Oligometastatic disease

Resection or RT for metastasis +/- lung resection or radiotherapy +/- SACT in NSCLC; SACT in small cell.

Pleural effusion

Talc Pleurodesis or Indwelling Pleural Catheter (IPC), ideally guided by patient choice.  

If evidence of Trapped Lung for Indwelling Pleural Catheter (IPC).

Talc poudrage at thoracoscopy if required for tissue diagnosis.

Superior vena cava obstruction (SVCO)

  • Begin administration of steroids
  • Stent/Radiotherapy (NSCLC)
  • Chemotherapy (small cell)

Malignant spinal cord compression

  • Begin administration of steroids as per local guidelines, MRI within 24 hrs
  • Refer to Neurosurgery
  • Radiotherapy - start within 24 hrs of MRI
  • Chemotherapy if small cell

Malignant airway obstruction

Begin administration of steroids. Refer /discuss with Thoracic Surgeons or interventionalbronchoscopist (stent, recanalisation or cryotherapy) as per local guidelines.

Significant haemoptysis

  • Consider tranexamic acid, stop relevant meds, consider antibiotics. 
  • Consider CT angiogram and discuss with interventional radiology, thoracic surgeons or interventional bronchoscopist. 
  • Consider urgent RT.

Editorial Information

Reviewer name(s): John Maclay.