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Publication year
2005Source
Nederlands Tijdschrift voor Geneeskunde, 149, 2, (2005), pp. 72-7ISSN
Publication type
Article / Letter to editor

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Organization
Radboudumc Extern
Medical Oncology
IQ Healthcare
Former Organization
Centre for Quality of Care Research
Journal title
Nederlands Tijdschrift voor Geneeskunde
Volume
vol. 149
Issue
iss. 2
Page start
p. 72
Page end
p. 7
Subject
EBP 4: Quality of Care; NCEBP 4: Quality of hospital and integrated care; UMCN 1.5: Interventional oncologyAbstract
A national, evidence-based guideline on the staging and treatment of patients with non-small cell lung carcinoma (NSCLC) has been compiled by the various disciplines involved. The initial diagnostic measures in patients with suspected lung cancer include history taking, physical examination and chest x-ray. Additional examinations include CT scan of the chest and upper abdomen, bronchoscopy, and 18F-fluorodeoxyglucose-positron-emission-tomography(FDG-PET)-scintigraphy, if curative therapy is planned. Cervical mediastinoscopy or endoscopic echography with fine needle aspiration can be performed for mediastinal tissue staging. The preferred treatment in stage I, II or limited III is radical resection. Postoperative radiotherapy is recommended in cases of incomplete resection and can be considered in patients in whom mediastinal lymph-node metastases are unexpectedly encountered. Chemoradiotherapy is recommended in locally advanced NSCLC. In patients with NSCLC stage I-III and poor performance status, palliative radiotherapy may be the only feasible treatment. Some patients with NSCLC stage III and stage IV can be offered palliative chemotherapy and supportive care. In cases of doubt about operability, resectability, significant pulmonary or cardiac comorbidity or combined treatment, a specialist centre should be consulted. Diagnostics should be completed within 3-5 weeks. Ensuing surgery or radiotherapy should be carried out within 2 weeks. Follow-up of patients with NSCLC includes history taking, physical examination and an optional chest x-ray. In the first year after treatment patient visits are planned quarterly, in the second year half-yearly and then yearly for at least five years.
This item appears in the following Collection(s)
- Academic publications [227425]
- Electronic publications [107155]
- Faculty of Medical Sciences [86157]
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