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Thoracic oncology

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https://www.readbyqxmd.com/read/28317123/motion-management-strategies-and-technical-issues-associated-with-stereotactic-body-radiotherapy-of-thoracic-and-upper-abdominal-tumors-a-review-from-nrg-oncology
#1
Edward D Brandner, Indrin J Chetty, Tawfik G Giaddui, Ying Xiao, M Saiful Huq
The efficacy of stereotactic body radiotherapy (SBRT) has been well demonstrated. However, it presents unique challenges for accurate planning and delivery especially in the lungs and upper abdomen where respiratory motion can be significantly confounding accurate targeting and avoidance of normal tissues. In this paper we review the current literature on SBRT for lung and upper abdominal tumors with particular emphasis on addressing respiratory motion and its affects. We provide recommendations on strategies to manage motion for different, patient specific situations...
March 20, 2017: Medical Physics
https://www.readbyqxmd.com/read/28298733/pitfalls-and-artifacts-in-the-interpretation-of-oncologic-pet-ct-of-the-chest
#2
Gustavo de Souza Portes Meirelles, Julia Capobianco, Marco Antônio Condé de Oliveira
PET/CT is widely used for the evaluation of patients with thoracic malignancies. Although the levels of (18)F-fluorodeoxyglucose (FDG) uptake are usually high in neoplastic diseases, they can also be physiological, due to artifacts. In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. Furthermore, some malignant tumors, such as adenocarcinoma in situ (formerly known as bronchoalveolar carcinoma) and carcinoid tumors, may not show FDG uptake. Here, we illustrate the main pitfalls and artifacts in the interpretation of the results of oncologic PET/CT of the chest, outlining strategies for avoiding misinterpretation...
January 2017: Radiologia Brasileira
https://www.readbyqxmd.com/read/28294667/-initial-experiences-with-vats-lobectomy
#3
Pál Gehér, Árpád Füredi, László István Kecskés, Béla Kiss
OBJECTIVE: The authors analyse the experience of videothoracoscopic (VATS) lung lobectomies performed since December 2010 at the Thoracic Surgery Department of Markusovszky University Teaching Hospital. PATIENTS AND METHOD: 78 patients (44 men and 34 women) underwent VATS lobectomy. The average age was 61.2 years ranging from 30 to 80. The indications were peripheral malignancy (35 cases) or the suspicion of that (43 cases), presence of curable distant metastasis was not considered as contraindication...
March 2017: Magyar Sebészet
https://www.readbyqxmd.com/read/28262299/high-risk-for-thoracotomy-but-not-thoracoscopic-lobectomy
#4
Laura L Donahoe, Moira de Valence, Eshetu G Atenafu, Waël C Hanna, Thomas K Waddell, Andrew F Pierre, Kazuhiro Yasufuku, Marc de Perrot, Marcelo Cypel, Shaf Keshavjee, Gail E Darling
BACKGROUND: Pulmonary lobectomy is the standard of care for resection of non-small cell lung cancer (NSCLC). Patients with compromised lung function who are considered high risk may be denied surgical treatment; thus, proper identification of those truly at high risk is critical. Video-assisted thoracic surgery (VATS) may reduce the operative risk. This study reviews our institutional experience of pulmonary lobectomy by open thoracotomy or VATS techniques in patients deemed to be high risk...
March 2, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28230245/ct-guided-percutaneous-hookwire-localization-increases-the-efficacy-and-safety-of-vats-for-pulmonary-nodules
#5
Theo J Klinkenberg, Lars Dinjens, Rienhart F E Wolf, Anthonie J van der Wekken, Caroline van de Wauwer, Geertruida H de Bock, Wim Timens, Massimo A Mariani, Harry J M Groen
BACKGROUND AND OBJECTIVES: The diagnosis of pulmonary nodules of unknown origin is challenging, and such nodules are not always suitable for transthoracic needle biopsy. With the advent of video assisted thoracic surgery (VATS) and CT-guided percutaneous hookwire localization (CT-PHL) we hypothesized that the combination of these two procedures will improve early diagnosis. METHODS: Selection criteria were a nodule not well approachable with fine needle biopsy and the therapeutic consequences of a diagnosis as assessed by the multidisciplinary oncology board...
