|
你现在的位置: 首页 > 癌症医典(肺癌) > 非小细胞肺癌的治疗
中文版 / English
非小细胞肺癌的治疗(PDQ®)

关于非小细胞肺癌的常用信息

非小细胞肺癌是一种恶性（癌症）细胞在肺部组织中形成所导致的疾病。

肺是位于胸腔内的一对圆锥形的呼吸器官。当你吸气时，肺将氧气带入体内。当你呼气时，肺会释放二氧化碳，这是一种由人体细胞产生的废料。每侧肺都由肺叶组成。左肺有两个肺叶。右肺比左肺稍微大些，有三个肺叶。两侧称为支气管的通道，从气管开始延伸至左肺和右肺。肺癌有时会累及支气管。肺的内部由名为肺泡的微小气囊和名为细支气管的小管组成。

呼吸系统的解剖图，显示了气管、双侧肺及其肺叶和气道，也显示出淋巴结和横膈。氧气被吸入肺部，通过肺泡的薄膜进入血液(见插图)。

胸膜是一层覆盖在每个肺的表面和胸腔内壁的薄膜，由此形成了一个称为胸膜腔的囊腔。胸膜腔内通常含有少量的液体，在呼吸时，可以帮助肺部平滑地移动。

肺癌主要分为两种不同的类型：非小细胞肺癌和小细胞肺癌。

更多关于肺癌的信息，请参阅以下的PDQ摘要

  • 小细胞肺癌的治疗
  • 儿童罕见癌症的治疗
  • 肺癌预防
  • 肺癌筛查

    • 非小细胞肺癌有几种类型。

    不同类型的非小细胞肺癌有不同的肿瘤细胞。不同种类的癌症细胞生长和扩散的方式也不同。不同类型的非小细胞肺癌是根据在癌症中发现的细胞种类以及这些细胞在显微镜下的形态来命名的。

  • 鳞状细胞癌:在沿肺内侧分布的薄而扁平的细胞中形成的癌症。这也被称为表皮样癌。
  • 大细胞癌：癌症可能从几种大细胞中开始发生。
  • 腺癌：起始于肺泡膜细胞且可生成粘液等物质的癌症。

    • 其他不常见的几种非小细胞肺癌：多形性癌、类癌瘤、唾液腺癌和未分类癌。

    吸烟是非小细胞肺癌的主要危险因素

    任何增加患病几率的因素都被称为危险因素。有危险因素并不意味着你会得癌症;没有危险因素并不意味着你不会得癌症。如果你认为自己有患肺癌的风险，请咨询你的医生。

    肺癌的风险因素包括以下几种：

  • 过去或现在有抽香烟、烟斗、或雪茄史。这是肺癌最重要的危险因素。一个人开始吸烟的时间越早，吸烟的频率越高，吸烟的时间越长，患肺癌的风险就越大。
  • 暴露在二手烟环境中。
  • 在工作场所接触石棉、砷、铬、铍、镍、煤烟或焦油。
  • 暴露于下列任何一种辐射:
  • 乳房或胸部的放射治疗。
  • 家中或工作场所的氡。
  • 影像学检查，如CT扫描。
  • 原子弹辐射。
  • 生活在大气污染的环境中
  • 拥有肺癌的家族史。
  • 感染人类免疫缺陷病毒（HIV）。
  • 摄入β-胡萝卜素补充剂和大量吸烟

    • 年龄大是大多数癌症的主要危险因素。随着年龄的增长，患癌症的几率会增加。

    当吸烟和其他风险因素同时存在时，患肺癌的风险增加。

    非小细胞肺癌的症状包括不停的咳嗽以及呼吸短促。

    有时肺癌并不引起任何体征和症状。肺癌可能会在因身体其他状况而行检查时，通过胸部x 射线被发现。一些体征和症状可能是有肺癌或者其他病症引起的。如果你有如下情况，及时去找医生检查：

  • 胸部不适或者疼痛。
  • 持续存在或随时间而加重的咳嗽
  • 呼吸困难。
  • 喘息。
  • 痰（从肺部咳出的粘液）中带血。
  • 声音嘶哑。
  • 食欲不振。
  • 不明原因导致的体重下降。
  • 体感疲惫。
  • 吞咽困难。
  • 面部和/或颈部曲张或怒张。

    • 检查肺部的检验可以用于非小细胞肺癌的检测（发现）、诊断以及分期。

    检测、诊断和给非小细胞肺癌分期的检测和程序可以同时进行。可能会用到如下的检测和步骤：

  • 体检和健康史：检查身体通用的健康标志，包括检查疾病标志，比如肿块或者其他不正常表征。也要检查病人之前的健康习惯，包括吸烟、工作环境、患过的疾病和治疗方法。
  • 实验室检测：对组织、血液、尿液或者体内其他物质的样品进行检验的医疗程序。这些检测有助于诊断疾病、安排治疗计划、检查治疗效果或者后续的疾病监测。
  • X线胸片：一种扫描胸部内部的器官和骨骼的X光片。x 射线是一种可以扫描全身，并且映射到胶片上的能量束，最终将身体内部的构造转变成图片。
    • 胸部x线检查。x射线被用来拍摄胸部器官和骨骼的照片。x射线穿过病人的身体，并将影像映射到胶片上。
  • CT扫描（CAT扫描）：从不同角度扫描人体内部区域，如胸部，并制作为一系列详细的影像片的过程。这些影像片是由一台和x 射线机器相连的电脑制作产生的。可能需要通过口服或者静脉注射一种显影剂使组织器官成像更加清晰。这个过程也可以被称作计算机体层摄影术、计算机断层扫描或者计算机轴向断层扫描。
  • 痰细胞学：病理学家在显微镜下观察痰的样品（从肺部咳出的粘液），检查是否存在癌细胞。
  • 胸腔穿刺术：用穿刺针抽取胸腔内壁与肺部之间的液体。病理学家在显微镜下对液体样品观察，寻找癌症细胞。

    • 如果怀疑患肺癌，需要做活组织检查。

    通常采用以下一种活组织检查:

  • 肺部的细针穿刺（FNA）活检：用细针从肺部吸取肺部的组织或液体。可以用CT扫描、超声、或者其他成像方式对肺部的异常组织或液体进行定位。在皮肤上切开一个小口，活检的针可以从这里插入到异常的组织或液体中。针吸出的一些样品被送至实验室。然后，病理学家便可通过显微镜观察样品，检查是否存在癌细胞。最后，要做一个x 胸片来确保没有气胸。
    • 细针穿刺肺组织活检。病人躺在CT的操作台上，CT扫描可以拍摄身体内部的CT图像帮助医生看清楚肺异常组织的位置。活检细针穿过胸壁，插入异常的肺组织区域。通过细针取出一小片组织，在显微镜下检查是否有癌细胞的征象。

    内镜超声(EUS)是一种用于引导肺、淋巴结或其他区域的FNA活检的超声结合内镜的检查方法。超声内镜是一种细管状的仪器，有光源和观察透镜。内窥镜末端的探针发出高能声波(超声波)经内部组织或器官反射回来而产生回声。这些回声形成了一幅身体组织的图像，称为声波图。

    超声内镜引导下细针穿刺活检。有超声探头和活检针的内窥镜通过口腔插入食道。探针将声波反射到身体组织上，使回声形成食管附近淋巴结的声波图(计算机图像)。声波图可以帮助医生确定活检针的位置从而取出淋巴结组织的样本。在显微镜下检查这个组织是否有癌细胞
  • 支气管镜检：通过观察肺部气管和大气道寻找异常区域的过程。将支气管镜通过鼻子或者口腔插入气管以及肺部。支气管镜是一种细管状仪器，上面带有一个镜头和一个光源以便观察。它可能也包含切除组织的工具，取出的组织要在显微镜下进行检查，以寻找癌症的迹象。
    • 支气管镜检。支气管镜通过口腔、气管和主支气管插入肺内，以寻找异常区域。支气管镜是一种细管状仪器，上面带有一个镜头和一个光源以便观察。它也可能带有切除组织的工具。取出的组织要在显微镜下进行检查，以寻找疾病的迹象。
  • 胸腔镜检查：一种用以检查胸腔内部器官异常区域的外科手术操作。在两个肋骨之间切开一个切口（开口），将胸腔镜插入胸腔内部。胸腔镜是一个细管状的仪器，上面带有一个镜头和光源以便观察。其也包含切除组织或者淋巴结样品的工具，取出的组织要在显微镜下进行检查，以寻找癌症的迹象。在有些情况下，这种方法也可以用来移除部分的食管或者肺。如果无法到达特定的组织、器官或者淋巴结，那就要进行开胸手术。在这个过程中，肋骨间要切开一个大的切口，并且需打开胸腔。
  • 纵膈镜检查术：检查纵膈器官、组织和淋巴结的异常区域的一种外科手术操作。在胸骨的顶端切开一个切口，将纵膈镜由此插入到胸部中。纵膈镜是呈细管状的一种设备，上面带有一个光源和一个镜头以便观察。它也可能带有一个可以移除组织或者淋巴结样品的工具，取出的组织要在显微镜下进行检查，以寻找癌症的迹象。
    • 纵隔镜检查。通过胸骨上方的切口将纵隔镜插入胸腔，在两肺间的纵膈结构间寻找异常区域。纵隔镜是一种细管状仪器，带有观察用的光源和透镜。它也可能带有切除组织的工具。组织样本可以从胸部右侧的淋巴结中取得，并在显微镜下检查是否有癌细胞迹象。在前纵膈切开术(纵隔切开术)中，切口在胸骨旁侧，从胸部左侧淋巴结取出组织样本。
  • 前纵膈切口纵膈镜检查术：观察肺部之间以及胸骨和心脏之间的组织器官的异常区域的一种外科手术操作。胸骨旁边切开一个切口（开口），插入纵隔镜。纵隔镜是细而且呈细管状的仪器，带有一个光源和一个镜头以便观察。它可能也包含切除组织或淋巴结的工具，取出的组织要在显微镜下进行检查，以寻找癌症的迹象。这也被称为Chamberlain检查术
  • 淋巴结活检：切除全部或部分淋巴结。病理学家在显微镜下观察淋巴结组织以检查癌细胞。

    • 可进行以下一项或多项实验室检查以研究组织样本：

  • 分子检测：用以在组织、血液或其它体液样本中检查某些基因、蛋白质或其它分子的实验室检查。分子检测用于寻找非小细胞肺癌中某些基因或染色体的变化。
  • 免疫组织化学检测:用抗体检查病人组织样本中某些抗原(标记物)的实验室检查。抗体通常与酶或荧光染料相连。抗体与组织样本中的特定抗原结合后，酶或染色剂被激活，然后在显微镜下可以看到抗原。这种类型的检测被用来辅助诊断癌症，并帮助区分不同类型的癌症。

    • 影响预后（复发的几率）和治疗方案的一些因素。

    预后（复发的几率）和治疗方案取决于以下因素：

  • 癌症分期（肿瘤大小以及是否只局限于肺部，或者已经蔓延到身体其他地方）。
  • 肺癌的类型。
  • 癌症是否发生特定基因的突变（改变），比如表皮生长因子受体（EGFR）基因或者间变性淋巴瘤激酶（ALK）基因。
  • 是否有一些症状和体征，比如咳嗽或者呼吸困难。
  • 病人的总体健康状况。

    • 对于大多数非小细胞肺癌的病人来说，目前的治疗并不能治愈癌症。

    肺癌一旦被确诊，可以考虑参加临床试验来改善治疗。全国的很多的地方都有针对所有分期的非小细胞肺癌临床试验。可在NCI网站了解正在进行的临床试验信息。

    Non-Small Cell Lung Cancer Treatment (PDQ®)

    General Information About Non-Small Cell Lung Cancer

    Non-small cell lung cancer is a disease in which malignant (cancer) cells form in the tissues of the lung.

