Lung Cancer Surveillance After Definitive Curative-Intent Therapy
Key Points
Key Points
Non-Small Cell Lung Cancer
The chance of NSCLC recurrence is greatest during the first 2 years following treatment with curative intent.
- Patients with an intrathoracic recurrence may be salvaged with surgical resection, stereotactic body radiotherapy (SBRT) or chemoradiation depending on the clinical scenario.
- Early identification of extra-thoracic metastatic recurrence may allow prompt molecular testing and facilitate the safe administration of precision palliative therapy before patients develop severe symptoms or deteriorate.
Two or more years after curative intent therapy, patients are at higher risk of developing a second primary lung cancer (1.5-2% per year) and may benefit from screening.
Small Cell Lung Cancer
- The risk of intracranial recurrence is significant. Therefore, close central nervous system (CNS) surveillance may afford treatment before permanent neurologic sequelae develop from symptomatic SCLC brain metastases.
Recommendations
...Recommendati...
...E: These recommendations apply to pa...
...hould undergo surveillance imaging for recurren...
...uld undergo surveillance imaging for detectio...
...should use a diagnostic chest CT that inc...
...nicians should use a low dose screening chest CT w...
...should NOT use FDG-PET/CT as a surveillance tool....
...rveillance imaging may be omitted in patients wh...
...should NOT use circulating biomarkers as a surv...
...III NSCLC patients, clinicians should NOT...
...tients who have undergone curative intent treatme...