• pierwsza linia leczenia: chemioterapia według schematów PG (cisplatyna i gemcytabina) lub KP (karboplatyna i paklitaksel)
  • druga linia leczenia: docetaksel, gemcytabina, winorelbina w monoterapii.

Rak wielkokomórkowy

W raku wielokomórkowym prowadzi się terapię taką jak w raku niepłaskonabłonkowym.

Rak wielkokomórkowy neuroendokrynny

W przypadku raka wielkokomórkowego neuroendokrynnego stosuje się leczenie jak w raku drobnokomórkowym lub niepłaskonabłonkowym.

Podsumowanie

Obecnie w Polsce leczenie systemowe w niedrobnokomórkowym raku płuca jest prowadzone przy użyciu leków refundowanych stosowanych w chemioterapii i w ramach programu lekowego Ministerstwa Zdrowia „Leczenie niedrobnokomórkowego raka płuca –program B.6”. Część pacjentów jest leczona w ramach badań klinicznych z zastosowaniem leków jeszcze nierefundowanych, będących w trakcie badań.

Ostatecznego wyboru sposobu leczenia chorego na NDRP dokonuje się nie tylko na podstawie aktualnych wytycznych, ale także biorąc pod uwagę jego stan sprawności, wyniki badań dodatkowych, wolę i preferencje leczonego.

ABSTRACT

Palliative systemic treatment in non-small-cell lung cancer

Palliative systemic treatment in non-small-cell lung cancer (NSCLC) is offered to Stage IV patients, i.e. those with distant metastases at baseline, as well as patients diagnosed with lower-stage disease if, for various reasons, radical treatment cannot be instituted. Palliative systemic treatment usually comprises a number of lines of treatment, i.e., periods of active therapy. Drugs making up individual lines of treatment are administered over a specific period or until disease progression occurs or unacceptable complications from the treatment develop. During treatment, imaging studies (most often CT) are repeated at particular intervals to determine the response to the treatment. The choice of palliative systemic therapy in NSCLC depends above all on cancer histology and the presence or absence of mutations to specific genes and the presence or absence of certain receptors.

Piśmiennictwo

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