    The lungs are a pair of cone-shaped breathing organs in the chest. The lungs bring oxygen into the body as you breathe in. They release carbon dioxide, a waste product of the body’s cells, as you breathe out. Each lung has sections called lobes. The left lung has two lobes. The right lung is slightly larger and has three lobes. Two tubes called bronchi lead from the trachea (windpipe) to the right and left lungs. The bronchi are sometimes also involved in lung cancer. Tiny air sacs called alveoli and small tubes called bronchioles make up the inside of the lungs.

    Anatomy of the respiratory system, showing the trachea and both lungs and their lobes and airways. Lymph nodes and the diaphragm are also shown. Oxygen is inhaled into the lungs and passes through the thin membranes of the alveoli and into the bloodstream (see inset).

    A thin membrane called the pleura covers the outside of each lung and lines the inside wall of the chest cavity. This creates a sac called the pleural cavity. The pleural cavity normally contains a small amount of fluid that helps the lungs move smoothly in the chest when you breathe.

    There are two main types of lung cancer: non-small cell lung cancer and small cell lung cancer.

    See the following PDQ summaries for more information about lung cancer:

  • Small Cell Lung Cancer Treatment
  • Unusual Cancers of Childhood Treatment
  • Lung Cancer Prevention
  • Lung Cancer Screening

    • There are several types of non-small cell lung cancer.

    Each type of non-small cell lung cancer has different kinds of cancer cells. The cancer cells of each type grow and spread in different ways. The types of non-small cell lung cancer are named for the kinds of cells found in the cancer and how the cells look under a microscope:

  • Squamous cell carcinoma: Cancer that forms in the thin, flat cells lining the inside of the lungs. This is also called epidermoid carcinoma.
  • Large cell carcinoma: Cancer that may begin in several types of large cells.
  • Adenocarcinoma: Cancer that begins in the cells that line the alveoli and make substances such as mucus.

    • Other less common types of non-small cell lung cancer are: pleomorphic, carcinoid tumor, salivary gland carcinoma, and unclassified carcinoma.

    Smoking is the major risk factor for non-small cell lung cancer.

    Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for lung cancer.

    Risk factors for lung cancer include the following:

  • Smoking cigarettes, pipes, or cigars, now or in the past. This is the most important risk factor for lung cancer. The earlier in life a person starts smoking, the more often a person smokes, and the more years a person smokes, the greater the risk of lung cancer.
  • Being exposed to secondhand smoke.
  • Being exposed to asbestos, arsenic, chromium, beryllium, nickel, soot, or tar in the workplace.
  • Being exposed to radiation from any of the following:
  • Radiation therapy to the breast or chest.
  • Radon in the home or workplace.
  • Imaging tests such as CT scans.
  • Atomic bomb radiation.
  • Living where there is air pollution.
  • Having a family history of lung cancer.
  • Being infected with the human immunodeficiency virus (HIV).
  • Taking beta carotene supplements and being a heavy smoker.

    • Older age is the main risk factor for most cancers. The chance of getting cancer increases as you get older.

    When smoking is combined with other risk factors, the risk of lung cancer is increased.

    Signs of non-small cell lung cancer include a cough that doesn't go away and shortness of breath.

    Sometimes lung cancer does not cause any signs or symptoms. It may be found during a chest x-ray done for another condition. Signs and symptoms may be caused by lung cancer or by other conditions. Check with your doctor if you have any of the following:

  • Chest discomfort or pain.
  • A cough that doesn’t go away or gets worse over time.
  • Trouble breathing.
  • Wheezing.
  • Blood in sputum (mucus coughed up from the lungs).
  • Hoarseness.
  • Loss of appetite.
  • Weight loss for no known reason.
  • Feeling very tired.
  • Trouble swallowing.
  • Swelling in the face and/or veins in the neck.

    • Tests that examine the lungs are used to detect (find), diagnose, and stage non-small cell lung cancer.

    Tests and procedures to detect, diagnose, and stage non-small cell lung cancer are often done at the same time. Some of the following tests and procedures may be used:

  • Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits, including smoking, and past jobs, illnesses, and treatments will also be taken.
  • Laboratory tests: Medical procedures that test samples of tissue, blood, urine, or other substances in the body. These tests help to diagnose disease, plan and check treatment, or monitor the disease over time.
  • Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
    • X-ray of the chest. X-rays are used to take pictures of organs and bones of the chest. X-rays pass through the patient onto film.
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • Sputum cytology: A procedure in which a pathologist views a sample of sputum (mucus coughed up from the lungs) under a microscope, to check for cancer cells.
  • Thoracentesis: The removal of fluid from the space between the lining of the chest and the lung, using a needle. A pathologist views the fluid under a microscope to look for cancer cells.

    • If lung cancer is suspected, a biopsy is done.

    One of the following types of biopsies is usually used:

  • Fine-needle aspiration (FNA) biopsy of the lung: The removal of tissue or fluid from the lung using a thin needle. A CT scan, ultrasound, or other imaging procedure is used to locate the abnormal tissue or fluid in the lung. A small incision may be made in the skin where the biopsy needle is inserted into the abnormal tissue or fluid. A sample is removed with the needle and sent to the laboratory. A pathologist then views the sample under a microscope to look for cancer cells. A chest x-ray is done after the procedure to make sure no air is leaking from the lung into the chest.
    • Fine-needle aspiration biopsy of the lung. The patient lies on a table that slides through the computed tomography (CT) machine, which takes x-ray pictures of the inside of the body. The x-ray pictures help the doctor see where the abnormal tissue is in the lung. A biopsy needle is inserted through the chest wall and into the area of abnormal lung tissue. A small piece of tissue is removed through the needle and checked under the microscope for signs of cancer.

    An endoscopic ultrasound (EUS) is a type of ultrasound that may be used to guide an FNA biopsy of the lung, lymph nodes, or other areas. EUS is a procedure in which an endoscope is inserted into the body. An endoscope is a thin, tube-like instrument with a light and a lens for viewing. A probe at the end of the endoscope is used to bounce high-energy sound waves (ultrasound) off internal tissues or organs and make echoes. The echoes form a picture of body tissues called a sonogram.

    Endoscopic ultrasound-guided fine-needle aspiration biopsy. An endoscope that has an ultrasound probe and a biopsy needle is inserted through the mouth and into the esophagus. The probe bounces sound waves off body tissues to make echoes that form a sonogram (computer picture) of the lymph nodes near the esophagus. The sonogram helps the doctor see where to place the biopsy needle to remove tissue from the lymph nodes. This tissue is checked under a microscope for signs of cancer.
  • Bronchoscopy: A procedure to look inside the trachea and large airways in the lung for abnormal areas. A bronchoscope is inserted through the nose or mouth into the trachea and lungs. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
    • Bronchoscopy. A bronchoscope is inserted through the mouth, trachea, and major bronchi into the lung, to look for abnormal areas. A bronchoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a cutting tool. Tissue samples may be taken to be checked under a microscope for signs of disease.
  • Thoracoscopy: A surgical procedure to look at the organs inside the chest to check for abnormal areas. An incision (cut) is made between two ribs, and a thoracoscope is inserted into the chest. A thoracoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. In some cases, this procedure is used to remove part of the esophagus or lung. If certain tissues, organs, or lymph nodes can’t be reached, a thoracotomy may be done. In this procedure, a larger incision is made between the ribs and the chest is opened.
  • Mediastinoscopy: A surgical procedure to look at the organs, tissues, and lymph nodes between the lungs for abnormal areas. An incision (cut) is made at the top of the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer.
    • Mediastinoscopy. A mediastinoscope is inserted into the chest through an incision above the breastbone to look for abnormal areas between the lungs. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a cutting tool. Tissue samples may be taken from lymph nodes on the right side of the chest and checked under a microscope for signs of cancer. In an anterior mediastinotomy (Chamberlain procedure), the incision is made beside the breastbone to remove tissue samples from the lymph nodes on the left side of the chest.
  • Anterior mediastinotomy: A surgical procedure to look at the organs and tissues between the lungs and between the breastbone and heart for abnormal areas. An incision (cut) is made next to the breastbone and a mediastinoscope is inserted into the chest. A mediastinoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue or lymph node samples, which are checked under a microscope for signs of cancer. This is also called the Chamberlain procedure.
  • Lymph node biopsy: The removal of all or part of a lymph node. A pathologist views the lymph node tissue under a microscope to check for cancer cells.

    • One or more of the following laboratory tests may be done to study the tissue samples:

  • Molecular test: A laboratory test to check for certain genes, proteins, or other molecules in a sample of tissue, blood, or other body fluid. Molecular tests check for certain gene or chromosome changes that occur in non-small cell lung cancer.
  • Immunohistochemistry: A laboratory test that uses antibodies to check for certain antigens (markers) in a sample of a patient’s tissue. The antibodies are usually linked to an enzyme or a fluorescent dye. After the antibodies bind to a specific antigen in the tissue sample, the enzyme or dye is activated, and the antigen can then be seen under a microscope. This type of test is used to help diagnose cancer and to help tell one type of cancer from another type of cancer.

    • Certain factors affect prognosis (chance of recovery) and treatment options.

    The prognosis (chance of recovery) and treatment options depend on the following:

  • The stage of the cancer (the size of the tumor and whether it is in the lung only or has spread to other places in the body).
  • The type of lung cancer.
  • Whether the cancer has mutations (changes) in certain genes, such as the epidermal growth factor receptor (EGFR) gene or the anaplastic lymphoma kinase (ALK) gene.
  • Whether there are signs and symptoms such as coughing or trouble breathing.
  • The patient’s general health.

    • For most patients with non-small cell lung cancer, current treatments do not cure the cancer.

    If lung cancer is found, taking part in one of the many clinical trials being done to improve treatment should be considered. Clinical trials are taking place in most parts of the country for patients with all stages of non-small cell lung cancer. Information about ongoing clinical trials is available from the NCI website.

