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Surgery, radiation, chemotherapy, and targeted treatments—alone or in combination


Most stage I and stage II non-small cell lung cancers are treated with surgery to remove the tumor. For this procedure, a surgeon removes the lobe, or section, of the lung containing the tumor.

We use video-assisted thoracoscopic surgery (VATS) for removal of tumor. For this procedure, the surgeon makes a small incision, or cut, in the chest and inserts a tube called a thoracoscope. The thoracoscope has a light and a tiny camera connected to a video monitor so that the surgeon can see inside the chest. A lung lobe can then be removed through the scope, without making a large incision in the chest.

Chemotherapy And Radiation

Meant particularly for patients with stage II and IIIA disease. Also given to patients with non-small cell lung tumors that can be surgically removed, evidence suggests that chemotherapy after surgery, known as “adjuvant chemotherapy,” may help prevent the cancer from returning.

In patients with stage IIIB lung cancer (which cannot be removed surgically), we recommend chemotherapy in combination with definitive (high-dose) radiation treatments. Patients with stage IV lung cancer, chemotherapy is the mainstay treatment, and radiationis used only for palliation of symptoms.


Chemotherapy and Radiation Therapy

Chemotherapy is the mainstay treatment of small cell lung cancer, regardless of stage. Radiation can be used for small subset of patients. For people with limited-stage small cell lung cancer, combination chemotherapy plus radiation therapy given at the same time is the recommended treatment. The most commonly used initial chemotherapy regimen isetoposide plus cisplatin.

For people with extensive-stage small cell lung cancer, chemotherapy alone using the EP regimen is the standard treatment. However, another regimen that may be used is carboplatin plus irinotecan.

Radiation therapy of the brain may be used before or after chemotherapy for some people whose cancer has spread to the brain.


A very small percentage of people who have limited-stage small cell lung cancer and no lymph node tumors may benefit from surgery, after which adjuvant chemotherapy is given.

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