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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 #22 Treating Stage III Unresectable NSCLC
Anonymous
Tratamiento para el cáncer de pulmón en estadio III no operable
En el caso de estadio IIIB no se pueden resecar, porque tienen un tumor que está invadiendo el mediastino y los grandes vasos. Normalmente ese tumor se podía sacar porque no hay metástasis, pero ya que la localización no es adecuada, no se puede sacar.
El tratamiento para un tumor en estadio IIIB cuando el tumor es inoperable, es dar quimioterapia con radioterapia al mismo tiempo. Como ustedes saben por un estudio famoso del grupo HOG, sabemos que el estándar es quimioterapia con cisplatino- etopósido y radiación, pero cisplatino-etopósido es una quimioterapia un poco antigua y tóxica. Por lo que hoy en día a pesar de que ese es el estándar de los grupos cooperativos americanos que usamos de referencia, preferimos dar carboplatino y paclitaxel, que es una quimioterapia fácil de manejar y que se da semanalmente.
Incluso en Estados Unidos, tenemos pacientes de edad mayor de 80-85 años que no van a tolerar el cisplatino ni etopósido, por eso el régimen de carboplatino-paclitaxel semanal es la quimioterapia de elección en estos estadios. Así que es muy importante tener estos criterios en cuenta cuando abordamos a los pacientes.
Treatment for lung cancer in stage III unresectable
In the case of stage III, is unresectable because they have a tumor invading the mediastinum or the great vessels. Usually this tumor would have been able to be resectable because it didn’t have metastasis, but the location is not adequate so that’s why it’s unresectable.
Treatment for a stage IIIB unresectable tumor is chemotherapy and radiotherapy at the same time. As you know, based in a famous trial by the group HOG, we know that the standard treatment is with cisplatin- etoposide and radiation, but cisplatin-etoposide is an old and toxic chemotherapy. So today, despite the standard American cooperative groups treatment, we prefer to use carboplatin and paclitaxel, which is a chemotherapy easy to handle and it’s given weekly.
Even in United States, we have elderly patients of 80-85 years old that will not tolerate cisplatin nor etoposide, so the weekly regimen of carboplatin- paclitaxel is the go therapy in these stages. So, it is very important to have these criteria when we are approaching the patients.
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