Stage III N2 non-small cell lung cancer treatment: decision-making among surgeons and radiation oncologists
| Autor: | Rolf Inderbitzi, Alexandros Papachristofilou, Francesca Caparrotti, Peter Kestenholz, Dirk Wagnetz, Paul Martin Putora, Hans Gelpke, André Dutly, Daniel R. Zwahlen, Markus Furrer, Mahmut Ozsahin, Thorsten Krueger, Peter Kraxner, Matthias Guckenberger, Isabelle Opitz, Stefano Cafarotti, Markus Glatzer, Jürg Heuberger, Pawel Leskow, Kathrin Zaugg, Olgun Elicin, Christoph Oehler, Francesco Martucci, Gregor J. Kocher, Franco Gambazzi, Wolfram Karenovics |
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| Přispěvatelé: | University of Zurich, Glatzer, Markus |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Oncology
medicine.medical_specialty Original Article on Radiotherapy in Thoracic Malignancies 10255 Clinic for Thoracic Surgery medicine.medical_treatment non-small cell lung cancer (NSCLC) Non-small cell lung cancer (NSCLC) 610 Medicine & health Disease ddc:616.0757 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Stage (cooking) Stage III N2 lung cancer Lung cancer ddc:617 Radiotherapy business.industry Immunotherapy medicine.disease 10044 Clinic for Radiation Oncology Radiation therapy 030228 respiratory system 030220 oncology & carcinogenesis Mediastinal lymph node Surgery 2730 Oncology business Adjuvant Decision-making |
| Zdroj: | Transl Lung Cancer Res Glatzer, Markus; Leskow, Pawel; Caparrotti, Francesca; Elicin, Olgun; Furrer, Markus; Gambazzi, Franco; Dutly, André; Gelpke, Hans; Guckenberger, Matthias; Heuberger, Jürg; Inderbitzi, Rolf; Cafarotti, Stefano; Karenovics, Wolfram; Kestenholz, Peter; Kocher, Gregor; Kraxner, Peter; Krueger, Thorsten; Martucci, Francesco; Oehler, Christoph; Ozsahin, Mahmut; ... (2021). Stage III N2 non-small cell lung cancer treatment: decision-making among surgeons and radiation oncologists. Translational lung cancer research, 10(4), pp. 1960-1968. AME Publishing 10.21037/tlcr-20-1210 Translational lung cancer research, Vol. 10, No 4 (2021) pp. 1960-1968 |
| ISSN: | 2218-6751 |
| Popis: | Background Stage III N2 non-small cell lung cancer (NSCLC) is a very heterogeneous disease associated with a poor prognosis. A number of therapeutic options are available for patients with Stage III N2 NSCLC, including surgery [with neoadjuvant or adjuvant chemotherapy (CTx)/neoadjuvant chemoradiotherapy (CRT)] or CRT potentially followed by adjuvant immunotherapy. We have no clear evidence demonstrating a significant survival benefit for either of these approaches, the selection between treatments is not always straightforward and can come down to physician and patient preference. The very heterogeneous definition of resectability of N2 disease makes the decision-making process even more complex. Methods We evaluated the treatment strategies for preoperatively diagnosed stage III cN2 NSCLC among Swiss thoracic surgeons and radiation oncologists. Treatment strategies were converted into decision trees and analysed for consensus and discrepancies. We analysed factors relevant to decision-making within these recommendations. Results For resectable "non-bulky" mediastinal lymph node involvement, there was a trend towards surgery. Numerous participants recommend a surgical approach outside existing guidelines as long as the disease was resectable, even in multilevel N2. With increasing extent of mediastinal nodal disease, multimodal treatment based on radiotherapy was more common. Conclusions Both, surgery- or radiotherapy-based treatment regimens are feasible options in the management of Stage III N2 NSCLC. The different opinions reflected in the results of this manuscript reinforce the importance of a multidisciplinary setting and the importance of shared decision-making with the patient. |
| Databáze: | OpenAIRE |
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