Management of locally advanced non-small cell lung cancer in the modern era: A national Italian survey on diagnosis, treatment and multidisciplinary approach
Autoři:
Alessio Bruni aff001; Niccolò Giaj-Levra aff002; Patrizia Ciammella aff003; Virginia Maragna aff004; Katia Ferrari aff005; Viola Bonti aff005; Francesco Grossi aff006; Stefania Greco aff007; Carlo Greco aff008; Paolo Borghetti aff009; Davide Franceschini aff010; Enrica Capelletto aff011; Marco Perna aff004; Giuseppe Banna aff012; Stefano Vagge aff013; Editta Baldini aff014; Emilio Bria aff015; Andrea Botti aff016; Marcello Tiseo aff017; Massimiliano Paci aff018; Maria Taraborrelli aff019; Venerino Poletti aff020; Pierluigi Granone aff022; Umberto Ricardi aff023; Silvia Novello aff011; Vieri Scotti aff004
Působiště autorů:
Radiotherapy Unit, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
aff001; Department of Advanced Radiation Oncology, IRCCS Sacro Cuore–Don Calabria Hospital, Negrar, Verona, Italy
aff002; Radiation Therapy Unit, Department of Oncology and Advanced Technology, AUSL-IRCCS, Reggio Emilia, Italy
aff003; Radiation Therapy Unit, Department of Oncology, Careggi University Hospital, Firenze, Italy
aff004; Section of Respiratory Medicine, Careggi University Hospital, Firenze, Italy
aff005; UOC Oncologia Medica Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
aff006; UOSD of Oncologic Pneumology, San Camillo Forlanini Hospital, Rome, Italy
aff007; Department of Radiation Oncology, Campus Bio-Medico University, Rome, Italy
aff008; Radiation Oncology Department University and Spedali Civili, Brescia, Italy
aff009; Department of Radiotherapy and Radiosurgery, Humanitas Cancer Center and Research Hospital, Rozzano, Milan, Italy
aff010; Oncology Department, University of Turin, AOU San Luigi, Orbassano (TO), Italy
aff011; Oncology Department, Ospedale Cannizzaro, Catania, Italy
aff012; Department of Radiation Oncology, Azienda Ospedaliera Universitaria San Martino di Genova—IST, Istituto Nazionale Ricerca sul Cancro, Genoa, Italy
aff013; UOC Oncologia Medica Ospedale San Luca, Lucca, Italy
aff014; U.O.C. Oncologia Medica, Comprehensive Cancer Center—Fondazione Policlinico Universitario A. Gemelli, IRCCS—Università Cattolica del Sacro Cuore, Roma, Italy
aff015; Medical Physics Unit, Department of Oncology and Advanced Technology, AUSL-IRCCS, Reggio Emilia, Italy
aff016; Department of Medicine and Surgery, University of Parma and Medical Oncology Unit, University Hospital of Parma, Parma, Italy
aff017; Division of Thoracic Surgery, Azienda USL-IRCCS of Reggio Emilia, Italy
aff018; Radiotherapy Unit, SS Annunziata Hospital—G. D'annunzio University, Chieti, Italy
aff019; Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì (I), Italy
aff020; Department of Respiratory Diseases & Allergy, Aarhus University Hospital, Aarhus, Denmark
aff021; Department of General Thoracic Surgery, Catholic University, Rome, Italy
aff022; Department of Oncology, University of Turin, Torino, Italy
aff023
Vyšlo v časopise:
PLoS ONE 14(11)
Kategorie:
Research Article
doi:
https://doi.org/10.1371/journal.pone.0224027
Souhrn
Concurrent chemotherapy and radiotherapy (cCRT) is considered the standard treatment of locally advanced non-small cell lung cancer (LA-NSCLC). Unfortunately, management is still heterogeneous across different specialists. A multidisciplinary approach is needed in this setting due to recent, promising results obtained by consolidative immunotherapy. The aim of this survey is to assess current LA-NSCLC management in Italy. From January to April 2018, a 15-question survey focusing on diagnostic/therapeutic LA-NSCLC management was sent to 1,478 e-mail addresses that belonged to pneumologists, thoracic surgeons, and radiation and medical oncologists. 421 answers were analyzed: 176 radiation oncologists, 86 medical oncologists, 92 pneumologists, 64 thoracic surgeons and 3 other specialists. More than a half of the respondents had been practicing for >10 years after completing residency training. Some discrepancies were observed in clinical LA-NSCLC management: the lack of a regularly planned multidisciplinary tumor board, the use of upfront surgery in multistation stage IIIA, and territorial diffusion of cCRT in unresectable LA-NSCLC. Our analysis demonstrated good compliance with international guidelines in the diagnostic workup of LA-NSCLC. We observed a relationship between high clinical experience and good clinical practice. A multidisciplinary approach is mandatory for managing LA-NSCLC.