February 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28210298/thoracic-oncology-hermes-european-curriculum-recommendations-for-training-in-thoracic-oncology
#6
REVIEW
Fernando Gamarra, Julie-Lyn Noël, Alessandro Brunelli, Anne-Marie C Dingemans, Enriqueta Felip, Mina Gaga, Bogdan Dragos Grigoriu, Georgia Hardavella, Rudolf M Huber, Samuel Janes, Gilbert Massard, Paul Martin Putora, Jean-Paul Sculier, Philipp A Schnabel, Sara Ramella, Dirk Van Raemdonck, Anne-Pascale Meert
Thoracic oncology HERMES: European curriculum recommendations for training in thoracic oncology http://ow.ly/mdqT300NHqO.
September 2016: Breathe
https://www.readbyqxmd.com/read/28161553/lower-incidence-of-esophagitis-in-the-elderly-undergoing-definitive-radiation-therapy-for-lung-cancer
#7
Payal D Soni, Philip S Boonstra, Matthew J Schipper, Latifa Bazzi, Robert T Dess, Martha M Matuszak, Feng-Ming Kong, James A Hayman, Randall K Ten Haken, Theodore S Lawrence, Gregory P Kalemkerian, Shruti Jolly
INTRODUCTION: Most patients with lung cancer are elderly and poorly represented in randomized clinical trials. They are often undertreated because of concerns about their ability to tolerate aggressive treatment. We tested the hypothesis that elderly patients undergoing definitive lung radiation might tolerate treatment differently than younger patients. METHODS: A total of 125 patients who underwent definitive lung radiotherapy were identified from a prospective institutional database (University of Michigan cohort)...
March 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28159404/-pd1-pd-l1-immunohistochemistry-in-thoracic-oncology-where-are-we
#8
Paul Hofman, Marius Ilié, Sandra Lassalle, Elodie Long, Coraline Bence, Catherine Butori, Véronique Hofman
The assays for the assessment of the PD-L1 status by immunohistochemistry are available in clinical studies in thoracic oncology to predict response to immunotherapies targeting the PD-1/PD-L1 pathway. With the arrival of this new class of molecules in second line and very soon in first line of treatment for patients with advanced or metastatic non-small cell lung cancer, these tests will certainly be required in routine once these new drugs will be granted marketing authorization. The rapid introduction of these "companion" or "complementary" tests seems essential to select patients to benefit from these effective but also expensive and sometimes toxic therapies...
February 2017: Annales de Pathologie
https://www.readbyqxmd.com/read/28156481/integrating-palliative-care-services-in-oncology-clinics-an-application-of-the-edmonton-symptom-assessment-system-esas
#9
Susanne Schmidt, Jessica Jones, Ifeoma Aduba, Laura LaNiel Tenner
168 Background: Research inpalliative care has shown improvements in overall survival, quality of life, symptom management, care satisfaction and reductions in the cost of care. Therefore, the American Society of Clinical Oncology has recommended early concurrent palliative care in patients with advanced cancer and with high symptom burden. Despite this recommendation, integrating palliative services at our NCI-designated cancer center has been challenging. The aims of this project were to quantitatively describe the symptom burden of patients in ambulatory oncology clinics; facilitate the establishment of an effective referral system by detecting discrepancies between symptom burden and referral practices; and improve the integration of palliative care services by implementing the Edmonton Symptom Assessment System (ESAS) tool into 5 of our oncology clinics...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28156476/assessment-of-the-relationship-between-three-cancer-survivor-well-being-tools
#10
Mary Jo Deprey, Stuart Chamovitz, Marty Jacobson, Kathleen Hall
74 Background: In 1999, the National Comprehensive Cancer Network issued guidelines for improving well-being of cancer survivors. Three tools, the Eastern Cooperative Oncology Group Performance Status (ECOGPS), the National Comprehensive Cancer Network Distress Thermometer (NCCNDT), and the Subjective Happiness Scale (SHS), are currently being used in a rural oncology survivorship clinic to assess patients' well-being. The question arose whether all three tools are necessary for adequate patient assessment...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152759/implementation-of-a-new-patient-health-questionnaire-into-standard-practice-in-outpatient-cancer-clinics-to-improve-patient-care-and-quality-of-treatment
#11
Catherine Brown, Andrea Perez-Cosio, Gursharan Gill, Mindy Liang, Geoffrey Liu
