title: Management of stage I and II nonsmall cell lung cancer.
abstract: The incidence of stage I and II nonsmall cell lung cancer is likely to increase with the ageing population and introduction of screening for high-risk individuals. Optimal management requires multidisciplinary collaboration. Local treatments include surgery and radiotherapy and these are currently combined with (neo)adjuvant chemotherapy in specific cases to improve long-term outcome. Targeted therapies and immunotherapy may also become important therapeutic modalities in this patient group. For resectable disease in patients with low cardiopulmonary risk, complete surgical resection with lobectomy remains the gold standard. Minimally invasive techniques, conservative and sublobar resections are suitable for a subset of patients. Data are emerging that radiotherapy, especially stereotactic body radiation therapy, is a valid alternative in compromised patients who are high-risk candidates for surgery. Whether this is also true for good surgical candidates remains to be evaluated in randomised trials. In specific subgroups adjuvant chemotherapy has been shown to prolong survival; however, patient selection remains important. Neoadjuvant chemotherapy may yield similar results as adjuvant chemotherapy. The role of targeted therapies and immunotherapy in early stage nonsmall cell lung cancer has not yet been determined and results of randomised trials are awaited.
authors.affiliation: Dept of Radiotherapy, Royal Marsden NHS Foundation Trust, Sutton, UK.|These authors equally contributed to this manuscript.
authors.forename: Fiona
authors.initials: F
authors.lastname: McDonald
authors.affiliation: Dept of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp, Belgium.|These authors equally contributed to this manuscript.
authors.forename: Michèle
authors.initials: M
authors.lastname: De Waele
authors.affiliation: Dept of Respiratory Disease, Maastricht University Medical Centre, Maastricht, the Netherlands.|These authors equally contributed to this manuscript.
authors.forename: Lizza E L
authors.initials: LE
authors.lastname: Hendriks
authors.affiliation: Manchester Academic Health Science Centre, Institute of Cancer Sciences, Manchester Cancer Research Centre (MCRC), University of Manchester, Manchester, UK.|Radiotherapy Related Research, Christie NHS Foundation Trust, Manchester, UK.
authors.forename: Corinne
authors.initials: C
authors.lastname: Faivre-Finn
authors.affiliation: Dept of Respiratory Disease, Maastricht University Medical Centre, Maastricht, the Netherlands.
authors.forename: Anne-Marie C
authors.initials: AC
authors.lastname: Dingemans
authors.affiliation: Dept of Thoracic and Vascular Surgery, Antwerp University Hospital, Antwerp, Belgium paul.van.schil@uza.be.
authors.forename: Paul E
authors.initials: PE
authors.lastname: Van Schil
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D019468:Disease Management; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000628:therapy*; D015201:Meta-Analysis as Topic; D009367:Neoplasm Staging; D011013:Pneumonectomy; D016634:Radiosurgery; D016032:Randomized Controlled Trials as Topic