Stage III Non-Small Cell Lung Cancer

Publication Date: July 20, 2023

Key Points

Key Points

  • Stage III non-small cell lung cancer (NSCLC) represents one of the most heterogenous subgroups of lung cancer. Consequently, it is also the subgroup in which choice and sequence of multimodality treatment varies significantly among clinicians, with variations being observed across and within institutes.
  • This guideline reviews the published evidence addressing diagnosis and management of stage III NSCLC and provides evidence-based guidance on the common clinical dilemmas that clinicians may have while evaluating a patient with suspected or known stage III NSCLC.
  • Three randomized control trials (RCTs) were published in 2022 and 2023 and prompted an amendment to the 2021 guideline.

Diagnosis

Diagnos...

...uation and Stagin...

...commendation 1.1For patients with suspecte...

...ommendation 1.2Following evaluation...

...ion 1.3For patients with suspected st...

...dation 1.4For patients who require pathologic...

...mendation 1.5For patients who require pathologic...

...commendation 1.6For patients who have suspe...

...ctice PointBiopsy should generally be performed fr...


Treatment

Treatment

Surgery

...ndation 2.1For patients with stage IIIA (N2)...

...dation 2.2(Update): Patients with stage III NS...

...Practice Poin...

...ents with stage III NSCLC generally should not...

...f oncogenic driver alterations, available therap...

...ts and providers should consider enr...


Neoadjuvant Th...

...ation 3.1Patients who are planned for a multimodal...

...3.2(Update): Patients with stage III NSC...

...ndation 3.3For patients with resec...


...ant Therapy...

...ommendation 4.1Patients with resected stage...

...ecommendation 4.2(Update): Patients with resect...

...4.3For patients with completely rese...


...resectable Diseas...

Recommendation 5.1Patients with stage...

....2Concurrent chemotherapy delivered with ra...

Recommendation 5.3Patients with stage III...

Recommendation 5.4Patients with stage III NSCL...

...n 5.5Doses higher than 60 Gy and up to 70 G...

...ecommendation 5.6Patients with stage II...

Recommendation 5.7Patients with stage III NSCL...


...tion and Staging in Stage III NSCLC...


...ment of Stage III NSCLCArrows with dotted lines in...