterogeneous aggregate of histologies. The most common histologies are squamous cell carcinoma, adenocarcinoma and large cell carcinoma. These histologies are typically classified together because the approaches to diagnosis, staging and prognosis, and treatment are similar.
Squamous cell carcinoma: About 25% to 30% of all lung cancers are this kind. Squamous cell lung cancers are linked to smoking and
tend to be found in the middle of the lungs, near a bronchus.
Adenocarcinoma: This type accounts for about 40% of lung cancers. It is usually found in the outer part of the lung.
Large-cell (undifferentiated) carcinoma: About 10% to 15% of lung cancers are this type. It can start in any
part of the lung. It tends to grow and spread quickly, which makes it harder to treat.
Patients are often diagnosed with an advanced stage of disease, and approximately 85% of lung cancer patients will die from their disease within one year with only 1% of patients surviving five years. Patients having Stage IIIb/IV NSCLC are not considered to be candidates for curative resection surgery or radiation, and radiation therapy is primarily used as palliative treatment in advanced stages of NSCLC.
The role of chemotherapy is now well established as the recommended treatment of advanced NSCLC (Non-small Cell Lung Cancer Collaborative Group 1995). The current globally accepted standard of cancer treatment for NSCLC is platinum-based combination therapy. Throughout most of the world, the combination therapy is six cycles of carboplatin plus paclitaxel. In Europe the most commonly used standard combination therapy for NSCLC is six cycles of cisplatin plus gemcitabine, although there is little evidence supporting the use of one combination therapy over the other.
|
|
