10
Treatment
Figure 2. Management of Stage III NSCLC
N2
Multidisciplinary discussion
or consult with surgeon
Resectable
superior
sulcus
Osimertinib after
platinum-based
chemotherapy
Postoperative RT should
NOT be routinely offered
Platinum-based
chemotherapy
Neoadjuvant
chemotherapy
Selected
patients with
T4N0 diease
• A complete resection (R0) of the primary
tumor and involved lymph nodes is
deemed possible;
• N3 lymph nodes are deemed to be not
involved by multidisciplinary consensus
• Perioperative (90-day) mortality is
expected to be low (≤5%)
Neoadjuvant
concurrent
chemoradiotherapy
Surgery
1
Patients with confirmed
stage III NSCLC
Resectable
Patients with
resected stage III
lung cancer
Patients who
did not receive
neoadjuvant
systemic therapy
Patients with mediastinal N2
involvement without extracapular
extension who have received
neoadjuvant or adjuvant platinum-
based chemotherapy
Should include a platinum-
based doublet, preferable
cisplatin/etoposide,
carboplatin/paclitaxel,
cisplatin/permetrexed
(non-squamous only), or
cisplatin/vinorelbine
2
Radiation therapy (RT) to 60 Gy
Doses higher than 60 Gy and
up to 70 Gy may be considered
for selected patients with
careful attention to doses to
heart, lungs, and esophagus
Patients with
EGFR exon 19
deletion or exon
L858R mutation
