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Neoadjuvant in lung cancer

Alex Herskovic, Bhargava Chitti, Paul Christos, A Gabriella Wernicke, Bhupesh Parashar
OBJECTIVES: Limited work, either retrospective or prospective, has been done to investigate whether or not there is a cause-specific mortality (CSM) or all-cause mortality (ACM) benefit to adding surgery following neoadjuvant treatment for Stage IIIB NSCLC. METHODS: We extracted patients with Stage IIIB NSCLC from the Survival, Epidemiology, and End Results Program (SEER) database treated from 2004 to 2012 with either radiation alone or radiation followed by surgery...
October 14, 2016: World Journal of Surgery
Sarah J Gao, Christopher D Corso, Elyn H Wang, Justin D Blasberg, Frank C Detterbeck, Daniel J Boffa, Roy H Decker, Anthony W Kim
INTRODUCTION: A subset of patients with potentially resectable clinical stage IIIA non-small cell lung cancer (NSCLC) are managed with trimodality therapy. However, little data exist to guide the timing of surgery after neoadjuvant therapy. This study examined whether the time interval between neoadjuvant chemoradiation (NCRT) and surgical resection impacts overall survival. METHODS: Clinical stage IIIA disease (T1-3 N2) NSCLC patients who underwent neoadjuvant chemoradiation therapy were identified in the National Cancer Data Base (NCDB) between 2004-2012 and categorized based on the interval between chemoradiation and surgery (0 to ≤3, 3 to ≤6, 6 to ≤9, and 9 to ≤12 weeks)...
October 5, 2016: Journal of Thoracic Oncology
Alfredo Navigante, Pablo Cresta Morgado
PURPOSE OF REVIEW: We discuss the principal issues about physical activity in advanced cancer patients through the analyses of the last articles and our experience in this field. RECENT FINDINGS: The efficacy of exercise training intervention could improve quality of life (QOL), fatigue and well being in advanced cancer patients. Several published studies have included, nevertheless, patients with early stage of disease and more recently, populations of patients with local advanced tumors of the breast, rectum and lung, who are undergoing neoadjuvant therapy...
September 28, 2016: Current Opinion in Supportive and Palliative Care
Zihui Tan, Xu Zhang, Xinye Wang, Jianhua Fu
OBJECTIVE: To evaluate the feasibility, safety and short-term clinical outcomes of robot-assisted minimally invasive esophagectomy (RAMIE). METHODS: Clinical data of 17 patients with esophageal cancer who received RAMIE between April 2016 and July 2016 were analyzed retrospectively. RESULTS: The age of the patients ranged from 44 to 83. Six patients received neoadjuvant radiochemotherapy while 11 patients underwent surgery alone. All patients were performed by the robot-assisted thoraco-laparoscopic minimally invasive esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Shan Xian Guo, Yan Jian, Ying Lan Chen, Yun Cai, Qing Yuan Zhang, Fang Fang Tou
Neoadjuvant Chemotherapy has been used for the stage III of non-small cell lung cancer (NSCLC) and has shown good clinical effects. However, the survival benefits of radiation therapy added in induction regimens remains controversial. We therefore conducted a meta-analysis of the published clinical trials to quantitatively evaluate the benefit of preoperative chemoradiotherapy. After searching the database of Pubmed, CNKI, EMBASE, ESMO, The Cochrane Library databases, The American Society of Clinical Oncology and Clinical Trials...
September 28, 2016: Scientific Reports
S Gao, C D Corso, E H Wang, J Blasberg, D Boffa, F C Detterbeck, A W Kim
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
S Appel, J D Goldstein, Z Symon, Y Lawrence, J Bar, T Rabin, M Ben Ayun, T Davidson, A Ben Nun
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Margaret M Monette, Rodney T Harney, Melanie S Morris, Daniel I Chu
INTRODUCTION: One of the most common late complications following stoma construction is prolapse. Although the majority of prolapse can be managed conservatively, surgical revision is required with incarceration/strangulation and in certain cases laparotomy and/or stoma reversal are not appropriate. This report will inform surgeons on safe and effective approaches to revising prolapsed stomas using local techniques. PRESENTATION OF CASE: A 58 year old female with an obstructing rectal cancer previously received a diverting transverse loop colostomy...
