Role of Postoperative Radiotherapy in the Management for Resected NSCLC – Decision Criteria in Clinical Routine Pre- and Post-LungART

Autor: Ben J. Slotman, Nicolaus Andratschke, Paul Van Houtte, Cécile Le Péchoux, Paul Martin Putora, Rafal Dziadziuszko, Dirk De Ruysscher, Esther G.C. Troost, José Belderbos, Ursula Nestle, Fiona McDonald, Joachim Widder, Umberto Ricardi, X. Geets, Markus Glatzer, Sara Ramella, Matthias Guckenberger, Yolande Lievens, Karin Dieckmann, Farkhad Manapov, Krisztian Süveg, Christoph Pöttgen, Stéphanie Peeters, Corinne Faivre-Finn
Přispěvatelé: UCL - SSS/IREC/MIRO - Pôle d'imagerie moléculaire, radiothérapie et oncologie, UCL - (SLuc) Centre du cancer, UCL - (SLuc) Service de radiothérapie oncologique, Radiation Oncology, CCA - Cancer Treatment and quality of life, University of Zurich, Süveg, Krisztian, RS: GROW - R3 - Innovative Cancer Diagnostics & Therapy, Radiotherapie
Jazyk: angličtina
Rok vydání: 2021
Předmět:
Cancer Research
Lung Neoplasms
SURGERY
medicine.medical_treatment
Medizin
NSCLC
Port (medical)
Carcinoma
Non-Small-Cell Lung
CANCER NSCLC
Decision tree
Adjuvant
Decision-making
Radiotherapy
Humans
Induction Chemotherapy
Interviews as Topic
Oncologists
Qualitative Research
Decision Support Techniques
Radiotherapy
Adjuvant
EPIDEMIOLOGY
1306 Cancer Research
Stage (cooking)
Non-Small-Cell Lung
610 Medicine & health
INTERCURRENT DISEASE
CHEMOTHERAPY
Multiple-criteria decision analysis
10044 Clinic for Radiation Oncology
STAGE-IIIA
Oncology
Resection margin
SURVIVAL
2730 Oncology
Pulmonary and Respiratory Medicine
medicine.medical_specialty
medicine
Lung cancer
METAANALYSIS
HODGKINS-DISEASE
Performance status
business.industry
General surgery
Carcinoma
INDIVIDUAL PATIENT DATA
Induction chemotherapy
medicine.disease
Radiation therapy
2740 Pulmonary and Respiratory Medicine
business
Zdroj: Süveg, K, le Pechoux, C, Faivre-Finn, C, Putora, P M, de Ruysscher, D, Widder, J, van Houtte, P, Troost, E G C, Slotman, B J, Ramella, S, Pöttgen, C, Peeters, S T H, Nestle, U, McDonald, F, Dziadziuszko, R, Belderbos, J, Ricardi, U, Manapov, F, Lievens, Y, Geets, X, Dieckmann, K, Guckenberger, M, Andratschke, N & Glatzer, M 2021, ' Role of Postoperative Radiotherapy in the Management for Resected NSCLC – Decision Criteria in Clinical Routine Pre-and Post-LungART ', Clinical Lung Cancer, vol. 22, no. 6, pp. 579-586 . https://doi.org/10.1016/j.cllc.2021.08.007
Clinical lung cancer, Vol. 22, no.6, p. 579-586 (2021)
Clinical Lung Cancer, 22(6), 579-586. Elsevier
Clinical Lung Cancer 22(2021)6, 579-586
Clinical Lung Cancer, 22(6), 579-586. CIG Media Group, L.P.
ISSN: 1525-7304
DOI: 10.1016/j.cllc.2021.08.007
Popis: The role of postoperative radiation therapy (PORT) in stage III N2 nonsmall cell lung cancer patients remains controversial. PORT is still widely used among European thoracic radiation oncology experts with a clear decrease in its use for patients with completely resected pN+ NSCLC after the presentation of LungART trial results at ESMO 2020. The full publication of the LungART trial hopefully will shed additional light on the dilemma of the decision-making process for PORT in completely resected pN+ patients and identify the appropriate patients who might benefit from PORT.Background: The role of postoperative radiation therapy (PORT) in stage III N2 NSCLC is controversial. We analyzed decision-making for PORT among European radiation oncology experts in lung cancer. Methods: Twenty-two experts were asked before and after presentation of the results of the LungART trial to describe their decision criteria for PORT in the management of pN+ NSCLC patients. Treatment strategies were subsequently converted into decision trees and analyzed. Results: Following decision criteria were identified: extracapsular nodal extension, incomplete lymph node resection, multistation lymph nodes, high nodal tumor load, poor response to induction chemotherapy, ineligibility to receive adjuvant chemotherapy, performance status, resection margin, lung function and cardiopulmonary comorbidities. The LungART results had impact on decision-making and reduced the number of recommendations for PORT. The only clear indication for PORT was a R1/2 resection. Six experts out of ten who initially recommended PORT for all R0 resected pN2 patients no longer used PORT routinely for these patients, while four still recommended PORT for all patients with pN2. Fourteen experts used PORT only for patients with risk factors, compared to eleven before the presentation of the LungART trial. Four experts stated that PORT was never recommended in R0 resected pN2 patients regardless of risk factors. Conclusion: After presentation of the LungART trial results at ESMO 2020, 82% of our experts still used PORT for stage III pN2 NSCLC patients with risk factors. The recommendation for PORT decreased, especially for patients without risk factors. Cardiopulmonary comorbidities became more relevant in the decision-making for PORT. (C) 2021 Elsevier Inc. All rights reserved.
Databáze: OpenAIRE
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