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By Alessandro Franciscon doctor
G A Turgeon, L Souhami, N Kopek, V Hirsh, L Ofiara, S L Faria
PURPOSE: Many Canadian institutions treat limited-disease small cell lung cancer with 40Gy in 15 fractions delivered once-a-day in 3weeks concomitantly with chemotherapy. This regimen is convenient and seems to be effective. Here, we report and compare with a literature review the outcomes of patients with limited-stage small cell lung cancer treated in our institution with this hypofractionated regimen. PATIENTS AND METHODS: From January 2004 to December 2012, patients with limited-stage small cell lung cancer treated curatively with platinum-based chemotherapy and concurrent thoracic radiotherapy at a dose of 40Gy in 16 fractions once-a-day were eligible for this review...
April 2017: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Andrew Warner, Max Dahele, Bo Hu, David A Palma, Suresh Senan, Cary Oberije, Kayoko Tsujino, Marta Moreno-Jimenez, Tae Hyun Kim, Lawrence B Marks, Ramesh Rengan, Luigi De Petris, Sara Ramella, Kim De Ruyck, Núria Rodriguez De Dios, Jeffrey D Bradley, George Rodrigues
PURPOSE: Concurrent chemoradiation therapy (con-CRT) is recommended for fit patients with locally advanced non-small cell lung cancer (LA-NSCLC) but is associated with toxicity, and observed survival continues to be limited. Identifying factors associated with early mortality could improve patient selection and identify strategies to improve prognosis. METHODS AND MATERIALS: Analysis of a multi-institutional LA-NSCLC database consisting of 1245 patients treated with con-CRT in 13 institutions was performed to identify factors predictive of 180-day survival...
March 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Michael Thomas, Christian Rübe, Petra Hoffknecht, Hans N Macha, Lutz Freitag, Albert Linder, Norman Willich, Michael Hamm, Gerhard W Sybrecht, Dieter Ukena, Karl-Matthias Deppermann, Cornelia Dröge, Dorothea Riesenbeck, Achim Heinecke, Cristina Sauerland, Klaus Junker, Wolfgang E Berdel, Michael Semik
BACKGROUND: Preoperative chemotherapy improves survival in patients with stage III non-small-cell lung cancer (NSCLC) amenable to resection. We aimed to assess the additional effect of preoperative chemoradiation on tumour resection, pathological response, and survival in these patients. METHODS: Between Oct 1, 1995, and July 1, 2003, patients with stage IIIA-IIIB NSCLC and invasive mediastinal assessment from 26 participating institutions of the German Lung Cancer Cooperative Group (GLCCG) were randomly assigned to one of two treatment groups...
July 2008: Lancet Oncology
Xiangpeng Zheng, Matthew Schipper, Kelley Kidwell, Jules Lin, Rishindra Reddy, Yanping Ren, Andrew Chang, Fanzhen Lv, Mark Orringer, Feng-Ming Spring Kong
PURPOSE: This study compared treatment outcomes of stereotactic body radiation therapy (SBRT) with those of surgery in stage I non-small cell lung cancer (NSCLC). METHODS AND MATERIALS: Eligible studies of SBRT and surgery were retrieved through extensive searches of the PubMed, Medline, Embase, and Cochrane library databases from 2000 to 2012. Original English publications of stage I NSCLC with adequate sample sizes and adequate SBRT doses were included. A multivariate random effects model was used to perform a meta-analysis to compare survival between treatments while adjusting for differences in patient characteristics...
November 1, 2014: International Journal of Radiation Oncology, Biology, Physics
Miklos Pless, Roger Stupp, Hans-Beat Ris, Rolf A Stahel, Walter Weder, Sandra Thierstein, Marie-Aline Gerard, Alexandros Xyrafas, Martin Früh, Richard Cathomas, Alfred Zippelius, Arnaud Roth, Milorad Bijelovic, Adrian Ochsenbein, Urs R Meier, Christoph Mamot, Daniel Rauch, Oliver Gautschi, Daniel C Betticher, René-Olivier Mirimanoff, Solange Peters
BACKGROUND: One of the standard options in the treatment of stage IIIA/N2 non-small-cell lung cancer is neoadjuvant chemotherapy and surgery. We did a randomised trial to investigate whether the addition of neoadjuvant radiotherapy improves outcomes. METHODS: We enrolled patients in 23 centres in Switzerland, Germany and Serbia. Eligible patients had pathologically proven, stage IIIA/N2 non-small-cell lung cancer and were randomly assigned to treatment groups in a 1:1 ratio...
September 12, 2015: Lancet
Jean-Yves Douillard, Rafael Rosell, Mario De Lena, Marcello Riggi, Patrick Hurteloup, Marc-Andre Mahe
PURPOSE: To study the impact of postoperative radiation therapy (PORT) on survival in the Adjuvant Navelbine International Trialist Association (ANITA) randomized study of adjuvant chemotherapy. METHODS AND MATERIALS: ANITA is a randomized trial of adjuvant cisplatin and vinorelbine chemotherapy vs. observation in completely resected non-small-cell lung carcinoma (NSCLC) Stages IB to IIIA. Use of PORT was recommended for pN+ disease but was not randomized or mandatory...
