Excerpt

This guidance updates and replaces NICE clinical guideline 24 (published February 2005).

New and updated recommendations are included on communication, diagnosis and staging, selection of patients with non-small-cell lung cancer (NSCLC) for treatment with curative intent, surgical techniques, smoking cessation, combination treatment for NSCLC, treatment of small-cell lung cancer (SCLC), managing endobronchial obstruction, managing brain metastases and follow-up and patient perspectives.

Contents

• Update Information
• Key priorities
• Key research recommendations
• Methodology
• Algorithms
• 1. Epidemiology
  • 1.1. Introduction
  • 1.2. Incidence
  • 1.3. Sex variation
  • 1.4. Histological subtypes
  • 1.5. Socio-economic status (SES)
  • 1.6. Ethnic variation
  • 1.7. Stage and performance status
  • 1.8. Treatment received
  • 1.9. Survival
  • 1.10. Facilities available at NHS Trusts in England and Wales
  • 1.11. Lung Cancer Specialist Nurse
  • References
• 2. Access to services and referral
  • 2.1. The importance of early diagnosis
  • 2.2. Referral and indications for chest radiography
• 3. Communication
  • References
• 4. Diagnosis and staging
  • 4.1. Introduction
  • 4.2. Effectiveness of Diagnostic and Staging Investigations
  • 4.3. Sequence of investigations
  • 4.4. Organisational factors relevant to diagnosis and staging
  • References
• 5. Treatment with curative intent for NSCLC
  • 5.1. Selection of patients with NSCLC for treatment with curative intent
  • 5.2. Pulmonary optimisation
  • 5.3. Options for treatment with curative intent for patients with NSCLC
  • 5.4. Radiotherapy with curative intent
  • 5.5. Combination Treatment for NSCLC
  • 5.6. Prophylactic Cranial Irradiation in NSCLC
  • References
• 6. Chemotherapy for NSCLC
• 7. Treatment of small cell lung cancer (SCLC)
  • 7.1. Staging of SCLC
  • 7.2. Assessment of patients with SCLC
  • 7.3. First line treatment of patients with limited stage disease SCLC (broadly staged as T1-4, N0-3, M0)
  • 7.4. Surgical treatment for patients with SCLC
  • 7.5. First line treatment for extensive stage disease small cell lung cancer (broadly staged as T1-4, N0-3, M1 a/b)
  • 7.6. Second line treatment for patients with SCLC who relapse after primary treatment
  • References
• 8. Palliative interventions and supportive and palliative care
  • 8.1. Common symptoms of lung cancer
  • 8.2. Palliative Radiotherapy
  • 8.3. Management of endobronchial obstruction
  • 8.4. Other treatments with palliative intent
  • 8.5. Management of brain metastases
  • 8.6. Spinal Cord Compression
  • 8.7. Hypercalcaemia, Bone Pain and Pathological Fractures
  • 8.8. Other symptoms: weight loss, loss of appetite, difficulty swallowing, fatigue and depression
  • References
• 9. Follow-up and patient perspectives
  • 9.1. The Patient's Perspective
  • References
• Appendix 1. Needs assessment questionnaire sent to LHB's in Wales and lung cancer leads in England
• Appendix 2. Summary of the 7^th edition of the TNM staging system in comparison with the 6^th edition
• Appendix 3. Questions for histopathologists regarding update of nice lung cancer guideline
• Appendix 4. Economic model to compare different testing strategies to stage the mediastinum in patients with NSCLC
• Appendix 5. Abbreviations
• Appendix 6. Glossary
• Appendix 7. Guideline Scope
• Appendix 8. List of topics covered by each chapter
• Appendix 9 People and organisations involved in production of the guideline
  • Appendix 9.1. Members of the Guideline Development Group
  • Appendix 9.2. Organisations invited to comment on guideline development
  • Appendix 9.3. Individuals carrying out literature reviews and complementary work
  • Appendix 9.4. Expert advisers to the Guideline Development Group
  • Appendix 9.5. Members of the Guideline Review Panel
• Appendix 10. The 2005 lung cancer guideline, including all original sections that have been updated by the 2011 document
• Appendix 11 Evidence review
  • Chapter 3. Communication
  • Chapter 4. Diagnosis and staging
  • Chapter 5. Curative treatment options for patients with NSCLC
  • Chapter 7. Treatment of SCLC
  • Chapter 8. Palliative interventions and Supportive and Palliative Care
  • Chapter 9. Follow up and patient perspectives
  • Appendix 1. Search strategies
  • Appendix 2. Economic plan
  • Appendix 3. Health economics
  • Appendix 4. Collated responses from the three invited histopathologists to questions in Appendix 3 of the full guideline

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