Traitements locaux : indication et résultats dans les stades précoces: Local treatments: Indication and results in early stages

Abstract

AbstractLobectomy with radical lymph node dissection remains the gold standard treatment for stage I primary non-small cell lung cancer (NSCLC). The spontaneous evolution of NSCLC lung tumors is very negative; the use of local non-surgical treatments is an major option for the care of these fragile patients who are not eligible for surgery. In recent years, stereotaxic radiotherapy (SBRT) and percutaneous ablation techniques (or percutaneous tumor destruction) have gradually taken their place in this indication.The choice of doses and fractionation and the stereotactic radiotherapy technique should be considered taking into account the patient’s clinical situation, previous treatments and the tumour to be treated (size and topography). Iterative treatments, catch-up treatments in case of failure of one of the type of treatments and reirradiations offer new perspectives for patients, replacing or delaying the use of systemic treatment. Finally, improved knowledge of response patterns on scan and metabolic imaging has helped to ensure safe and reliable patient follow-up.© 2020 SPLF. Published by Elsevier Masson SAS. All rights reserved.