November 2016: Annals of Medicine and Surgery
David Jonathan Heineman, Martijn Geert Ten Berge, Johannes Marlene Daniels, Michaël Ignatius Versteegh, Perla Jacqueline Marang-van de Mheen, Michael Wilhelmus Wouters, Wilhelmina Hendrika Schreurs
BACKGROUND: Clinical staging of non-small cell lung cancer (NSCLC) determines the initial treatment offered to a patient. The similarity between clinical and pathologic staging in some studies is as low as 50%, and others publish results as high as 91%. The Dutch Lung Surgery Audit is a clinical database that registers the clinical and pathologic TNM of almost all NSCLC patients who undergo operations in the Netherlands. The objective of this study was to determine the accuracy of clinical staging of NSCLC...
September 21, 2016: Annals of Thoracic Surgery
José M Borro, Francisco Regueiro, Sonia Pértega, Manuel Constenla, Salvador Pita
INTRODUCTION: Video-assisted thoracoscopic surgery has become the technique of choice in the early stages of lung cancer in many centers although there is no evidence that all of the surgical approaches achieve the same long-term survival. METHOD: We carried out a retrospective review of 276 VATS lobectomies performed in our department, analyzing age, sex, comorbidities, current smoker, FEV1 and FCV, surgical approach, TNM and pathological stage, histologic type, neoadjuvant or coadjuvant chemotherapy, relapse and metastasis time, with the main aim of evaluating the survival rate and disease-free time, especially with regard to the two/three versus single port approach...
September 7, 2016: Archivos de Bronconeumología
Yue-Can Zeng, Shilpa Vyas, Quang Dang, Lindsay Schultz, Stephen R Bowen, Veena Shankaran, Farhood Farjah, Brant K Oelschlager, Smith Apisarnthanarax, Jing Zeng
PURPOSE: The aim of this study is to present the dosimetry, feasibility, and preliminary clinical results of a novel pencil beam scanning (PBS) posterior beam technique of proton treatment for esophageal cancer in the setting of trimodality therapy. METHODS: From February 2014 to June 2015, 13 patients with locally advanced esophageal cancer (T3-4N0-2M0; 11 adenocarcinoma, 2 squamous cell carcinoma) were treated with trimodality therapy (neoadjuvant chemoradiation followed by esophagectomy)...
September 5, 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Jason B Liu, Karl Y Bilimoria, Katherine Mallin, David P Winchester
BACKGROUND: Although strong volume-outcome relationships exist for many cancer operations, patients continue to undergo these operations at low-volume hospitals. METHODS: Patients were identified from the National Cancer Data Base from 2010-2013 who underwent resection for bladder, breast, esophagus, lung, pancreas, rectum, and stomach cancers. Low-volume hospitals were defined as those in the bottom quartile by surgical volume for each cancer type separately. Logistic regression models were constructed to assess patient-level factors associated with undergoing cancer surgery at low-volume hospitals across cancer types while controlling for tumor characteristics...
August 30, 2016: Surgery
Joshua K Sabari, Jamie E Chaft
Despite broad advances in molecularly targeted therapies, lung cancer remains the leading cause of cancer related mortality in the United States. Epidermal growth factor receptor (EGFR) mutations occur in approximately 17% of advanced non-small cell lung cancer (NSCLC) in the US population. The remarkable efficacy of small-molecule EGFR tyrosine kinase inhibitors (TKIs) in this unique subset of patients has revolutionized the therapeutic approach to lung cancer. The success of these agents in the metastatic setting leads to the logical question of what role these drugs may have in the adjuvant setting for patients with earlier stage disease...
August 2016: Annals of Translational Medicine
Xiaoliang Zhao, Yanjun Su, Jian You, Liqun Gong, Zhenfa Zhang, Meng Wang, Zhenqing Zhao, Zhen Zhang, Xiaolin Li, Changli Wang
To evaluate the safety and efficacy of combining Endostar antiangiogenic therapy with neoadjuvant chemotherapy for the treatment of stage IIIA (N2) NSCLC, we conducted a randomized, controlled, open-label clinical study of 30 NSCLC patients. Patients were randomly assigned to the test or control groups, which received either two cycles of an NP neoadjuvant chemotherapy regimen combined with Endostar or the NP regimen alone, respectively, at a 2:1 ratio. Efficacy was assessed after 3 weeks, and surgical resection occurred within 4 weeks, in the 26 patients who successfully completed treatment...