Klíčová slova:
Cancer detection and diagnosis – Cancer treatment – Diagnostic medicine – Lung and intrathoracic tumors – Non-small cell lung cancer – Oncology – Physicians – Surgical and invasive medical procedures
Zdroje
1. Aupérin A, Le Péchoux C, Rolland E, Curran WJ, Furuse K, Fournel P et al. Meta-analysis of concomitant versus sequential radiochemotherapy in locally advanced non-small-cell lung cancer. J Clin Oncol. 2010;28(13):2181–90. doi: 10.1200/JCO.2009.26.2543 20351327
2. Glatzer M, Elicin O, Ramella S, Nestle U, Putora PM. Radio(chemo)therapy in locally advanced nonsmall cell lung cancer. Eur Respir Rev 2016; 25: 65–70. doi: 10.1183/16000617.0053-2015 26929423
3. Dillman RO, Seagren SL, Propert KJ, Guerra J, Eaton WL, Perry MC et al. A randomized trial of induction chemotherapy plus high-dose radiation versus radiation alone in stage III non-small-cell lung cancer. N Engl J Med 1990; 323: 940–945. doi: 10.1056/NEJM199010043231403 2169587
4. O’Rourke N, Roqué I Figuls M, Farré Bernadó N, Macbeth F. Concurrent chemoradiotherapy in non-small cell lung cancer. Cochrane Database Syst Rev 2010; 6: CD002140.
5. Bradley JD, Paulus R, Komaki R, Masters G, Blumenschein G, Schild S et al. Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage IIIA or IIIB non-small-cell lung cancer (RTOG 0617): a randomised, two-by-two factorial phase 3 study. Lancet Oncol 2015; 16: 187–199. doi: 10.1016/S1470-2045(14)71207-0 25601342
6. Non-small Cell Lung Cancer Collaborative Group. Chemotherapy in non-small cell lung cancer. A meta-analysis using updated data on individual patients from 52 randomised clinical trials. BMJ. 1995;311:899–909. [no author listed] 7580546
7. Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R et al. Durvalumab after Chemoradiotherapy in Stage III Non–Small-Cell Lung Cancer. N Engl J Med. 2017;377(20):1919–1929. doi: 10.1056/NEJMoa1709937 28885881
8. Antonia SJ, Villegas A, Daniel D, Vicente D, Murakami S, Hui R et al. Overall Survival with Durvalumab after Chemoradiotherapy in Stage III NSCLC. N Engl J Med. 2018;379(24):2342–2350. doi: 10.1056/NEJMoa1809697 30280658
9. De Leyn P, Dooms C, Kuzdzal J, Lardinois D, Passlick B, Rami-Porta R et al. Revised ESTS guidelines for preoperative mediastinal lymph node staging for non-small-cell lung cancer. Eur J Cardiothorac Surg. 2014;45(5):787–98. doi: 10.1093/ejcts/ezu028 24578407
10. Adams K, Shah PL, Edmonds L, Lim E. Test performance of endobronchial ultrasound and transbronchial needle aspiration biopsy for mediastinal staging in patients with lung cancer: systematic review and meta-analysis. Thorax 2009;64:757–62. doi: 10.1136/thx.2008.109868 19454408
11. Chandra S, Nehra M, Agarwal D, Mohan A. Diagnostic accuracy of endobronchial ultrasound-guided transbronchial needle biopsy in mediastinal lymphadenopathy: a systematic review and meta-analysis. Respir Care 2012;57:384–91. doi: 10.4187/respcare.01274 22004665
12. Postmus PE, Kerr KM, Oudkerk M, Senan S, Waller DA, Vansteenkiste J et al. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017;28(suppl_4):iv1–iv21. doi: 10.1093/annonc/mdx222 28881918
13. Bilfinger TV, Albano D, Perwaiz M, Keresztes R, Nemesure B et al. Survival Outcomes Among Lung Cancer Patients Treated Using a Multidisciplinary Team Approach. Clin Lung Cancer. 2018;19:346–351. doi: 10.1016/j.cllc.2018.01.006 29506890
14. Crawford SM. Multidisciplinary team working contributes to lung cancer survival. BMJ. 2018;361:k1904. doi: 10.1136/bmj.k1904 29925606
15. Campbell BA, Ball D, Mornex F. Multidisciplinary lung cancer meetings: improving the practice of radiation oncology and facing future challenges. Respirology. 2015;20:192–8. doi: 10.1111/resp.12459 25581058
16. Albain KS, Swann RS, Rusch VW, Turrisi AT 3rd, Shepherd FA, Smith C, et al. Radiotherapy plus chemotherapy with or without surgical resection for stage III non-small-cell lung cancer: a phase III randomised controlled trial. Lancet 2009; 374: 379–386. doi: 10.1016/S0140-6736(09)60737-6 19632716
17. Pless M, Stupp R, Ris HR, Stahel RA, Weder W, Thierstein S et al. Induction chemoradiation in stage IIIA/ N2 non-small-cell lung cancer: a phase 3 randomised trial. Lancet 2015; 386: 1049–1056. doi: 10.1016/S0140-6736(15)60294-X 26275735
18. Eberhardt WE, Pottgen C, Gauler TC, Friedel G, Veit S, Heinrich V et al. Phase III study of surgery versus definitive concurrent chemoradiotherapy boost in patients with resectable stage IIIA(N2) and selected IIIB non–small-cell lung cancer after induction chemotherapy and concurrent chemoradiotherapy (ESPATUE). J Clin Oncol 2015; 33: 4194–4201. doi: 10.1200/JCO.2015.62.6812 26527789
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PLOS One
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