Diagnosis and management of patients with stage III non‑small cell lung cancer: A joint statement by the Lebanese Society of Medical Oncology and the Lebanese Pulmonary Society (Review)

Αoun-Bacha,Zeina; Bitar,Nizar; Abi Saleh,Wajdi; Assi,Hazem; Bahous,Joudy; Boukhalil,Pierre; Chami,Hasan; Dabar,Georges; El Karak,Fadi; Farhat,Fadi; Ghanem,Hadi; Ghosn,Marwan; Juvelikian,George; Nasr,Fadi; Nehme,Ralph; Riachy,Moussa; Tabet,Georges; Tfayli,Arafat; Waked,Mirna; Youssef,Pierre

doi:10.3892/ol.2023.13699

Diagnosis and management of patients with stage III non‑small cell lung cancer: A joint statement by the Lebanese Society of Medical Oncology and the Lebanese Pulmonary Society (Review)

Authors:
- Zeina Αoun-Bacha
- Nizar Bitar
- Wajdi Abi Saleh
- Hazem Assi
- Joudy Bahous
- Pierre Boukhalil
- Hasan Chami
- Georges Dabar
- Fadi El Karak
- Fadi Farhat
- Hadi Ghanem
- Marwan Ghosn
- George Juvelikian
- Fadi Nasr
- Ralph Nehme
- Moussa Riachy
- Georges Tabet
- Arafat Tfayli
- Mirna Waked
- Pierre Youssef
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Affiliations: Division of Pulmonary Medicine, Hôtel-Dieu de France Medical Center, Saint-Joseph University, Beirut 1104 2020, Lebanon, Division of Hematology-Oncology, Sahel General Hospital, Beirut 1514, Lebanon, Division of Pulmonary Medicine and Critical Care, Clémenceau Medical Center, Beirut 1103, Lebanon, Division of Hematology/Oncology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon, Division of Pulmonary Medicine, Saint Georges Hospital University Medical Center, Beirut 1481, Lebanon, Division of Pulmonary Medicine and Critical Care, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon, Division of Pulmonary Medicine and Critical Care, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon, Division of Hematology-Oncology, Hôtel-Dieu de France Medical Center, Saint-Joseph University, Beirut 1104 2020, Lebanon, Division of Hematology Oncology, Hammoud Hospital University Medical Center, Sidon 1551, Lebanon, Division of Hematology-Oncology, Lebanese American University Medical Center-Rizk Hospital, Beirut 1481, Lebanon, Division of Hematology-Oncology, Hôtel-Dieu de France Medical Center, Saint-Joseph University, Beirut 1104 2020, Lebanon, Division of Pulmonary Medicine, Saint Georges Hospital University Medical Center, Beirut 1481, Lebanon, Division of Pulmonary Medicine and Critical Care, Lebanese American University Medical Center-Rizk Hospital, Beirut 1481, Lebanon, Department of Thoracic Surgery, Hôtel-Dieu de France Medical Center, Saint-Joseph University, Beirut 1004 2020, Lebanon, Division of Hematology/Oncology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon, Department of Surgery, Saint Georges Hospital University Medical Center, Beirut 1481, Lebanon
Published online on: February 6, 2023 https://doi.org/10.3892/ol.2023.13699
Article Number: 113
Copyright: © Αoun-Bacha et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Proper management of stage III non‑small cell lung cancer (NSCLC) might result in a cure or patient long‑term survival. Management should therefore be preceded by adequate and accurate diagnosis and staging, which will inform therapeutic decisions. A panel of oncologists, surgeons and pulmonologists in Lebanon convened to establish a set of recommendations to guide and unify clinical practice, in alignment with international standards of care. Whilst chest computerized tomography (CT) scanning remains a cornerstone in the discovery of a lung lesion, a positron‑emission tomography (PET)/CT scan and a tumor biopsy allows for staging of the cancer and defining the resectability of the tumor(s). A multidisciplinary discussion meeting is currently widely advised for evaluating patients on a case‑by‑case basis, and should include at least the treating oncologist, a thoracic surgeon, a radiation oncologist and a pulmonologist, in addition to physicians from other specialties as needed. The standard of care for unresectable stage III NSCLC is concurrent chemotherapy and radiation therapy, followed by consolidation therapy with durvalumab, which should be initiated within 42 days of the last radiation dose; for resectable tumors, neoadjuvant therapy followed by surgical resection is recommended. This joint statement is based on the expertise of the physician panel, available literature and evidence governing the treatment, management and follow‑up of patients with stage III NSCLC.

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