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Chief of Hematology/Oncology and Medical Director at Memorial Cancer Institute, and Clinical Associate Professor of Medicine at Florida International University

Chief of Hematology/Oncology
Medical Director of Memorial Cancer Institute

Lung Cancer Video Library - Spanish Language: Video #20 Treating Early Stage Non-Small Cell Lung Cancer (NSCLC)


TRANSCRIPTS - Spanish and English

Tratamiento para el estadio temprano del cáncer de pulmón de células no pequeñas

A veces es difícil recordar cual es el estadio I o II y uno se puede perder hablando del estadio. En general, el estadio I y II son sencillos porque son tumores que son confinados al pulmón, son tumores que no han invadido el mediastino y son operables. Para el estadio I y II lo que haces es cirugía como primera intervención y dependiendo de los hallazgos patológicos después de la cirugía, hacemos quimioterapia porque muchas veces a pesar de que hemos resecado tumores pequeños, como del estadio IB que son tumores pequeños de 3.5 cm, hay un riesgo de recurrencia y mortalidad grande.

Desafortunadamente, incluso en la cirugía más perfecta que es el estadio IA que pueden ser tumores de 2cm de cáncer de pulmón, los pacientes no necesariamente se curan después de los 5 años. Vemos que una parte del 10 al 20% igual van a morir por la recurrencia del cáncer de pulmón, he ahí la necesidad de dar quimioterapia.

Ahora, la quimioterapia tampoco es para todos. Hay mucha evidencia clínica que para estadio II no es discusión, se da la quimioterapia de 4 ciclos de cisplatino más el agente de elección como etopósido, pemetrexed, vinorelbina, taxanes. Después de eso, solo es observación y seguimiento del paciente.

Para estadio IA, el beneficio de la quimioterapia no existe o no está documentado, por eso no hacemos quimioterapia. Por eso es un área de mucha investigación para tratar de clasificar que pacientes tienen un riesgo alto que justifique quimioterapia u otra intervención y que pacientes no. 

Treatment for early stage non-small cell lung cancer

Sometimes it’s difficult to remember which cases are stage I and which one are stage II, one can get lost talking about the stage. In general, stage I and II are simple because the tumor is confined to the lung, they are tumors that have not invaded the mediastinum and are surgically removed. For stage I and II, what we have to is surgery as first intervention and depending on the pathological findings, we can then do a surgery. We do chemotherapy because sometimes despite the small resected tumors like in stage IB (tumors smaller than 3.5 cm), there is a high risk of recurrence and mortality.

Unfortunately, even in the most perfect surgery in stage IA, than can be tumors of over 2 cm, patients don’t necessarily heal after 5 years. We see that a part of 10 to 20% will still die for lung cancer recurrence, so we need to give chemotherapy.

Now, chemotherapy is not for everybody. There is clinical evidence that for stage II chemotherapy the option is to give 4 cycles of cisplatin and the choice agent like etoposide, pemetrexed, vinorelbine or taxanes. After that, it’s only observation and the follow up of the patient.

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