    非小细胞肺癌的治疗(PDQ®)

    非小细胞肺癌的不同分期

    肺癌在确诊之后，需要进行全面检查，以确定癌细胞是否已在肺内扩散或已扩散至身体其他部位。

    确定癌细胞是否在肺内或身体其他部位扩散的过程称为分期。在分期过程中收集的信息最终决定疾病的分期。为了制定治疗计划，了解分期是很重要的。一些用于诊断非小细胞肺癌的检测也用于分期。（请参阅“常用信息”部分。）

    在分期过程中可能使用的其他检测及程序包括:

  • MRI（磁共振成像）：是使用磁体、无线电波和计算机产生一系列身体内部区域的详细图片的过程，例如大脑。这个过程也被称为核磁共振成像（NMRI）。
  • CT扫描（CAT扫描）：从不同角度扫描人体内部区域，如胸部，并制作为一系列详细的影像片的过程。这些影像片是由一台和x 射线机器相连的电脑制作产生的。可能需要通过口服或者静脉注射一种显影剂使组织器官成像更加清晰。这个过程也可以被称作计算机体层摄影术、计算机断层扫描或者计算机轴向断层扫描。
  • PET扫描（正电子发射断层扫描）：一种用于发现体内恶性肿瘤细胞的方法。注射少量带有放射性的葡萄糖（糖）到静脉中。PET扫描仪绕着身体周围旋转，对于体内含有葡萄糖的部分进行成像。在图像中，由于恶性肿瘤细胞活性更高，和正常细胞比起来会吸收更多的葡萄糖，所以成像的亮度更高。
    • 正电子发射断层扫描（PET）。病人躺在PET仪器的操作台上。用头枕和白色带子使病人固定。将少量放射性葡萄糖（糖）注射到病人的静脉中，扫描仪拍摄出体内葡萄糖被利用的部位。癌细胞比正常细胞吸收更多的葡萄糖，因此在影像片中显得更明亮。
  • 骨扫描:一项检查骨骼中是否存在快速分裂的细胞（如癌细胞）的检测方法。微量的放射性物质被注射进静脉并通过血液循环到达全身。在骨骼的癌症病灶中聚集的放射性物质会被扫描仪检测出来。
  • 肺功能实验（PFT）:一种检测肺部功能是否完好的实验。它检测肺部可以容纳多少气体、可以多快地吸入和排出气体。它也可以检测呼吸时消耗了多少氧气以及排出了多少二氧化碳。这也被称作肺部功能实验。
  • 骨髓穿刺活检：通过在胯骨或者胸骨中插入一个空心针，移取骨髓、血液和 一小部分骨骼。病理学家会在显微镜下观察骨髓，血液和骨质，寻找癌症迹象。

    • 癌症在体内有三种扩散方式。

    癌症可以通过组织、淋巴系统和血液扩散。

  • 组织。癌症从原发处扩散到邻近组织中。
  • 淋巴系统。癌组织从原发处侵入淋巴系统。癌细胞通过淋巴管可扩散到身体其他部位。
  • 血液。癌组织可以从原发处侵入血液中。癌细胞通过血管可扩散到身体其他部位。

    • 癌症可以从原发处扩散至身体其他部位。

    癌症转移是指癌症扩散至身体其他部位。癌细胞从原发部位（原发性肿瘤）脱离，侵入淋巴系统或血液。

  • 淋巴系统。癌组织侵入淋巴系统后，通过淋巴管在身体另一部位形成肿瘤（转移性肿瘤）。
  • 血液。癌组织侵入血液后，通过血液循环在身体另一部位形成肿瘤（转移性肿瘤）。

    • 转移性肿瘤与原发性肿瘤类型相同。例如，如果非小细胞肺癌扩散至大脑，则脑中的癌细胞实际上仍为肺癌细胞。该病应称为转移性肺癌，而非脑癌。

    许多癌症死亡是由于癌细胞从原发肿瘤扩散到其他组织和器官。这被称为转移癌。这个动画展示了癌细胞是如何从体内最初形成的位置转移到身体的其他部位的。

    非小细胞肺癌的分期如下：

    隐匿（隐蔽）期

    在隐匿期，癌症不能被影像学或支气管镜检查发现。癌细胞可在痰液或支气管冲洗液中被发现（从通向肺部的气道内采集的细胞样本）。癌细胞可能已经扩散到身体的其他部位。

    0期

    在0期，在气道内壁发现异常细胞。这些异常细胞可能会变成癌细胞并扩散到附近的正常组织。0期可能是原位腺癌（AIS）或原位鳞状细胞癌（SCIS）。

    I期

    I期时，癌症已经形成。I期又被分为IA期和IB期。

  • IA期
    • IA期肺癌。肿瘤仅在肺部，直径小于或等于3厘米。癌细胞没有扩散到淋巴结。

    肿瘤仅在肺部，直径小于或等于3厘米。癌细胞没有扩散到淋巴结。

  • IB期
    • IB期肺癌。肿瘤大于3厘米但不大于4厘米。癌细胞没有扩散到淋巴结；或者肿瘤是4厘米或更小。癌细胞没有扩散到淋巴结，并且发现以下一种或多种情况：（a）癌细胞已经扩散到主支气管，但还没有扩散到隆突；和/或（b）癌症已经扩散到肺的脏层胸膜；和/或（c）部分肺或全肺已经出现肺不张或肺炎（肺部炎症）

    肿瘤大于3厘米但不大于4厘米。癌细胞没有扩散到淋巴结。

    或

    肿瘤小于或等于4厘米，且发现以下一种或多种情况：

  • 癌症已经扩散到主支气管，但还没有扩散到隆突。
  • 癌症已经扩散到肺表脏层胸膜的最内层。
  • 部分肺或全肺已经膨胀不全或发展成肺炎。

    • 癌症没有扩散到淋巴结。

    II期

    II期分为IIA期和IIB期

  • IIA期
    • ⅡA期肺癌。肿瘤大于4厘米但不大于5厘米。癌细胞没有扩散到淋巴结，可能会发现以下一种或多种情况：（a）癌细胞已经扩散到主支气管，但没有扩散到隆突；和/或（b）癌细胞已经扩散到肺的脏层胸膜；和/或（c）部分肺或全肺已经出现肺不张或有肺炎（肺部炎症）。

    肿瘤大于4厘米但不大于5厘米。癌细胞没有扩散到淋巴结，可能会发现以下一种或多种情况：

  • 癌症已经扩散到主支气管，但还没有扩散到隆突。
  • 癌症已经扩散到肺表面脏层胸膜的最内层。
  • 部分肺或全肺已经膨胀不全或发展成肺炎。
  • IIB期：
    • IIB期肺癌（1）。原发肿瘤小于或等于5厘米，癌细胞已经扩散到与原发肿瘤位于同侧胸部的淋巴结。癌细胞累及的淋巴结位于肺内或支气管旁。

    肿瘤小于或等于5厘米，癌细胞已经扩散到与原发肿瘤位于同侧的淋巴结。癌细胞累及的淋巴结在肺内或支气管旁。此外，还可能发现以下一种或多种情况:

  • 癌症已经扩散到主支气管，但还没有扩散到隆突。
  • 癌症已经扩散到肺表面脏层胸膜的最内层。
  • 部分肺或全肺已经膨胀不全或发展成肺炎。

    • 或

    IIB期肺癌（2）。癌细胞未扩散至淋巴结，有下列一种或多种情况：(a)原发肿瘤大于5厘米但不大于7厘米;和/或(b)在与原发肿瘤同一肺叶上存在一个或多个单独的肿瘤;癌症已经扩散到下列任何一处:(c)胸壁和/或壁层胸膜，(d)膈神经，和/或(e)心包的壁层。

    癌细胞尚未扩散至淋巴结，并发现以下一项或多项:

  • 肿瘤大于5厘米，但不大于7厘米。
  • 在与原发肿瘤同一肺叶上有一个或多个单独的肿瘤。
  • 癌症已扩散至以下任何部位：
  • 壁层胸膜
  • 胸壁
  • 膈神经
  • 心包外层组织

    • III期

    III期分为IIIA期，IIIB期和IIIC期

  • IIIA期
    • IIIA期肺癌(1)。肿瘤5厘米或更小，癌细胞已扩散到与原发肿瘤位于同侧胸部的淋巴结。癌细胞累及的淋巴结位于气管或主动脉周围(未显示)，或者气管与支气管的分界处。此外，还可能发现以下一种或多种情况:(a)癌细胞已扩散到主支气管，但未扩散到隆突;及/或(b)癌细胞已扩散至壁层胸膜;和/或(c)部分肺或全肺已出现肺不张或有肺炎(肺的炎症)。

    肿瘤小于或等于5厘米，癌细胞已经扩散到与原发肿瘤位于同侧的淋巴结。癌细胞累及的淋巴结位于气管或主动脉周围，或者气管与支气管的分界处。此外，还可能发现以下一种或多种情况:

  • 癌症已经扩散到主支气管，但还没有扩散到隆突。
  • 癌症已经扩散到肺表面脏层胸膜的最内层。
  • 部分肺或全肺膨胀不全或发展成肺炎。

    • 或

    IIIA期肺癌(2)。癌细胞已扩散到与原发肿瘤位于同侧胸部的淋巴结。癌细胞累及的淋巴结在肺部或支气管附近。此外，还可能发现以下一种或多种情况:(a)肿瘤大于5厘米但不大于7厘米;和/或(b)在与原发肿瘤相同的肺叶内存在一个或多个单独的肿瘤;癌症已经扩散到下列任何一部位:(c)胸壁和/或壁层胸膜，(d)膈神经，和/或(e)心包的壁层。

    癌细胞已扩散到与原发肿瘤位于同侧胸部的淋巴结。癌细胞累及的淋巴结在肺部或支气管附近。还发现以下一种或多种情况:

  • 肿瘤大于5厘米，但不大于7厘米。
  • 在与原发肿瘤同一肺叶上有一个或多个单独的肿瘤。
  • 癌症已扩散至以下任何部位：
  • 壁层胸膜
  • 胸壁
  • 膈神经
  • 心包外层组织

    • 或

    IIIA期肺癌(3)。癌症可能已经扩散到与原发肿瘤位于胸部同侧的淋巴结。癌细胞累及的淋巴结在肺部或支气管附近。同时发现以下一种或多种情况：(a)原发肿瘤大于7厘米;和/或(b)在与原发肿瘤不同的肺叶上有一个或多个的单独肿瘤;和/或肿瘤不论大小，癌细胞已经扩散到以下部位:(c)气管，(d)隆突， (e)食管，(f)胸骨或脊椎，(g)横膈，(h)心脏，(i)通往或来自心脏的大血管(主动脉或腔静脉)，或喉返神经(未显示)。

    癌症可能已经扩散到与原发肿瘤位于胸部同侧的淋巴结。癌细胞累及的淋巴结在肺部或支气管附近。还发现以下一种或多种情况:

  • 肿瘤大于7厘米。
  • 与原发肿瘤不同的肺叶上有一个或多个的单独肿瘤。
  • 肿瘤不论大小，癌细胞已经扩散到以下部位：
  • 气管：
  • 气管隆突
  • 食管
  • 胸骨或脊椎
  • 膈肌
  • 心脏
  • 通向或来自心脏的主要血管（主动脉或腔静脉）。
  • 喉神经（喉头）；
  • IIIB期
    • IIIB期肺癌(1)。原发肿瘤直径小于或等于5厘米，癌细胞已扩散至与原发肿瘤位于同侧胸部锁骨以上淋巴结或位于原发肿瘤对侧胸部的任何淋巴结。此外，还可能发现以下一种或多种情况：(a)癌细胞已扩散到主支气管，但未扩散到隆突;及/或(b)癌细胞已扩散至脏层胸膜;和/或(c)部分肺或全肺已出现肺不张或有肺炎(肺的炎症)。

