- The National Institute for Health and Care Excellence (NICE) has issued updated guidelines on the diagnosis and treatment of lung cancer.
Why this matters
- The updated guidelines include research on staging, radiotherapy, and systemic treatments published since the guidelines were last updated in 2011.
Key updates and recommendations
- A new NSCLC staging algorithm describes when to use certain diagnostic and staging procedures, and in what order.
- Nonultrasound-guided transbronchial needle aspiration is no longer recommended.
- Pretreatment brain imaging is recommended for patients with stage II and III NSCLC who are candidates for curative treatment.
- Lobectomy remains the treatment of choice for stage I and II NSCLC.
- Stereotactic ablative radiotherapy (SABR) is recommended for nonsurgical patients, except for tumors within a 2-cm radius of the main airways and proximal bronchial tree.
- Recommendations for conventional or hyperfractionated radiotherapy schedules for patients not undergoing surgery or SABR.
- Chemoradiotherapy and surgery should be offered for operable stage IIIA-N2 NSCLC.
- A new systemic therapy algorithm recommends medications for advanced NSCLC based on tumor histology and biomarkers.
- Recommendation for prophylactic cranial irradiation for SCLC was downgraded from "offer" to "consider."
- Twice-daily chemoradiotherapy for limited-stage SCLC is recommended, if possible.