Authors' objectives:

This report summarises the research evidence on the management of lung cancer.

Authors' recommendations: Lung cancer is the third most common cause of death in the UK. The disease progresses rapidly and the prognosis is usually poor; around 80% of patients die within a year of diagnosis. Since cigarette smoking is responsible for about 90% of cases of lung cancer, action against smoking should be the primary focus of efforts to improve outcomes. A range of co-ordinated interventions to reduce smoking should be provided at both local and national levels. Palliative care should be an integral part of patient management from the outset. All patients should be offered accurate information about their disease and its management. A range of interventions can be used to control symptoms and improve quality of life. These include not only anti-cancer treatments such as radiotherapy and chemotherapy, but also pain relief and psycho-educational interventions such as breathing re-training. As treatment options are normally determined by tumour type, diagnosis should include identification of tumour type except when this would not influence management. Decisions about treatment should take account of the patient's fitness, not age. Surgery offers a chance of long-term survival for a minority of patients with non-small cell lung cancer and every effort should be made to identify those who might benefit. Tumour stage must be adequately assessed before surgery to reduce the risk of inappropriate operations. Systems should be established to allow CHART (continuous hyperfractionated accelerated radiotherapy) to be offered to suitable patients. This will require that radiotherapy is available at weekends. Chemotherapy using established combinations of drugs should normally be offered to patients with small cell lung cancer. Chemotherapy may be appropriate for patients with non-small cell lung cancer but requires further evaluation.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/ehcb.htm

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination