Stage III Non-Small Cell Lung Cancer

Publication Date: July 23, 2024

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.
  • Four randomized control trials (RCTs) published in 2022, 2023, and 2024, prompted an amendment to the 2021 guideline.

Diagnosis

...agnosis...

...aluation and Staging

....1For patients with suspected stage III NSCLC, an...

...dation 1.2Following evaluation with CT sca...

...1.3For patients with suspected stage III...

...mendation 1.4For patients who require pat...

....5For patients who require pathologic...

...dation 1.6For patients who have suspected or conf...

...d Practice PointBiopsy should generally be perf...


...urgery

...n 2.1For patients with stage IIIA (N2) NS...

....2For selected patients with T4N0 disease...

...ractice Points...

...ts with stage III NSCLC generally shou...

...oncogenic driver alterations, available the...

...providers should consider enrollme...


Treatment

...atment...

...djuvant Therapy...

....1Patients who are planned for a multim...

Recommendation 3.2Patients with stage...

...dation 3.3For patients with resectable s...


Adjuvant Ther...

...ion 4.1Patients with resected stage...

...tion 4.2Patients with resected sta...

...on 4.3For patients with completely resected NSC...


...resectable Dis...

...ecommendation 5.1Patients with stage III NS...

...on 5.2Concurrent chemotherapy delivere...

....3Patients with stage III NSCLC who are not...

...5.4Patients with stage III NSCLC receiving co...

Recommendation 5.5Doses higher than 60 Gy an...

...endation 5.6Patients with stage III NS...

...n 5.7Patients with stage III NSCLC r...

...endation 5.8(Update): Patients with unrese...


...ure 1. Evaluation and Staging in Stage III NSCLC...


...Management of Stage III NSCLCArrows with...