    肿瘤直径小于或等于5厘米，癌细胞已扩散至与原发肿瘤位于同侧胸部锁骨以上淋巴结或位于原发肿瘤对侧胸部的任何淋巴结。此外，还可能发现以下一项或多项:

  • 癌症已经扩散到主支气管，但还没有扩散到隆突。
  • 癌症已经扩散到肺表面脏层胸膜的最内层。
  • 部分肺或全肺已经膨胀不全或发展成肺炎。

    • 或

    IIIB期肺癌(2)。肿瘤可以是任何大小，癌细胞已扩散到与原发肿瘤位于同侧胸部的淋巴结。累及的淋巴结位于气管或主动脉周围(未显示)，或者气管与支气管的分界处。此外，还发现以下一种或多种情况:(a)在与原发肿瘤相同或不同的肺叶上有一个或多个的单独肿瘤;和/或(b)癌症已经扩散到下列部位:胸壁或壁层胸膜、喉返神经、气管、隆突、食管、胸骨或脊椎（没有显示）、横隔、膈神经、心脏、出入心脏的大血管（主动脉或腔静脉）、或者心包。

    肿瘤可以是任何大小，癌细胞已扩散到与原发肿瘤位于同侧胸部的淋巴结。累及的淋巴结位于气管或主动脉周围(未显示)，或者气管与支气管的分界处。此外，还发现以下一种或多种情况:

  • 在与原发肿瘤相同或不同的肺叶上有一个或多个的单独肿瘤
  • 癌症已扩散至以下任何部位：
  • 壁层胸膜
  • 胸壁
  • 膈神经
  • 心包外层组织
  • 气管：
  • 气管隆突
  • 食管
  • 胸骨或脊椎
  • 膈肌
  • 心脏
  • 通向或来自心脏的主要血管（主动脉或腔静脉）。
  • 喉神经（喉头）；
  • IIIC期
    • IIIC期肺癌。肿瘤可以是任何大小，癌细胞已经扩散到与原发肿瘤同侧胸部锁骨以上的淋巴结，或者扩散到位于原发肿瘤对侧胸部的任何淋巴结。此外，还发现以下一种或多种情况：(a)在与原发肿瘤同肺叶或不同肺叶中有一个或多个单独的肿瘤;和/或(b)癌症已经扩散到下列部位：胸壁或壁层胸膜、喉返神经、气管、隆突、食管、胸骨或脊椎（没有显示）、横隔、膈神经、心脏、出入心脏的大血管（主动脉或腔静脉）、或者心包壁层。

    肿瘤可以是任何大小，癌细胞已经扩散到与原发肿瘤同侧胸部锁骨以上的淋巴结，或者扩散到位于原发肿瘤对侧胸部的任何淋巴结。此外，还发现以下一种或多种情况：

  • 在与原发肿瘤相同或不同的肺叶上有一个或多个的单独肿瘤
  • 癌症已扩散至以下任何部位：
  • 壁层胸膜
  • 胸壁
  • 膈神经
  • 心包外层组织
  • 气管：
  • 气管隆突
  • 食管
  • 胸骨或脊椎
  • 膈肌
  • 心脏
  • 通向或来自心脏的主要血管（主动脉或腔静脉）。
  • 喉神经（喉头）；

    • IV期

    IVA期分为IVA期和IVB期

  • IVA期
    • IVA期肺癌。肿瘤可以是任何大小，癌细胞可能已经扩散到淋巴结。发现以下一种或多种情况：(a)肺内有一个或多个肿瘤，但没有原发肿瘤;和/或(b)在胸腔积液或心包积液中发现癌细胞，或在胸膜或心包中发现癌症病灶;和/或(c)癌细胞已扩散到单个不邻近肺的器官或组织，如大脑、肾上腺、肾脏、肝脏或骨骼，或扩散到不邻近肺的淋巴结。

    肿瘤可以是任何大小，癌细胞可能已经扩散到淋巴结。发现以下一种或多种情况：

  • 肺内有一个或多个肿瘤，但没有原发肿瘤。
  • 在胸膜或心包中发现癌症细胞
  • 在肺或心脏周围的体液中可找到癌细胞。
  • 癌细胞已扩散到不邻近肺的器官或组织，如大脑、肝脏、肾上腺、肾脏、骨骼、或不邻近肺的淋巴结。
  • IVB期
    • 癌细胞已经扩散到一个或多个不邻近肺的器官的多个部位，如大脑、肾上腺、肾脏、肝脏、远段的淋巴结或骨骼。

    癌细胞已经扩散到一个或多个不邻近肺的器官的多个部位

    Non-Small Cell Lung Cancer Treatment (PDQ®)

    Stages of Non-Small Cell Lung Cancer

    After lung cancer has been diagnosed, tests are done to find out if cancer cells have spread within the lungs or to other parts of the body.

    The process used to find out if cancer has spread within the lungs or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. Some of the tests used to diagnose non-small cell lung cancer are also used to stage the disease. (See the General Information section.)

    Other tests and procedures that may be used in the staging process include the following:

  • MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the brain. This procedure is also called nuclear magnetic resonance imaging (NMRI).
  • CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the brain, abdomen, and lymph nodes, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
  • PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do.
    • PET (positron emission tomography) scan. The patient lies on a table that slides through the PET machine. The head rest and white strap help the patient lie still. A small amount of radioactive glucose (sugar) is injected into the patient's vein, and a scanner makes a picture of where the glucose is being used in the body. Cancer cells show up brighter in the picture because they take up more glucose than normal cells do.
  • Bone scan: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of radioactive material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner.
  • Pulmonary function test (PFT): A test to see how well the lungs are working. It measures how much air the lungs can hold and how quickly air moves into and out of the lungs. It also measures how much oxygen is used and how much carbon dioxide is given off during breathing. This is also called lung function test.
  • Bone marrow aspiration and biopsy: The removal of bone marrow, blood, and a small piece of bone by inserting a hollow needle into the hipbone or breastbone. A pathologist views the bone marrow, blood, and bone under a microscope to look for signs of cancer.

    • There are three ways that cancer spreads in the body.

    Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

    • Cancer may spread from where it began to other parts of the body.

    When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.

  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.

    • The metastatic tumor is the same type of cancer as the primary tumor. For example, if non-small cell lung cancer spreads to the brain, the cancer cells in the brain are actually lung cancer cells. The disease is metastatic lung cancer, not brain cancer.

    Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.

    The following stages are used for non-small cell lung cancer:

    Occult (hidden) stage

    In the occult (hidden) stage, cancer cannot be seen by imaging or bronchoscopy. Cancer cells are found in sputum or bronchial washings (a sample of cells taken from inside the airways that lead to the lungs). Cancer may have spread to other parts of the body.

    Stage 0

    In stage 0, abnormal cells are found in the lining of the airways. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 may be adenocarcinoma in situ (AIS) or squamous cell carcinoma in situ (SCIS).

    Stage I

    In stage I, cancer has formed. Stage I is divided into stages IA and IB.

  • Stage IA:
    • Stage IA lung cancer. The tumor is in the lung only and is 3 centimeters or smaller. Cancer has not spread to the lymph nodes.

    The tumor is in the lung only and is 3 centimeters or smaller. Cancer has not spread to the lymph nodes.

  • Stage IB:
    • Stage IB lung cancer. The tumor is larger than 3 centimeters but not larger than 4 centimeters. Cancer has not spread to the lymph nodes; OR the tumor is 4 centimeters or smaller. Cancer has not spread to the lymph nodes and one or more of the following is found: (a) cancer has spread to the main bronchus, but has not spread to the carina; and/or (b) cancer has spread to the inner membrane that covers the lung; and/or (c) part of the lung or the whole lung has collapsed or has pneumonitis (inflammation of the lung).

    The tumor is larger than 3 centimeters but not larger than 4 centimeters. Cancer has not spread to the lymph nodes.

    or

    The tumor is 4 centimeters or smaller and one or more of the following is found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

    • Cancer has not spread to the lymph nodes.

    Stage II

    Stage II is divided into stages IIA and IIB.

  • Stage IIA:
    • Stage IIA lung cancer. The tumor is larger than 4 centimeters but not larger than 5 centimeters. Cancer has not spread to the lymph nodes and one or more of the following may be found: (a) cancer has spread to the main bronchus, but has not spread to the carina; and/or (b) cancer has spread to the inner membrane that covers the lung; and/or (c) part of the lung or the whole lung has collapsed or has pneumonitis (inflammation of the lung).

    The tumor is larger than 4 centimeters but not larger than 5 centimeters. Cancer has not spread to the lymph nodes and one or more of the following may be found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.
  • Stage IIB:
    • Stage IIB lung cancer (1). The primary tumor is 5 centimeters or smaller and cancer has spread to the lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus.

    The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following may be found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

    • or

    Stage IIB lung cancer (2). Cancer has not spread to lymph nodes and one or more of the following is found: (a) the primary tumor is larger than 5 centimeters but not larger than 7 centimeters; and/or (b) there are one or more separate tumors in the same lobe of the lung as the primary tumor; and/or cancer has spread to any of the following: (c) the chest wall and/or the membrane that lines the inside of the chest wall, (d) the nerve that controls the diaphragm, and/or (e) the outer layer of tissue of the sac around the heart.

    Cancer has not spread to the lymph nodes and one or more of the following is found:

  • The tumor is larger than 5 centimeters but not larger than 7 centimeters.
  • There are one or more separate tumors in the same lobe of the lung as the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.

    • Stage III

    Stage III is divided into stages IIIA, IIIB, and IIIC.

  • Stage IIIA:
    • Stage IIIA lung cancer (1). The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta (not shown), or where the trachea divides into the bronchi. Also, one or more of the following may be found: (a) cancer has spread to the main bronchus, but has not spread to the carina; and/or (b) cancer has spread to the inner membrane that covers the lung; and/or (c) part of the lung or the whole lung has collapsed or has pneumonitis (inflammation of the lung).

    The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta, or where the trachea divides into the bronchi. Also, one or more of the following may be found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

    • or

    Stage IIIA lung cancer (2). Cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found: (a) the tumor is larger than 5 centimeters but not larger than 7 centimeters; and/or (b) there are one or more separate tumors in the same lobe of the lung as the primary tumor; and/or cancer has spread to any of the following: (c) the chest wall and/or the membrane that lines the inside of the chest wall, (d) the nerve that controls the diaphragm, and/or (e) the outer layer of tissue of the sac around the heart.

    Cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found:

  • The tumor is larger than 5 centimeters but not larger than 7 centimeters.
  • There are one or more separate tumors in the same lobe of the lung as the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.

    • or

    Stage IIIA lung cancer (3). Cancer may have spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found: (a) the primary tumor is larger than 7 centimeters; and/or (b) there are one or more separate tumors in a different lobe of the lung with the primary tumor; and/or the tumor is any size and cancer has spread to any of the following: (c) trachea, (d) carina, (e) esophagus, (f) breastbone or backbone, (g) diaphragm, (h) heart, (i) major blood vessels that lead to or from the heart (aorta or vena cava), or the nerve that controls the larynx (not shown).