214 Background: Patient socio-demographic, lifestyle, and risk factor information at the Princess Margaret Cancer Centre (PM) is routinely collected for clinical purposes. The only standardized patient information presently being gathered in the outpatient cancer clinics at the PM is symptom management data, which is linked directly into the electronic medical records. Collecting and recording additional data can improve the quality of patient care, help identify risk factors, and guide treatment options. Our aim was to determine the feasibility of collecting this additional information in a clinical setting...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152712/application-of-a-standard-practice-based-system-to-measure-and-compare-quality-of-cancer-survivorship-care
#12
Katherine Ramsey Gilmore, Patricia Chapman, Paula A Lewis-Patterson, Maria Alma Rodriguez
239 Background: Despite the growing committment to improve survivorship care, measuring its quality remains difficult. In 2006, the American Society of Clinical Oncologists (ASCO) launched a practice-based system known as the Quality Oncology Practice Initiative (QOPI) to measure the quality of cancer care. Here, we demonstrate the use of QOPI procedures to compare compliance with survivorship care plans (SCPs) across different disease-specific clinics. METHODS: Measures based on survivorship clinical practice guidelines were abstracted from SCPs issued to survivors scheduled for appointments in site-specific clinics...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28149588/pemetrexed-induced-radiation-recall-dermatitis-in-a-patient-with-lung-adenocarcinoma-case-report-and-literature-review
#13
Jin Ge, Vivek Verma, Andrew Hollander, Corey Langer, Charles B Simone
Radiation recall dermatitis (RRD) is an inflammatory reaction in a previously irradiated field subsequent to the administration of pharmacologic or promoting agents. Herein, we describe a 47-year-old man with NSCLC who was treated with radiotherapy and pemetrexed-based chemotherapy three years prior to developing RRD upon resumption of pemetrexed-based chemotherapy. RRD with pemetrexed is rare and consists of five cases reported thus far. Although RRD is a rare phenomenon, it should be considered in any patient with dermatologic reactions that occur at the site of previous exposure to radiation therapy...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28149567/minimalist-video-assisted-thoracic-surgery-biopsy-of-mediastinal-tumors
#14
Federico Tacconi, Paola Rogliani, Benedetto Cristino, Francesco Gilardi, Leonardo Palombi, Eugenio Pompeo
BACKGROUND: Mediastinal tumors often require surgical biopsy to achieve a precise and rapid diagnosis. However, subjects with mediastinal tumors may be unfit for general anesthesia, particularly when compression of major vessels or airways does occur. We tested the applicability in this setting of a minimalist (M) uniportal, video-assisted thoracic surgery (VATS) strategy carried out under locoregional anesthesia in awake patients (MVATS). METHODS: We analyzed in a comparative fashion including propensity score matching, data from a prospectively collected database of patients who were offered surgical biopsy for mediastinal tumors through either MVATS or standard VATS...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28149553/the-impact-of-operative-approaches-on-outcomes-of-middle-and-lower-third-esophageal-squamous-cell-carcinoma
#15
Ju-Wei Mu, Shu-Geng Gao, Qi Xue, You-Sheng Mao, Da-Li Wang, Jun Zhao, Yu-Shun Gao, Jin-Feng Huang, Jie He
BACKGROUND: The aim of this study was to investigate the perioperative outcomes and 3-year overall survival (OS) of 2 approaches including Sweet and open Ivor Lewis esophagectomy in the surgical treatment of middle and lower third esophageal squamous cell carcinoma. METHODS: The medical records of 1,746 consecutive patients who underwent esophagectomy for middle and lower esophageal cancer between January 2009 and September 2015 at the First Department of Thoracic Oncologic Surgery of Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College were retrospectively reviewed...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28134011/the-year-in-thoracic-surgery
#16
Julissa E Jurado, Brendon Stiles
The past year has produced several important articles in the field of thoracic surgery, spanning many different diseases. Thoracic surgeons continue to investigate methods to perform complex operations and procedures less invasively, with the least possible morbidity to our patients. We also continue to critically evaluate new technology and procedures to ensure that they meet our rigorous standards for oncologic efficacy and for management of benign disease. Importantly, as we continue to evolve, thoracic surgeons have remained focused on optimizing processes of care, both inside and outside the operating room...
