What is the treatment for squamous cell carcinoma of the lung?

Hi,

Welcome to icliniq.com.

I understand your concern.

I had seen all these reports (attachments were removed to protect the patient's identity), and based on this, it is squamous cell carcinoma of the lung. Based on the CT (computed tomography) and bronchoscopy report, it looks like endobronchial and extrabronchial growth.

The CT report shows a hilar mass with a cut-off middle lobe bronchus and a tumor along the bronchus intermedius.

Nothing was mentioned about the mediastinal nodes. It is occluding the middle lobe bronchus on bronchoscopy, and the rest is fine. I want to see the CT image to ensure there are no significant mediastinal nodes. Also, if I consider him for upfront surgery, negative margins are possible.

Further, I would like to proceed with PET (positron emission tomography), CECT (contrast-enhanced computed tomography), and MRI (magnetic resonance imaging) of the brain to rule out any metastatic disease.

If both are normal, I would like to see a pulmonary function test (PFT). If PFT is adequate for surgical resection, then I would like to do invasive mediastinal staging by EBUS (endobronchial ultrasound) to rule out any N2 (non–small cell lung cancer) or N3 disease (non–small cell lung cancer). If no N2 or N3 disease exists, I would like to proceed with a mediastinoscopy.

Regarding the extent of surgical resection, I cannot comment without seeing imaging. Still, if positive, based on CT and bronchoscopy, the patient will require at least a middle lobectomy with bronchotomy and lower lobectomy. If single-station N2 disease occurs at any point, then immunotherapy and reassessment for surgery are required.

If multi-station N2, N3 disease, then definitive CTRT (cardiotoxicity of radiation therapy). And if negative margins are not possible based on the scan, we will proceed with the definitive CTRT. This is a provisional plan.

I hope this information will help you.

Kindly revert in case of further queries.

Thank you.

Hi,

Welcome back to icliniq.com.

I understand your concern.

Thank you for the CT (computed tomography) (attachments removed to protect the patient's identity), but actually I was asking for images of the CT scan. On the basis of the CT scan report, it looks like single-station N2 (non–small cell lung cancer) disease.

Further, I would like to proceed with PET (positron emission tomography), CECT (contrast-enhanced computed tomography), and MRI (magnetic resonance imaging) of the brain to rule out any metastatic disease.

If both are normal, then I would like to see a pulmonary function test (PFT), and if the PFT is adequate for surgical resection, then I would like to do invasive mediastinal staging by EBUS (endobronchial ultrasound) to rule out any N2 or N3 (non–small cell lung cancer) disease.

And if it is a single N2 station, then neoadjuvant chemotherapy and immunotherapy followed by reassessment for surgery.

I hope this information will help you.

Kindly revert in case of further queries.

Thank you.