    Cancer may have spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are in the lung or near the bronchus. Also, one or more of the following is found:

  • The tumor is larger than 7 centimeters.
  • There are one or more separate tumors in a different lobe of the lung with the primary tumor.
  • The tumor is any size and cancer has spread to any of the following:
  • Trachea.
  • Carina.
  • Esophagus.
  • Breastbone or backbone.
  • Diaphragm.
  • Heart.
  • Major blood vessels that lead to or from the heart (aorta or vena cava).
  • Nerve that controls the larynx (voice box).
  • Stage IIIB:
    • Stage IIIB lung cancer (1). The primary tumor is 5 centimeters or smaller and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following may be found: (a) cancer has spread to the main bronchus, but has not spread to the carina; and/or (b) cancer has spread to the inner membrane that covers the lung; and/or (c) part of the lung or the whole lung has collapsed or has pneumonitis (inflammation of the lung).

    The tumor is 5 centimeters or smaller and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following may be found:

  • Cancer has spread to the main bronchus, but has not spread to the carina.
  • Cancer has spread to the innermost layer of the membrane that covers the lung.
  • Part of the lung or the whole lung has collapsed or has developed pneumonitis.

    • or

    Stage IIIB lung cancer (2). The tumor may be any size and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta (not shown), or where the trachea divides into the bronchi. Also, one or more of the following is found: (a) there are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor; and/or (b) cancer has spread to any of the following: the chest wall or the membrane that lines the inside of the chest wall, the nerve that controls the voice box, the trachea, the carina, the esophagus, the breastbone or backbone (not shown), the diaphragm, the nerve that controls the diaphragm, the heart, the major blood vessels that lead to or from the heart (aorta or vena cava), or the outer layer of tissue of the sac around the heart.

    The tumor may be any size and cancer has spread to lymph nodes on the same side of the chest as the primary tumor. The lymph nodes with cancer are around the trachea or aorta, or where the trachea divides into the bronchi. Also, one or more of the following is found:

  • There are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.
  • Trachea.
  • Carina.
  • Esophagus.
  • Breastbone or backbone.
  • Diaphragm.
  • Heart.
  • Major blood vessels that lead to or from the heart (aorta or vena cava).
  • Nerve that controls the larynx (voice box).
  • Stage IIIC:
    • Stage IIIC lung cancer. The tumor may be any size and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following is found: (a) there are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor; and/or (b) cancer has spread to any of the following: the chest wall or the membrane that lines the inside of the chest wall, the nerve that controls the voice box, the trachea, the carina, the esophagus, the breastbone or backbone (not shown), the diaphragm, the nerve that controls the diaphragm, the heart, the major blood vessels that lead to or from the heart (aorta or vena cava), or the outer layer of tissue of the sac around the heart.

    The tumor may be any size and cancer has spread to lymph nodes above the collarbone on the same side of the chest as the primary tumor or to any lymph nodes on the opposite side of the chest as the primary tumor. Also, one or more of the following is found:

  • There are one or more separate tumors in the same lobe or a different lobe of the lung with the primary tumor.
  • Cancer has spread to any of the following:
  • The membrane that lines the inside of the chest wall.
  • Chest wall.
  • The nerve that controls the diaphragm.
  • Outer layer of tissue of the sac around the heart.
  • Trachea.
  • Carina.
  • Esophagus.
  • Breastbone or backbone.
  • Diaphragm.
  • Heart.
  • Major blood vessels that lead to or from the heart (aorta or vena cava).
  • Nerve that controls the larynx (voice box).

    • Stage IV

    Stage IV is divided into stages IVA and IVB.

  • Stage IVA:
    • Stage IVA lung cancer. The tumor may be any size and cancer may have spread to the lymph nodes. One or more of the following is found: (a) there are one or more tumors in the lung that does not have the primary tumor; and/or (b) cancer is found in fluid around the lungs or heart or there are cancer nodules in the lining around the lungs or the sac around the heart; and/or (c) cancer has spread to one place in an organ or tissue not near the lung, such as the brain, adrenal gland, kidney, liver, or bone, or to a lymph node that is not near the lung.

    The tumor may be any size and cancer may have spread to the lymph nodes. One or more of the following is found:

  • There are one or more tumors in the lung that does not have the primary tumor.
  • Cancer is found in the lining around the lungs or the sac around the heart.
  • Cancer is found in fluid around the lungs or the heart.
  • Cancer has spread to one place in an organ not near the lung, such as the brain, liver, adrenal gland, kidney, bone, or to a lymph node that is not near the lung.
  • Stage IVB:
    • Stage IVB lung cancer. The cancer has spread to multiple places in one or more organs that are not near the lung, such as the brain, adrenal gland, kidney, liver, distant lymph nodes, or bone.

    Cancer has spread to multiple places in one or more organs that are not near the lung.

    非小细胞肺癌的治疗(PDQ®)

    复发性非小细胞肺癌

    复发性非小细胞肺癌是指癌症治疗后再次复发（再次发病）。癌症可在大脑、肺部或身体其他部位再发。

    Non-Small Cell Lung Cancer Treatment (PDQ®)

    Recurrent Non-Small Cell Lung Cancer

    Recurrent non-small cell lung cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the brain, lung, or other parts of the body.

    非小细胞肺癌的治疗(PDQ®)

    治疗方案概述

    对非小细胞肺癌患者有不同类型的治疗手段。

    非小细胞癌有多种治疗方法。有些为标准疗法（当前使用的治疗），有些仍处在临床试验测试阶段。临床治疗试验是一种调查研究，目的是提高当前治疗手段，或获取关于癌症患者的新型治疗信息。如果临床试验表明了新的治疗手段优于当前标准疗法，那么新疗法即可作为标准疗法。患者可能也想加入到临床试验中。而有些临床试验只针对尚未进行治疗的患者。

    十种标准治疗

    手术

    四类治疗肺癌的手术：

  • 肺楔形切除术：切除肿瘤及周围部分正常组织的手术。肺段切除则需要切除更多的正常组织。
    • 肺楔形切除术。切除部分含有癌细胞的肺叶和周围少量健康组织。
  • 肺叶切除术：切除一整个肺叶的手术 。
    • 肺叶切除术。切除一个肺叶
  • 全肺切除术：切除整个一侧肺的手术。
    • 全肺切除术。切除整个一侧肺
  • 袖式切除术：切除部分支气管的手术。

    • 即使医生在术中切除了所有能看到的癌组织，有些患者术后仍需化疗或放疗来杀死残留的癌细胞。辅助疗法就是降低术后癌症复发风险的治疗。

    放射治疗

    放射治疗是一种癌症治疗方法，使用高能x射线或其他类型的辐射杀死癌细胞或阻止癌细胞生长。放射治疗有两种类型:

  • 体外放射治疗是利用体外的机器将辐射发送到癌症部位。
  • 体内放射治疗把一种放射性物质密封在针、种子、金属丝、或导管中，直接放置在癌症病灶中或病灶附近。

    • 立体定向体部放射治疗是一种体外放射治疗。每次放射治疗都使用特殊的设备将病人置于相同的位置。放射机以较比平常更大的辐射剂量直接对准肿瘤部位辐射，每天一次，连续几天。在每次治疗中都让病人处于相同的位置，可以减少对附近健康组织的损害。这一过程也被称为立体定向外照射放射治疗和立体定向放射治疗。

    立体定向放射外科是一种体外放射治疗，用于治疗已经扩散到脑部的肺癌。在放射治疗过程中，在头骨上固定一个坚硬的头部框架，以保持头部不动。机器将单次大剂量的辐射直接对准脑中的肿瘤。这个过程不需要外科手术。它也被称为放射外科。

    对于气道内的肿瘤，可通过内窥镜直接对肿瘤进行放射治疗。

    放射治疗的方式取决于癌症的分型和分期。也取决于癌症的位置。非小细胞肺癌的治疗采用外放射和内放射治疗。

    化疗

    化疗是一种癌症治疗方法，使用药物来阻止癌细胞的生长，或者杀死癌细胞，或者阻止癌细胞分裂。通过口服或静脉注射或肌肉注射的方式，药物可进入血液并能到达全身的癌细胞(全身化疗)。当化疗药直接进入脑脊液、器官或腹腔等体腔时，药物主要作用于这些部位的癌细胞(局部化疗)。

    化疗的方式取决于待治疗癌症的分型和分期。

    关于更多信息，请参阅非小细胞肺癌的药物批准。

    靶向治疗

    靶向治疗是一种使用药物或其他物质攻击特定癌细胞的治疗方法。靶向治疗对正常细胞的伤害通常比化疗或放疗小。单克隆抗体和酪氨酸激酶抑制剂是用于治疗晚期、转移性或复发性非小细胞肺癌的两种主要靶向治疗类型。

    单克隆抗体治疗是利用在体外由单一类型的免疫细胞培养出的抗体来治疗癌症的方法。这些抗体可以识别癌细胞上的特异位点，或可促进癌细胞生长的来自血液或组织中的正常因子。抗体与这些物质结合后，可以使癌细胞死亡、或抑制其生长，或阻止其扩散。单克隆抗体需注射入体内来发挥作用。它可单独使用，也可直接将药物、毒素、或放射性材料运输到癌细胞。

    有几种不同的单克隆抗体

  • 血管内皮生长因子(VEGF)抑制剂治疗:癌细胞产生一种叫做VEGF的物质，它促进形成新的血管(血管生成)并帮助癌细胞生长。VEGF抑制剂阻断VEGF并阻止新血管的形成。这可能会杀死癌细胞，因为它们需要新的血管才能生长。贝伐单抗和雷莫芦单抗是VEGF抑制剂和血管生成抑制剂。
  • 表皮生长因子受体(EGFR)抑制剂治疗:EGFR是在某些细胞表面发现的蛋白质，包括癌细胞。表皮生长因子附着在细胞表面的表皮生长因子受体上，使细胞生长和分裂。EGFR抑制剂阻断受体，阻止表皮生长因子附着在癌细胞上。这阻止了癌细胞的生长和分裂。西妥昔单抗和耐昔妥珠单抗是EGFR抑制剂。

    • 酪氨酸激酶抑制剂是一种小分子药物，它能穿过细胞膜，在癌细胞内起作用，阻断癌细胞生长和分裂所需的信号。一些酪氨酸激酶抑制剂也有血管生成抑制作用。

    有不同类型的酪氨酸激酶抑制剂:

  • 表皮生长因子受体(EGFR)酪氨酸激酶抑制剂:EGFR是在某些细胞表面和内部发现的蛋白质，包括癌细胞。表皮生长因子附着在细胞内的EGFR上，向细胞的酪氨酸激酶区域发送信号，促使细胞生长和分裂。EGFR酪氨酸激酶抑制剂阻断这些信号，进而阻止癌细胞生长和分裂。厄洛替尼、吉非替尼、阿法替尼和奥西替尼是不同的EGFR酪氨酸激酶抑制剂。当EGFR基因发生突变（改变）时，其中一些药物的效果更好。
  • 激酶抑制剂可影响有特定基因改变的细胞:ALK、ROS1、BRAF和MEK基因的某些变化，以及NTRK融合基因，会导致产生过多的蛋白质。阻断这些蛋白质可以阻止癌症的生长和扩散。克唑替尼用于阻止ALK和ROS1基因合成蛋白质。色瑞替尼、艾乐替尼、布加替尼和劳拉替尼被用来阻止ALK基因产生蛋白质。达拉菲尼用于阻止BRAF基因产生的蛋白质。曲米替尼用于阻止MEK基因产生的蛋白质。拉罗替尼用于阻止NTRK融合基因产生的蛋白质。

    • 关于更多信息，请参阅非小细胞肺癌的药物批准。

    免疫治疗

    免疫治疗是一种利用病人的免疫系统对抗癌症的疗法。人体产生或实验室制备的物质用于增强、引导或恢复人体对癌症的天然防御。这种癌症治疗也被称为生物治疗。

    免疫检查点抑制剂治疗是一种免疫治疗:

  • 免疫检查点抑制剂:PD-1是一种位于T细胞表面的蛋白质，有助于控制人体的免疫反应。当PD-1结合到癌细胞上的另一种叫做PDL-1的蛋白质上时，它会阻止T细胞杀死癌细胞。PD-1抑制剂与PDL-1相结合，允许T细胞杀死癌细胞。帕博利珠单抗、阿特珠单抗和德瓦鲁单抗是几种免疫检查点抑制剂。
    • 免疫检查点抑制剂。检查点蛋白，如肿瘤细胞上的PD-L1和T细胞上的PD-1，有助于抑制免疫反应。PD-L1与PD-1的结合阻止了T细胞杀死体内的肿瘤细胞(左图)。用免疫检查点抑制剂(抗PD-L1或抗PD-1)阻断PD-L1与PD-1的结合，使T细胞能够杀伤肿瘤细胞(右图)。
    免疫治疗利用人体的免疫系统来对抗癌症。这个动画解释了一种使用免疫检查点抑制剂来治疗癌症的免疫治疗。

    关于更多信息，请参阅非小细胞肺癌的药物批准。

    激光治疗

    激光治疗是利用激光束（一种窄束强光）来杀死癌细胞。

    光动力疗法（PDT）

    光动力疗法是利用药物与某类型激光的共同作用杀死癌细胞。注射入血管的药物经照射后会被激活。药物在癌细胞处聚集得较多，在正常组织处聚集较少。激光束通过光导纤维管被传送至癌细胞，使得药物被激活并杀死癌细胞。光动力疗法对健康组织伤害较小。它主要用于治疗位于皮肤或仅在皮下或内脏脏层的肿瘤。若肿瘤位于气道处，PDT将通过内镜被直接导至肿瘤处。

    冷冻外科手术

    冷冻治疗是利用仪器冷冻异常组织，例如原位癌，并使其坏死。这种治疗也称为冷冻疗法。若肿瘤位于气道，冷冻手术可通过内镜完成。

    电烙术

    电烙术是利用电流加热过的探针或穿刺针来破坏异常组织。若肿瘤位于气道，电烙术可通过内镜完成。

    等待观察

    等待观察是指当症状和体征未出现或改变时，仅监测患者病情，而不给予其任何治疗措施。这仅针对某些罕见的非小细胞肺癌病例。

    新型疗法正处于临床试验的测试阶段。

    此部分概述是介绍临床试验正在研究的治疗方法。本文可能未涵盖所有正在研究中的新型治疗。有关临床试验的信息可在NCI网址中找到。

    化学预防

    化学预防是指使用药物、维生素或其他物质来降低患癌症的风险或降低癌症复发的风险。对于肺癌，使用化学预防来减少肺部形成新肿瘤的机率。

    放射增敏剂

    放射增敏剂是一种能使肿瘤细胞更容易被放射治疗杀死的物质。在非小细胞肺癌的治疗中，正在对化疗与放射疗法联合下给予放射增敏剂的效果进行研究。

    新组合

    新型联合治疗正处于临床试验的研究阶段。

    非小细胞肺癌的治疗可能会引起副作用。

    有关癌症治疗的副作用的信息，请参阅我们的副作用页面。

    患者可能会考虑加入到临床试验中。

    对一些患者来说，参加临床试验或许是最佳的治疗选择。临床试验是癌症研究过程的一部分。临床试验的目的是为了确定新疗法是否安全有效或优于标准疗法。

    很多现在的标准疗法都是基于以前的临床试验结果。参与临床试验的患者可能接受标准治疗，也可能最先接受新疗法。

    参加临床试验的患者还能帮助改善癌症未来的治疗方式。即使未能研究出有效的新疗法，临床试验也常常能解决一些重要的问题，推进研究。

    患者可以在开始癌症治疗之前、期间或之后进入临床试验。

    有些临床试验只允许未经治疗的患者参加。有些试验针对病情未好转的癌症患者。还有一些临床试验旨在研究新的措施来防止癌症复发（再次发作）或减少癌症治疗副作用。

    临床试验正在全国许多地方进行。有关NCI支持的临床试验的信息可在NCI的临床试验搜索网站上找到。其他组织支持的临床试验可以在ClinicalTrials.gov网站上找到。

    可能需要后续检查

    确诊癌症或确定其分期可能需要重复检查。为判断治疗效果也应多次检查。这些检查结果会决定是否需要继续治疗、或改变治疗方案。

    在治疗结束后，还会持续的做一些检查。这些检查的结果可以表明你的健康状况是否发生改变，或者癌症是否复发（再发）。这些检查被叫做随访检查或者复查。

    Non-Small Cell Lung Cancer Treatment (PDQ®)

    Treatment Option Overview

    There are different types of treatment for patients with non-small cell lung cancer.

    Different types of treatments are available for patients with non-small cell lung cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Ten types of standard treatment are used:

    Surgery

    Four types of surgery are used to treat lung cancer:

  • Wedge resection: Surgery to remove a tumor and some of the normal tissue around it. When a slightly larger amount of tissue is taken, it is called a segmental resection.
    • Wedge resection of the lung. Part of the lung lobe containing the cancer and a small amount of healthy tissue around it is removed.
  • Lobectomy: Surgery to remove a whole lobe (section) of the lung.
    • Lobectomy. A lobe of the lung is removed.
  • Pneumonectomy: Surgery to remove one whole lung.
    • Pneumonectomy. The whole lung is removed.
  • Sleeve resection: Surgery to remove part of the bronchus.

    • After the doctor removes all the cancer that can be seen at the time of the surgery, some patients may be given chemotherapy or radiation therapy after surgery to kill any cancer cells that are left. Treatment given after the surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.

    Radiation therapy

    Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:

  • External radiation therapy uses a machine outside the body to send radiation toward the cancer.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.

    • Stereotactic body radiation therapy is a type of external radiation therapy. Special equipment is used to place the patient in the same position for each radiation treatment. Once a day for several days, a radiation machine aims a larger than usual dose of radiation directly at the tumor. By having the patient in the same position for each treatment, there is less damage to nearby healthy tissue. This procedure is also called stereotactic external-beam radiation therapy and stereotaxic radiation therapy.

    Stereotactic radiosurgery is a type of external radiation therapy used to treat lung cancer that has spread to the brain. A rigid head frame is attached to the skull to keep the head still during the radiation treatment. A machine aims a single large dose of radiation directly at the tumor in the brain. This procedure does not involve surgery. It is also called stereotaxic radiosurgery, radiosurgery, and radiation surgery.

    For tumors in the airways, radiation is given directly to the tumor through an endoscope.

    The way the radiation therapy is given depends on the type and stage of the cancer being treated. It also depends on where the cancer is found. External and internal radiation therapy are used to treat non-small cell lung cancer.

    Chemotherapy

    Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the cerebrospinal fluid, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy).

    The way the chemotherapy is given depends on the type and stage of the cancer being treated.

    See Drugs Approved for Non-Small Cell Lung Cancer for more information.

    Targeted therapy

    Targeted therapy is a type of treatment that uses drugs or other substances to attack specific cancer cells. Targeted therapies usually cause less harm to normal cells than chemotherapy or radiation therapy do. Monoclonal antibodies and tyrosine kinase inhibitors are the two main types of targeted therapy being used to treat advanced, metastatic, or recurrent non-small cell lung cancer.

    Monoclonal antibody therapy is a cancer treatment that uses antibodies made in the laboratory from a single type of immune system cell. These antibodies can identify substances on cancer cells or normal substances in the blood or tissues that may help cancer cells grow. The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. Monoclonal antibodies are given by infusion. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.

    There are different types of monoclonal antibody therapy:

  • Vascular endothelial growth factor (VEGF) inhibitor therapy: Cancer cells make a substance called VEGF, which causes new blood vessels to form (angiogenesis) and helps the cancer grow. VEGF inhibitors block VEGF and stop new blood vessels from forming. This may kill cancer cells because they need new blood vessels to grow. Bevacizumab and ramucirumab are VEGF inhibitors and angiogenesis inhibitors.
  • Epidermal growth factor receptor (EGFR) inhibitor therapy: EGFRs are proteins found on the surface of certain cells, including cancer cells. Epidermal growth factor attaches to the EGFR on the surface of the cell and causes the cells to grow and divide. EGFR inhibitors block the receptor and stop the epidermal growth factor from attaching to the cancer cell. This stops the cancer cell from growing and dividing. Cetuximab and necitumumab are EGFR inhibitors.

    • Tyrosine kinase inhibitors are small-molecule drugs that go through the cell membrane and work inside cancer cells to block signals that cancer cells need to grow and divide. Some tyrosine kinase inhibitors also have angiogenesis inhibitor effects.

    There are different types of tyrosine kinase inhibitors:

  • Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors: EGFRs are proteins found on the surface and inside certain cells, including cancer cells. Epidermal growth factor attaches to the EGFR inside the cell and sends signals to the tyrosine kinase area of the cell, which tells the cell to grow and divide. EGFR tyrosine kinase inhibitors stop these signals and stop the cancer cell from growing and dividing. Erlotinib, gefitinib, afatinib, and osimertinib are types of EGFR tyrosine kinase inhibitors. Some of these drugs work better when there is also a mutation (change) in the EGFR gene.
  • Kinase inhibitors that affect cells with certain gene changes: Certain changes in the ALK, ROS1, BRAF, and MEK genes, and NTRK gene fusions, cause too much protein to be made. Blocking these proteins may stop the cancer from growing and spreading. Crizotinib is used to stop proteins from being made by the ALK and ROS1 genes. Ceritinib, alectinib, brigatinib, and lorlatinib are used to stop proteins from being made by the ALK gene. Dabrafenib is used to stop proteins being made by the BRAF gene. Trametinib is used to stop proteins being made by the MEK gene. Larotrectinib is used to stop proteins being made by a NTRK gene fusion.

    • See Drugs Approved for Non-Small Cell Lung Cancer for more information.

    Immunotherapy

    Immunotherapy is a treatment that uses the patient's immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body's natural defenses against cancer. This type of cancer treatment is also called biotherapy or biologic therapy.

