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

Diagnosis

...ion and Staging...

...ation 1.1For patients with suspect...

...ion 1.2Following evaluation with CT scan as...

...ation 1.3For patients with suspected s...

...mmendation 1.4For patients who require pathol...

...ation 1.5For patients who require pathol...

...1.6For patients who have suspecte...

...e PointBiopsy should generally be performed fr...


Treatment

...reatment

...rgery...

...mendation 2.1For patients with stage IIIA (N2) NSC...

...endation 2.2(Update): Patients with stage III...

...od Practice Points...

...ts with stage III NSCLC generally should not b...

...of oncogenic driver alterations, a...

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


...juvant Therap...

...mmendation 3.1Patients who are pla...

...commendation 3.2(Update): Patients wi...

...ecommendation 3.3For patients with...


...djuvant Therap...

...endation 4.1Patients with resected stage I...

...ion 4.2(Update): Patients with resected stag...

....3For patients with completely resected...


...sectable Disease...

...ation 5.1Patients with stage III NSCL...

...ommendation 5.2Concurrent chemotherapy delivered w...

...on 5.3Patients with stage III NSCLC who are not...

...n 5.4Patients with stage III NSCLC re...

...on 5.5Doses higher than 60 Gy and up to 70 Gy m...

...ndation 5.6Patients with stage III NSCLC rec...

...5.7Patients with stage III NSCLC receiving...


...igure 1. Evaluation and Staging in Stage I...


...e 2. Management of Stage III NSCLCArrows wi...