Lung Cancer Surgery and Comprehensive Treatment

  Due to the increase in environmental pollution and the increase in the number of smokers and the amount of smoking, the incidence and mortality of lung cancer have increased significantly in recent decades in countries around the world. In the United States, about 160,000 people die of lung cancer each year, 75% of whom are non-small cell lung cancer. The latest statistics show that the incidence rate of lung cancer has exceeded that of various malignant tumors in major cities in China. Nearly 800,000 people die of lung cancer in China every year, among which, non-small cell lung cancer patients account for about 80%. However, due to the rapid development process of lung cancer, complex etiology and many adulterating factors in treatment, it is necessary to clarify standardized and guiding treatment plan in order to reduce blind and inappropriate treatment, so that patients can achieve the most effective treatment effect with the most economical cost.  A comprehensive judgment must be made to determine the best treatment plan for lung cancer. In most cases, the best treatment is multidisciplinary and comprehensive.  The first step is to determine the type of lung cancer. Lung cancer is divided into non-small cell carcinoma (NSCLC) and small cell lung cancer (SCLC) according to pathology, which account for about 80% and 20% of all lung cancer cases, respectively. Among them, non-small cell lung cancer is subdivided into squamous carcinoma, adenocarcinoma and large cell carcinoma. Small cell undifferentiated carcinoma is more sensitive to radiotherapy and chemotherapy, but is prone to recurrence. Overall speaking, lung cancer is best treated by surgery.  Secondly, it depends on the stage of lung cancer. Internationally, a unified standard is used to divide lung cancer into four stages: I, II, III and IV. Among them, stage I and II are characterized by smaller tumors, easier to be removed and no distant metastasis, which can be treated with surgery, radiotherapy and chemotherapy, and the final healing effect is better. Stage III, on the other hand, is based on surgery combined with radiotherapy and chemotherapy. Stage IV lung cancer cannot be operated, and only radiotherapy and chemotherapy can be used. Our department has achieved good results in treating this type of patients with lung cancer by using cluster polyenergy knife and radioactive particle implantation.  Thirdly, it depends on the patient’s physical condition. It is mainly to check whether the patient’s vital organs, heart, liver, lung and kidney functions are normal and there are no important underlying diseases such as diabetes and myocardial infarction.  The best treatment method can be found by combining the above overall conditions. Chemotherapy, cluster concentrator knife with radioactive particle implantation can be used for cases that are not suitable for surgery and radiotherapy, and for cases that have relapsed after surgery and radiotherapy or have had systemic metastases. In addition, chemotherapy can be used as an adjuvant treatment before surgery and as a means to consolidate the efficacy after surgery and radiotherapy.