    Immune checkpoint inhibitor therapy is a type of immunotherapy.

  • Immune checkpoint inhibitor therapy: PD-1 is a protein on the surface of T cells that helps keep the body’s immune responses in check. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing the cancer cell. PD-1 inhibitors attach to PDL-1 and allow the T cells to kill cancer cells. Nivolumab, pembrolizumab, atezolizumab, and durvalumab are types of immune checkpoint inhibitors.
    • Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).
    Immunotherapy uses the body’s immune system to fight cancer. This animation explains one type of immunotherapy that uses immune checkpoint inhibitors to treat cancer.

    See Drugs Approved for Non-Small Cell Lung Cancer for more information.

    Laser therapy

    Laser therapy is a cancer treatment that uses a laser beam (a narrow beam of intense light) to kill cancer cells.

    Photodynamic therapy (PDT)

    Photodynamic therapy (PDT) is a cancer treatment that uses a drug and a certain type of laser light to kill cancer cells. A drug that is not active until it is exposed to light is injected into a vein. The drug collects more in cancer cells than in normal cells. Fiberoptic tubes are then used to carry the laser light to the cancer cells, where the drug becomes active and kills the cells. Photodynamic therapy causes little damage to healthy tissue. It is used mainly to treat tumors on or just under the skin or in the lining of internal organs. When the tumor is in the airways, PDT is given directly to the tumor through an endoscope.

    Cryosurgery

    Cryosurgery is a treatment that uses an instrument to freeze and destroy abnormal tissue, such as carcinoma in situ. This type of treatment is also called cryotherapy. For tumors in the airways, cryosurgery is done through an endoscope.

    Electrocautery

    Electrocautery is a treatment that uses a probe or needle heated by an electric current to destroy abnormal tissue. For tumors in the airways, electrocautery is done through an endoscope.

    Watchful waiting

    Watchful waiting is closely monitoring a patient’s condition without giving any treatment until signs or symptoms appear or change. This may be done in certain rare cases of non-small cell lung cancer.

    New types of treatment are being tested in clinical trials.

    This summary section describes treatments that are being studied in clinical trials. It may not mention every new treatment being studied. Information about clinical trials is available from the NCI website.

    Chemoprevention

    Chemoprevention is the use of drugs, vitamins, or other substances to reduce the risk of cancer or to reduce the risk cancer will recur (come back). For lung cancer, chemoprevention is used to lessen the chance that a new tumor will form in the lung.

    Radiosensitizers

    Radiosensitizers are substances that make tumor cells easier to kill with radiation therapy. The combination of chemotherapy and radiation therapy given with a radiosensitizer is being studied in the treatment of non-small cell lung cancer.

    New combinations

    New combinations of treatments are being studied in clinical trials.

    Treatment for non-small cell lung cancer may cause side effects.

    For information about side effects caused by treatment for cancer, see our Side Effects page.

    Patients may want to think about taking part in a clinical trial.

    For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

    Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

    Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

    Patients can enter clinical trials before, during, or after starting their cancer treatment.

    Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.

    Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

    Follow-up tests may be needed.

    Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

    Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.

    非小细胞肺癌的治疗(PDQ®)

    根据分期的治疗方案

    有关以下列出的治疗方法信息，请参阅治疗选择概述部分。

    隐匿性非小细胞肺癌

    隐匿性非小细胞肺癌的治疗依赖于疾病的分期。隐匿性肿瘤经常在早期（肿瘤仅仅发生在肺部）发现，有时可以通过手术治愈。

    使用我们的临床试验搜索来找到NCI支持（正在接收病人）的癌症临床试验。您可以基于癌症分型、患者年龄和试验地点搜索临床试验。也可以获得关于临床试验的基本信息。

    0期

    0 期癌症的治疗可能包含以下几个方面：

  • 手术（楔形切除或肺段切除）。
  • 光动力疗法、电灼烧术、冷冻外科手术、或激光手术治疗支气管内或支气管附近的肿瘤。

    • 使用我们的临床试验搜索来找到NCI支持（正在接收病人）的癌症临床试验。您可以基于癌症分型、患者年龄和试验地点搜索临床试验。也可以获得关于临床试验的基本信息。

    I期非小细胞肺癌

    IA期非小细胞肺癌和IB期非小细胞肺癌的治疗包括:

  • 手术（楔形切除术，肺段切除术，袖式切除术，或者肺叶切除术）。
  • 体外放射治疗，包括体部立体定向放疗用于治疗不能手术或选择不行手术的病人
  • 手术后化疗或者放疗的临床试验。
  • 通过内镜进行治疗的临床试验，比如光动力治疗（PDT）。
  • 手术后进行化学预防的临床试验。

    • 使用我们的临床试验搜索来找到NCI支持（正在接收病人）的癌症临床试验。您可以基于癌症分型、患者年龄和试验地点搜索临床试验。也可以获得关于临床试验的基本信息。

    II期非小细胞肺癌

    IIA期非小细胞肺癌和IIB期非小细胞肺癌的治疗包括:

  • 手术（楔形切除术，肺段切除术，袖式切除术，肺叶切除术或者全肺切除术）。
  • 化疗后手术
  • 手术后化疗。
  • 体外放射治疗用于不能手术的病人
  • 手术后放射治疗的临床试验。

    • 使用我们的临床试验搜索来找到NCI支持（正在接收病人）的癌症临床试验。您可以基于癌症分型、患者年龄和试验地点搜索临床试验。也可以获得关于临床试验的基本信息。

    IIIA 期非小细胞肺癌

    可通过手术切除的IIIA 期非小细胞肺癌的治疗可能包括以下内容：

  • 手术后化疗。
  • 手术后进行放射治疗。
  • 化疗后手术
  • 手术后进行化疗和放射治疗的联合治疗。
  • 化疗和放疗后进行手术。
  • 新的治疗方案组合的临床试验。

    • 不能通过手术切除的IIIA 期非小细胞肺癌的治疗可能包括以下内容：

  • 同期放化疗或续惯放化疗。
  • 单纯进行体外放射治疗可用于那些不能采用联合治疗的病人，或作为缓解治疗用于减轻患者症状并改善生活质量。
  • 内照射治疗或者激光手术，作为姑息治疗，用于减轻症状并改善生活质量。
  • 在化疗和放疗后用免疫检查点抑制剂进行免疫治疗，如度伐单抗
  • 新的治疗方案组合的临床试验。

    • 更多有关包括咳嗽、气短、胸痛在内的体征和症状的支持疗法，请参阅PDQ中关于心肺综合征的概述。

    位于肺上沟区的非小细胞肺癌，通常被称为肺上沟瘤，开始于肺的上部并扩散到邻近组织，如胸壁、大血管、和脊椎。肺上沟瘤的治疗可包括以下方面:

  • 单纯放射治疗
  • 手术。
  • 化疗和放疗后进行手术。
  • 新的治疗方案组合的临床试验。

    • 一些已经生长至胸壁的IIIA 期非小细胞肺癌可能会被完全切除。胸壁肿瘤的治疗可能包含以下内容：

  • 手术。
  • 手术和放射治疗。
  • 单纯放射治疗
  • 化疗与放射治疗或手术结合，或者三者相结合。
  • 新的治疗方案组合的临床试验。

    • 使用我们的临床试验搜索来找到NCI支持（正在接收病人）的癌症临床试验。您可以基于癌症分型、患者年龄和试验地点搜索临床试验。也可以获得关于临床试验的基本信息。

    IIIB期和IIIC期非小细胞肺癌

    IIIB期非小细胞肺癌和IIIC期非小细胞肺癌的治疗可能包括以下内容:

  • 化疗后进行体外放射治疗。
  • 在同时期进行单独的化疗和放射治疗。
  • 在同时期进行单独的化疗和放射治疗，放疗剂量随时长而增加。
  • 在同期进行单独的化疗和放射治疗。在这些治疗之前或之后进行单独的化疗。
  • 在化疗和放疗后用免疫检查点抑制剂进行免疫治疗，如度伐单抗
  • 对于那些不能化疗的病人，仅采取体外放射疗法。
  • 体外放射治疗作为姑息性治疗，可减轻症状，提高生活质量。
  • 采用激光治疗和/或体内放射治疗，以减轻症状和改善生活质量。
  • 新的体外放射治疗方案和新型治疗方法的临床试验。
  • 联合放化疗及放疗增敏剂的临床试验。
  • 靶向治疗联合化疗和放疗的临床试验。

    • 更多有关包括咳嗽、气短、胸痛在内的体征和症状的支持疗法，请参阅以下的PDQ概述。

  • 心肺综合征
  • 癌痛

    • 使用我们的临床试验搜索来找到NCI支持（正在接收病人）的癌症临床试验。您可以基于癌症分型、患者年龄和试验地点搜索临床试验。也可以获得关于临床试验的基本信息。

    新诊断的IV期、复发性的非小细胞肺癌

    新诊断的IV期、复发性的非小细胞肺癌的治疗可能包括以下内容:

  • 联合化疗
  • 化疗联合单克隆抗体靶向治疗，如贝伐单抗、西妥昔单抗、或奈西木单抗。
  • 联合化疗后，使用化疗作为维持治疗，以防止癌症的进展。
  • 使用表皮生长因子受体(EGFR)酪氨酸激酶抑制剂进行靶向治疗，如奥西马替尼、吉非替尼、厄洛替尼或阿法替尼。
  • 使用间变性淋巴瘤激酶(ALK)抑制剂进行靶向治疗，如艾乐替尼、 克唑替尼、 色瑞替尼、布加替尼或劳拉替尼。
  • 使用BRAF或MEK抑制剂进行靶向治疗，如达拉菲尼或曲美替尼 。
  • 使用NTRK抑制剂进行靶向治疗，如拉罗替尼
  • 使用免疫检查点抑制剂进行免疫治疗，如帕博利珠单抗，联合或不联合化疗
  • 激光治疗和/或体内放射治疗用于治疗阻塞气道的肿瘤。
  • 体外放射治疗作为姑息性治疗，可减轻症状，提高生活质量。
  • 切除第二原发癌的手术。
  • 手术切除扩散到脑部的癌症，然后对全脑进行放射治疗。
  • 采用立体定向放射外科治疗法治疗已扩散到脑部但不能用手术治疗的肿瘤。
  • 针对新药以及新的治疗组合的临床试验。

    • 使用我们的临床试验搜索来找到NCI支持（正在接收病人）的癌症临床试验。您可以基于癌症分型、患者年龄和试验地点搜索临床试验。也可以获得关于临床试验的基本信息。

    进展IV期、复发性非小细胞肺癌

    进展IV期、复发性非小细胞肺癌的治疗方法可能包括如下内容：

  • 化疗
  • 表皮生长因子受体(EGFR)酪氨酸激酶抑制剂的靶向治疗，如厄洛替尼、吉非替尼、阿法替尼或奥西替尼。
  • 使用间变性淋巴瘤激酶(ALK)抑制剂进行靶向治疗，如克唑替尼、色瑞替尼、艾乐替尼或布加替尼。
  • 使用BRAF或MEK抑制剂进行靶向治疗，如达拉菲尼或曲美替尼 。
  • 使用免疫检查点抑制剂进行免疫治疗，如纳武利尤单抗、帕博利珠单抗、阿特珠单抗。
  • 针对新药以及新的治疗组合的临床试验。

    • 使用我们的临床试验搜索来找到NCI支持（正在接收病人）的癌症临床试验。您可以基于癌症分型、患者年龄和试验地点搜索临床试验。也可以获得关于临床试验的基本信息。

    Non-Small Cell Lung Cancer Treatment (PDQ®)

    Treatment Options by Stage

    For information about the treatments listed below, see the Treatment Option Overview section.

