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Pancoast Tumour — SCE Medical Oncology MCQ

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HardLung CancerPancoast TumourSCE Medical Oncology

A 60-year-old man with unresectable NSCLC and a superior sulcus (Pancoast) tumour causing Horner syndrome and severe shoulder/arm pain is planned for curative-intent treatment. What is the standard multimodality approach?

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Correct answer: B — Neoadjuvant chemoradiotherapy followed by surgical resection

Superior sulcus (Pancoast) tumours are managed with a trimodality approach: neoadjuvant concurrent cisplatin-based chemoradiotherapy (45 Gy) followed by surgical resection if technically feasible. This approach, established by the Intergroup 0160 trial, achieves 5-year survival of approximately 40-50% in patients achieving R0 resection. Horner syndrome alone does not preclude resection. T4 disease involving the vertebral body or brachial plexus above T1 may preclude surgery.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer