الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 113 |  |  |
| | | from | 113 | | |
Abstract
Lung cancer is the leading cause of cancer related death in both
genders worldwide. It is the second most common solid tumor type in
both genders after prostate cancer in men and breast cancer in women.
The primary risk factors for lung cancer are tobacco smoking,
asbestos, recurring lung inflammation, lung scarring secondary to
tuberclusis, family history, and exposure to other carcinogens
(polycyclic aromatic hydrocarbons, chromium, nickel, organic arsenic
compounds).
The WHO divides lung cancer into 2 major classes based on its
biology, therapy, and prognosis: non-small cell lung cancer (NSCLC)
and small cell lung cancer (SCLC). NSCLC accounts for more than
85% of all lung cancer cases, and it includes 2 major types:1) nonsquamus
carcinoma (including Adenocarcinoma, large-cell carcinoma
,and other cell types), and 2) squamus cell (epidermoid carcinoma).
Surgery, radiation therapy, and chemotherapy are the 3
modalities commonly used to treat patients with NSCLC.
Specific targeted therapies have been developed for treatment of
advanced NSCLC. Vascular endothelial growth factor receptor
inhibitors like bevacizumab, epidermal growth factor receptor
inhibitors like erlotinib, gefitinib, afatinib, and cetuximab, and ALK
inhibitors like crizotinb, ceritinib.
Maintenance therapy refers to systemic therapy that may be
given to patients with advanced NSCLC after 4-6 cycles of first line
chemotherapy , however patients are only candidates for maintenance
therapy if they have responded to previous treatment, or have stable
disease, or they have not progressed. Continuation maintenance therapy refers to the use of at least one of the agents that was given in
the first line regiemen. Switch maintenance therapy refers to the
initiation of a different agent that was not included as part of the first
line treatment. Maintenance therapy is not the standard of care for all
patients (e.g, not recommended for patients with P.S 3-4, those with
progression); close observation (category 2A) is also a valid treatment option.