    Occult Non-Small Cell Lung Cancer

    Treatment of occult non-small cell lung cancer depends on the stage of the disease. Occult tumors are often found at an early stage (the tumor is in the lung only) and sometimes can be cured by surgery.

    Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage 0

    Treatment of stage 0 may include the following:

  • Surgery (wedge resection or segmental resection).
  • Photodynamic therapy, electrocautery, cryosurgery, or laser surgery for tumors in or near the bronchus.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage I Non-Small Cell Lung Cancer

    Treatment of stage IA non-small cell lung cancer and stage IB non-small cell lung cancer may include the following:

  • Surgery (wedge resection, segmental resection, sleeve resection, or lobectomy).
  • External radiation therapy, including stereotactic body radiation therapy for patients who cannot have surgery or choose not to have surgery.
  • A clinical trial of chemotherapy or radiation therapy following surgery.
  • A clinical trial of treatment given through an endoscope, such as photodynamic therapy (PDT).
  • A clinical trial of surgery followed by chemoprevention.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage II Non-Small Cell Lung Cancer

    Treatment of stage IIA non-small cell lung cancer and stage IIB non-small cell lung cancer may include the following:

  • Surgery (wedge resection, segmental resection, sleeve resection, lobectomy, or pneumonectomy).
  • Chemotherapy followed by surgery.
  • Surgery followed by chemotherapy.
  • External radiation therapy for patients who cannot have surgery.
  • A clinical trial of radiation therapy following surgery.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage IIIA Non-Small Cell Lung Cancer

    Treatment of stage IIIA non-small cell lung cancer that can be removed with surgery may include the following:

  • Surgery followed by chemotherapy.
  • Surgery followed by radiation therapy.
  • Chemotherapy followed by surgery.
  • Surgery followed by chemotherapy combined with radiation therapy.
  • Chemotherapy and radiation therapy followed by surgery.
  • A clinical trial of new combinations of treatments.

    • Treatment of stage IIIA non-small cell lung cancer that cannot be removed with surgery may include the following:

  • Chemotherapy and radiation therapy given over the same period of time or one followed by the other.
  • External radiation therapy alone for patients who cannot be treated with combined therapy, or as palliative treatment to relieve symptoms and improve the quality of life.
  • Internal radiation therapy or laser surgery, as palliative treatment to relieve symptoms and improve the quality of life.
  • Chemotherapy and radiation therapy followed by immunotherapy with an immune checkpoint inhibitor, such as durvalumab.
  • A clinical trial of new combinations of treatments.

    • For more information about supportive care for signs and symptoms including cough, shortness of breath, and chest pain, see the PDQ summary on Cardiopulmonary Syndromes.

    Non-small cell lung cancer of the superior sulcus, often called Pancoast tumor, begins in the upper part of the lung and spreads to nearby tissues such as the chest wall, large blood vessels, and spine. Treatment of Pancoast tumors may include the following:

  • Radiation therapy alone.
  • Surgery.
  • Chemotherapy and radiation therapy followed by surgery.
  • A clinical trial of new combinations of treatments.

    • Some stage IIIA non-small cell lung tumors that have grown into the chest wall may be completely removed. Treatment of chest wall tumors may include the following:

  • Surgery.
  • Surgery and radiation therapy.
  • Radiation therapy alone.
  • Chemotherapy combined with radiation therapy and/or surgery.
  • A clinical trial of new combinations of treatments.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Stage IIIB and Stage IIIC Non-Small Cell Lung Cancer

    Treatment of stage IIIB non-small cell lung cancer and stage IIIC non-small cell lung cancer may include the following:

  • Chemotherapy followed by external radiation therapy.
  • Chemotherapy and radiation therapy given as separate treatments over the same period of time.
  • Chemotherapy and radiation therapy given as separate treatments over the same period of time, with the dose of radiation therapy increasing with time.
  • Chemotherapy and radiation therapy given as separate treatments over the same period of time. Chemotherapy alone is given before or after these treatments.
  • Chemotherapy and radiation therapy followed by immunotherapy with an immune checkpoint inhibitor, such as durvalumab.
  • External radiation therapy alone for patients who cannot be treated with chemotherapy.
  • External radiation therapy as palliative therapy, to relieve symptoms and improve the quality of life.
  • Laser therapy and/or internal radiation therapy to relieve symptoms and improve the quality of life.
  • Clinical trials of new external radiation therapy schedules and new types of treatment.
  • A clinical trial of chemotherapy and radiation therapy combined with a radiosensitizer.
  • Clinical trials of targeted therapy combined with chemotherapy and radiation therapy.

    • For more information about supportive care for signs and symptoms such as cough, shortness of breath, and chest pain, see the following PDQ summaries:

  • Cardiopulmonary Syndromes
  • Cancer Pain

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Newly Diagnosed Stage IV, Relapsed, and Recurrent Non-Small Cell Lung Cancer

    Treatment of newly diagnosed stage IV, relapsed, and recurrent non-small cell lung cancer may include the following:

  • Combination chemotherapy.
  • Combination chemotherapy and targeted therapy with a monoclonal antibody, such as bevacizumab, cetuximab, or necitumumab.
  • Combination chemotherapy followed by more chemotherapy as maintenance therapy to help keep cancer from progressing.
  • Targeted therapy with an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, such as osimertinib, gefitinib, erlotinib, or afatinib.
  • Targeted therapy with an anaplastic lymphoma kinase (ALK) inhibitor, such as alectinib, crizotinib, ceritinib, brigatinib, or lorlatinib.
  • Targeted therapy with a BRAF or MEK inhibitor, such as dabrafenib or trametinib.
  • Targeted therapy with a NTRK inhibitor, such as larotrectinib.
  • Immunotherapy with an immune checkpoint inhibitor, such as pembrolizumab, with or without chemotherapy.
  • Laser therapy and/or internal radiation therapy for tumors that are blocking the airways.
  • External radiation therapy as palliative therapy, to relieve symptoms and improve the quality of life.
  • Surgery to remove a second primary tumor.
  • Surgery to remove cancer that has spread to the brain, followed by radiation therapy to the whole brain.
  • Stereotactic radiosurgery for tumors that have spread to the brain and cannot be treated with surgery.
  • A clinical trial of new drugs and combinations of treatments.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    Progressive Stage IV, Relapsed, and Recurrent Non-Small Cell Lung Cancer

    Treatment of progressive stage IV, relapsed, and recurrent non-small cell lung cancer may include the following:

  • Chemotherapy.
  • Targeted therapy with an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, such as erlotinib, gefitinib, afatinib, or osimertinib.
  • Targeted therapy with an anaplastic lymphoma kinase (ALK) inhibitor, such as crizotinib, ceritinib, alectinib, or brigatinib.
  • Targeted therapy with a BRAF or MEK inhibitor, such as dabrafenib or trametinib.
  • Immunotherapy with an immune checkpoint inhibitor, such as nivolumab, pembrolizumab, or atezolizumab.
  • A clinical trial of new drugs and combinations of treatments.

    • Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

    非小细胞肺癌的治疗(PDQ®)

    以了解更多关于非小细胞肺癌的信息

    更多来自国家癌症研究所的有关非小细胞肺癌的信息，请参阅以下内容：

  • 肺癌主页
  • 肺癌预防
  • 肺癌筛查
  • 批准用于非小细胞肺癌的药物
  • 癌症靶向治疗
  • 用于癌症治疗的激光
  • 癌症光动力疗法
  • 癌症治疗中的冷冻外科手术
  • 烟草（包括辅助戒烟）
  • 二手烟和癌症

    • 有关国家癌症研究所的常用癌症信息和其他资源，请参见以下内容

  • 关于癌症
  • 癌症分期
  • 化疗与你：支持癌症患者
  • 放射治疗与你：支持癌症患者
  • 应对癌症
  • 向医生询问关于癌症的问题
  • 幸存者和护理人员
    • Non-Small Cell Lung Cancer Treatment (PDQ®)

    To Learn More About Non-Small Cell Lung Cancer

    For more information from the National Cancer Institute about non-small cell lung cancer, see the following:

  • Lung Cancer Home Page
  • Lung Cancer Prevention
  • Lung Cancer Screening
  • Drugs Approved for Non-Small Cell Lung Cancer
  • Targeted Cancer Therapies
  • Lasers in Cancer Treatment
  • Photodynamic Therapy for Cancer
  • Cryosurgery in Cancer Treatment
  • Tobacco (includes help with quitting)
  • Secondhand Smoke and Cancer

    • For general cancer information and other resources from the National Cancer Institute, see the following:

  • About Cancer
  • Staging
  • Chemotherapy and You: Support for People With Cancer
  • Radiation Therapy and You: Support for People With Cancer
  • Coping with Cancer
  • Questions to Ask Your Doctor about Cancer
  • For Survivors and Caregivers
    • 非小细胞肺癌的治疗(PDQ®)

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the treatment of non-small cell lung cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Non-Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq. Accessed . [PMID: 26389355]

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

    Non-Small Cell Lung Cancer Treatment (PDQ®)

    About This PDQ Summary

    About PDQ

    Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.

    PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.

    Purpose of This Summary

    This PDQ cancer information summary has current information about the treatment of non-small cell lung cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

    Reviewers and Updates

    Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Updated") is the date of the most recent change.

    The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.

    Clinical Trial Information

    A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

    Clinical trials can be found online at NCI's website. For more information, call the Cancer Information Service (CIS), NCI's contact center, at 1-800-4-CANCER (1-800-422-6237).

    Permission to Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Non-Small Cell Lung Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated . Available at: https://www.cancer.gov/types/lung/patient/non-small-cell-lung-treatment-pdq. Accessed . [PMID: 26389355]

    Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Disclaimer

    The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the Managing Cancer Care page.

    Contact Us

    More information about contacting us or receiving help with the Cancer.gov website can be found on our Contact Us for Help page. Questions can also be submitted to Cancer.gov through the website’s E-mail Us.

    < 1 2 3 4 5 6 7 >
    目录
    章 节
    关于非小细胞肺癌的常用信息 非小细胞肺癌的不同分期 复发性非小细胞肺癌 治疗方案概述 根据分期的治疗方案 以了解更多关于非小细胞肺癌的信息 About This PDQ Summary
    地址：北京市朝阳区潘家园南里17号中国医学科学院肿瘤医院科研楼216、217室  邮编：100021  电话：010-87788070、010-87788069  邮箱：bjzlxh8746@163.com

    Copyright by 北京肿瘤学会 All rights reserved. 京ICP .备案：18036179号﹣1号