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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 #21 Treating stage IIIA N2 NSCLC
January 17, 2017, 01:26 PM
Luis Raez, MD FACP FCCP, Faculty, Board Member

Tratamiento para el cáncer de pulmón de células pequeñas en estadio IIIA N2

Para estadios III de cancer de pulmón, el tratamiento es más complicado, porque se trata de una multimodalidad. Idealmente en unos pacientes con estadio III, tienen que ir a una reunión multidisciplinaria donde tengamos al cirujano, al radiooncólogo y al oncólogo médico porque muchas veces los pacientes en estadio III pueden ir a cirugía y después de la cirugía se les da quimioterapia y radiación (cuando hay compromiso mediastinal o estadio N2), sino a los pacientes en estadio III solo le damos quimioterapia adyuvante después de la cirugía.

El estadio III es complicado porque a veces el paciente no puede ser operado o no estamos seguros de que pueda ser operado. A veces, hay que disminuir el tamaño del tumor por lo que se da quimioterapia primero para reducir el tamaño y ya después se va a cirugía.

Hay varias combinaciones, a veces la tercera opción es que el paciente va a cirugía porque parece operable, pero después de la cirugía descubrimos que hay enfermedad mediastinal (ganglios comprometidos), entonces no solo se le da quimioterapia después de la cirugía, pero también se le tener que dar radiación.

Esas son las tres posibilidades que hay para un estadio III, por eso lo mejor es hacer una reunión multidisciplinaria para decidir en grupo qué es lo mejor para el cancer de pulmón en este estadio.

Treatment for small cell lung cancer in IIIA N2 stage

For lung cancer in stage III, the treatment is more complicated because it is multimodality. Ideally stage III patients should go to a multidisciplinary reunion with a surgeon, radio-oncologist and the oncologist, because sometimes these patients go into surgery and then receive chemotherapy and radiation (only when the mediastinum is affected or is in N2 stage), when they could only receive adjuvant chemotherapy after surgery.

Stage III is complicated because sometimes the patient cannot go into surgery or we are not sure if he is a candidate. Sometimes, we have to reduce the size of the tumor by giving chemotherapy first and then go into surgery. 

There are several combinations, sometimes the third option is the patient going into surgery, but after the procedure we sometimes identify mediastinum affection (lymph nodes are affected), so the treatment has to be of chemotherapy and radiation.

The three options for stage III treatment are available, but it is better to make a multidisciplinary reunion to decide which is the best treatment for the patient.

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