Lege Artis Medicinae

[MODERN PRINCIPLES OF EARLY DETECTION, DIAGNOSIS AND TREATMENT IN LUNG CANCER]

OSTOROS Gyula, KOVÁCS GÁBOR, BÖSZÖRMÉNYI Nagy György, STRAUSZ János

JANUARY 21, 2006

Lege Artis Medicinae - 2006;16(01)

[New clinical guidelines for the diagnosis and treatment of lung cancer contain important advancements. It is necessary therefore that these novelties are widely known by health care professionals. With an existing X-ray screening network in Hungary, we have a unique chance to discover lung malignancies in an early stage in the population. Annual screening is recommended in risk groups over 40 years of age using a nation wide established digital screening network technology. In the therapy of small cell lung cancer there has been no major advance in the past ten years. However, by today, the number of small cell lung cancer patients represent only about 15% of all lung cancer cases. There have been advancements in other fields of the therapy of non small cell lung cancer. Third generation cytotoxic agents used in a platinum based chemotherapy protocol improved quality of life, response rate and survival time. Radiochemotherapy used in locally advanced stages also represented a step forward. In early stage of non small cell lung cancer it has been revealed that significantly improved survival time can be reached with adjuvant combined cytotoxic chemotherapy. Based on these results adjuvant chemotherapy became part of the therapeutic protocol. The use of molecular targeted chemotherapy in the clinical practice of non small cell lung cancer treatment is also a novelty. New therapeutic approaches are epidermal growth factor inhibitors, angiogenesis inhibitors, antivascular, signal transduction modifiers, apoptosis inducing, eicosanoid signal transduction modifiers and immunotherapeutic drugs. Placebo controlled trials have proved the effectiveness of the epidermal growth factor tyrosine kinase inhibitor erlotinib in the second and third line therapy of non small cell lung cancer and can be administered in the European Union in this indication. The improvement in the complex care of lung cancer patients in Hungary is characterized by the gradual increase in the prevalence data, meaning the gradual increase of the number of lung cancer patients still alive.]

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