Non-small cell lung cancer in stage IIIB involves cancer of any size that has spread to lymph nodes above the collar bone or the opposite side of the chest and/or to any of the other structures in the chest cavity like the heart, major blood vessels or trachea. Chemotherapy, the use of drugs to kill cancer cells, with or without radiation therapy is the treatment of choice in those who are healthy enough at this stage to receive it, says the Mayo Clinic. Chemotherapy is used in diverse ways in these cases.
Combination Chemotherapy
According to the American Cancer Society, a combination of two drugs is most often used in chemotherapy for non-small cell lung cancer. The common combinations consist of either cisplatin or carboplatin and one other drug. Other combinations like gemcitabin with paclitaxel or vinorelbine have been found to be equally effective and with fewer side effects. Other drugs commonly used in chemotherapy for non-small cell lung cancer are docetaxel, irinotecan, etoposide, vinblastine and pemetrexed.
In some cases, chemotherapy may be combined with other agents that are designed to attack specific structures or functions in the cancer cells; this treatment is called targeted therapy. Targeted therapy drugs for non-small cell lung cancer are bevacizumab and cetuximab.
Single Drug Chemotherapy
Some cases do not do well on the first line drugs, even when combined. In such cases, second line treatment usually consists of single-drug chemotherapy, typically with pemetrexed or docetaxel.
Adjuvant Chemotherapy
According to the American Cancer Society, a small number of cases in the IIIB stage are still operable and undergo surgery. In such cases, chemotherapy is used to destroy any cancer cells that might have been missed during the surgical removal of the cancer. This is called adjuvant chemotherapy.
Neoadjuvant Chemotherapy
Chemotherapy given before surgery or radiation therapy can make the treatments more effective. The drugs may cause the cancer bulk to shrink, making the cancer easier to remove surgically. This type of chemotherapy is called neoadjuvant therapy.