January 1, 2017: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28113017/cardiac-toxicity-after-radiotherapy-for-stage-iii-non-small-cell-lung-cancer-pooled-analysis-of-dose-escalation-trials-delivering-70-to-90-gy
#17
Kyle Wang, Michael J Eblan, Allison M Deal, Matthew Lipner, Timothy M Zagar, Yue Wang, Panayiotis Mavroidis, Carrie B Lee, Brian C Jensen, Julian G Rosenman, Mark A Socinski, Thomas E Stinchcombe, Lawrence B Marks
Purpose The significance of radiotherapy (RT) -associated cardiac injury for stage III non-small-cell lung cancer (NSCLC) is unclear, but higher heart doses were associated with worse overall survival in the Radiation Therapy Oncology Group (RTOG) 0617 study. We assessed the impact of heart dose in patients treated at our institution on several prospective dose-escalation trials. Patients and Methods From 1996 to 2009, 127 patients with stage III NSCLC (Eastern Cooperative Oncology Group performance status, 0 to 1) received dose-escalated RT to 70 to 90 Gy (median, 74 Gy) in six trials...
January 23, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28109369/successful-treatment-of-an-aggressive-tracheal-malignancy-with-immunotherapy
#18
Asishana A Osho, Christopher J Azzoli, Sara Pai, Mari Mino-Kenudson, William C Faquin, Tiffany G Huynh, Michael Lanuti, Douglas J Mathisen, Ashok Muniappan
Immune checkpoint inhibitors are emerging as therapeutic options for oncology patients in whom conventional treatment regimens have failed. These immunotherapies counteract tumor-induced tolerance and have been shown to be effective in thoracic malignancies, including non-small cell lung cancer (NSCLC). This report highlights the successful use of nivolumab-an immunotherapeutic agent that binds to proteins involved in T-cell proliferation-for the management of recurrent tracheal squamous cell cancer after exhaustion of conventional surgical, chemotherapeutic, and radiation therapy options...
February 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28096827/lung-exposure-during-simultaneous-myocardial-revascularization-and-lung-surgery-through-median-sternotomy
#19
Dariusz Jagielak, Radoslaw Kozaryn, Rafal Pawlaczyk, Piotr Siondalski, Witold Rzyman, Jan Rogowski
Coronary artery disease is a frequent comorbidity in patients undergoing major thoracic surgery. Simultaneous operations eliminate the necessity of a second operation and, more importantly, minimize the delay in compulsory postoperative oncological therapy. We describe a relaxing incision in the contralateral pericardium, which allows for simple displacement of the heart. This maneuver improves exposure of the pulmonary hilum and middle mediastinum on the side of resection.
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28087132/practice-patterns-of-thoracic-radiotherapy-for-extensive-stage-small-cell-lung-cancer-survey-of-us-academic-thoracic-radiation-oncologists
#20
Carl M Post, Vivek Verma, Timur Mitin, Charles B Simone
PURPOSE: Despite the recent CREST trial demonstrating a survival benefit to thoracic radiotherapy (TRT) for patients with extensive-stage small-cell lung cancer (ES-SCLC) with response to chemotherapy, as well as endorsement by current National Comprehensive Cancer Network guidelines, TRT may not be uniformly delivered in clinical practice across all circumstances. METHODS AND MATERIALS: We surveyed US academic thoracic radiation oncologists regarding their practice patterns for TRT and assessed conditions in which withholding TRT could be warranted...
December 22, 2016: Clinical Lung Cancer
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