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Systemic Treatment of Chest Tumors: Highlighting Some Differences Between Eastern and Western Countries

[ Vol. 14 , Issue. 2 ]


Victor HF Lee* and Dora L.W. Kwong   Pages 120 - 136 ( 17 )


Introduction: Malignant chest tumors are common tumors in humans. Among them, lung cancer including Non-Small-Cell Lung Cancer (NSCLC) and smallcell lung cancer are the most common types. Surgery alone for early-stage, or in combination with chemotherapy and radiation therapy for more advanced disease have been the major components of treatment strategies for the past few decades. The recent discovery of oncogenic drivers for NSCLC has led to the devise of new targeted therapies which dramatically improve the quality of life and survival of patients whose tumors harbor such mutations. New generations of targeted therapy which specifically target the drug-resistant mutations gradually evolve, benefiting patients who are refractory or intolerant to first-line targeted therapy. The survival of NSCLC patients without identifiable mutations has also improved, as contributed by use of the relatively non-toxic chemotherapeutic and anti-angiogenic agents, as well as the advances of radiation techniques with better tumor coverage and reduced toxicities. The treatment outcomes of other rarer chest tumors including mesothelioma, thymic epithelial tumors and neuroendocrine tumors have also improved significantly, secondary to earlier detection, more accurate and uniform diagnostic criteria and classification, emergence of new treatment options and multidisciplinary management. In addition, the epidemiology, patterns of genetic and environmental predisposition and treatment strategies of these tumors may differ substantially between Western and Asian countries.

Conclusion: The approaches of this review are to highlight the recent management advances and contrast the differences of treatment practice between Western and Asian countries.


Chest tumors, mutations, targeted therapy, multidisciplinary management, overview.


Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pok Fu Lam, Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Pok Fu Lam

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