August 23, 2016: Oncotarget
Zhengbo Song, Xinmin Yu, Yiping Zhang
OBJECTIVE: Programmed death-ligand 1 (PD-L1) is known to be over-expressed in non-small cell lung cancer (NSCLC). However, the impact of chemotherapy on the altered status of PD-L1 expression has not been examined for NSCLC. The present study was intended to examine the impact of neoadjuvant chemotherapy on PD-L1 expression and its prognostic significance in lung squamous cell carcinoma (SCC). PATIENTS AND METHODS: Matched tumor samples were obtained from 76 SCC patients prior to and after neoadjuvant chemotherapy...
September 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Chen-Ping Hsieh, Ming-Ju Hsieh, Ching-Feng Wu, Jui-Ying Fu, Yun-Hen Liu, Yi-Cheng Wu, Cheng-Ta Yang, Ching-Yang Wu
BACKGROUND: Lung cancer is the leading cause of cancer deaths in the world, and more and more treatment modalities have been introduced in order to improve patients' survival. For patients with advanced non-small cell lung cancer (NSCLC), survival prognosis is poor and multimodality neoadjuvant therapies are given to improve patients' survival. However, the possibility of occult metastases may lead to discrepancy between clinical and pathologic staging and underestimation of the disease severity...
July 2016: Journal of Thoracic Disease
Maria Angela Gosein, Dylan Narinesingh, Cemonne Ann-Alicia Celeste Nixon, Sanjeeva Reddy Goli, Paramanand Maharaj, Alexander Sinanan
BACKGROUND: Cowden syndrome is an autosomal dominant disorder with a predisposition to multiple benign and malignant tumors. In our patient, in addition to breast and endometrial malignancies as well as facial trichilemmomas, she was noted to have multiple meningiomas, pancreatic lipomas and lung cysts. These latter lesions have been noted in previous Cowden syndrome case reports, but are not included in the diagnostic criteria at this time. To our knowledge, this is the first case of multiple meningiomas in this syndrome...
2016: BMC Research Notes
Nicolas Paleiron, Olivier Bylicki, Michel André, Emilie Rivière, Frederic Grassin, Gilles Robinet, Christos Chouaïd
Targeted therapies have markedly improved the management of patients with advanced non-small-cell lung cancer (NSCLC), but their efficacy in localized NSCLC is less well established. The aim of this review is to analyze trials of targeted therapies in localized NSCLC. In patients with wild-type EGFR, tyrosine kinase inhibitors have shown no efficacy in Phase III trials. Few data are available for EGFR-mutated localized NSCLC, as routine biological profiling is not recommended. Available studies are small, often retrospectives, and/or conducted in a single-center making it difficult to draw firm conclusions...
2016: OncoTargets and Therapy
Maria C De Santis, Luigia Nardone, Barbara Diletto, Roberta Canna, Michela Dispinzieri, Lorenza Marino, Laura Lozza, Vincenzo Valentini
OBJECTIVE: After breast conservative surgery (BCS) and whole-breast radiotherapy (WBRT), the use of boost irradiation is recommended especially in patients at high risk. However, the standard technique and the definition of the boost volume have not been well defined. METHODS: We retrospectively compared an anticipated pre-operative photon boost on the tumour, administered with low-dose fractionated radiotherapy, and neoadjuvant chemotherapy with two different sequential boost techniques, administered after BCS and standard adjuvant WBRT: (1) a standard photon beam (2) and an electron beam technique on the tumour bed of the same patients...
October 2016: British Journal of Radiology
Thomas Bilfinger, Roger Keresztes, Denise Albano, Barbara Nemesure
BACKGROUND Five-year survival rates among stage IIIA lung cancer patients range between 2% and 15%, and there is currently no consensus regarding optimal treatment approaches for these patients. The current investigation evaluated survival outcomes among stage IIIA lung cancer patients receiving 2 different treatment modalities, neoadjuvant chemotherapy followed by resection versus chemoradiation alone. MATERIAL AND METHODS This retrospective study is based on 127 patients attending the Lung Cancer Evaluation Center at Stony Brook Cancer Center between 2002 and 2014...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
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