November 1, 2008: International Journal of Radiation Oncology, Biology, Physics
Elizabeth M Gore, Kyounghwa Bae, Stuart J Wong, Alexander Sun, James A Bonner, Steven E Schild, Laurie E Gaspar, Jeffery A Bogart, Maria Werner-Wasik, Hak Choy
PURPOSE: This study was conducted to determine if prophylactic cranial irradiation (PCI) improves survival in locally advanced non-small-cell lung cancer (LA-NSCLC). PATIENTS AND METHODS: Patients with stage III NSCLC without disease progression after treatment with surgery and/or radiation therapy (RT) with or without chemotherapy were eligible. Participants were stratified by stage (IIIA v IIIB), histology (nonsquamous v squamous), and therapy (surgery v none) and were randomly assigned to PCI or observation...
January 20, 2011: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Panagiota Economopoulou, Giannis Mountzios
Central nervous system (CNS) metastases, including brain metastases (BM) and leptomeningeal metastases (LM) represent a frequent complication of non-small cell lung cancer (NSCLC). Patients with BM comprise a heterogeneous group, with a median survival that ranges from 3 to 14 months. However, in the majority of patients, the occurrence of CNS metastases is usually accompanied by severe morbidity and substantial deterioration in quality of life. Local therapies, such as whole brain radiotherapy (WBRT), stereotactic radiosurgery (SRS) or surgical resection, either alone or as part of a multimodality treatment are available treatment strategies for BM and the choice of therapy varies depending on patient group and prognosis...
December 2016: Translational Lung Cancer Research
Toshiaki Takahashi, Takeharu Yamanaka, Takashi Seto, Hideyuki Harada, Hiroshi Nokihara, Hideo Saka, Makoto Nishio, Hiroyasu Kaneda, Koichi Takayama, Osamu Ishimoto, Koji Takeda, Hiroshige Yoshioka, Motoko Tachihara, Hiroshi Sakai, Koichi Goto, Nobuyuki Yamamoto
BACKGROUND: Results from a previous phase 3 study suggested that prophylactic cranial irradiation reduces the incidence of symptomatic brain metastases and prolongs overall survival compared with no prophylactic cranial irradiation in patients with extensive-disease small-cell lung cancer. However, because of the absence of brain imaging before enrolment and variations in chemotherapeutic regimens and irradiation doses, concerns have been raised about these findings. We did a phase 3 trial to reassess the efficacy of prophylactic cranial irradiation in the treatment of extensive-disease small-cell lung cancer...
May 2017: Lancet Oncology
Dirk De Ruysscher, Madelon Pijls-Johannesma, Søren M Bentzen, André Minken, Rinus Wanders, Ludy Lutgens, Monique Hochstenbag, Liesbeth Boersma, Bradly Wouters, Guido Lammering, Johan Vansteenkiste, Philippe Lambin
PURPOSE: To identify time factors for combined chemotherapy and radiotherapy predictive for long-term survival of patients with limited-disease small-cell lung cancer (LD-SCLC). METHODS: A systematic overview identified suitable phase III trials. Using meta-analysis methodology to compare results within trials, the influence of the timing of chest radiation and the start of any treatment until the end of radiotherapy (SER) on local tumor control, survival, and esophagitis was analyzed...
March 1, 2006: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Dirk De Ruysscher, Corinne Faivre-Finn, Ursula Nestle, Coen W Hurkmans, Cécile Le Péchoux, Allan Price, Suresh Senan
PURPOSE: To derive recommendations for routine practice and clinical trials for techniques used in high-dose, high-precision thoracic radiotherapy for lung cancer. METHODS: A literature search was performed to identify published articles considered both clinically relevant and practical to use. Recommendations were categorized under the following headings: patient selection, patient positioning and immobilization, tumor motion, computed tomography and [18F]fluorodeoxyglucose-positron emission technology scanning, generating target volumes, radiotherapy treatment planning, treatment delivery, and scoring of response and toxicity...
December 20, 2010: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Wilfried Ernst Erich Eberhardt
No abstract text is available yet for this article.
February 20, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Kathy S Albain, R Suzanne Swann, Valerie W Rusch, Andrew T Turrisi, Frances A Shepherd, Colum Smith, Yuhchyau Chen, Robert B Livingston, Richard H Feins, David R Gandara, Willard A Fry, Gail Darling, David H Johnson, Mark R Green, Robert C Miller, Joanne Ley, Willliam T Sause, James D Cox
BACKGROUND: Results from phase II studies in patients with stage IIIA non-small-cell lung cancer with ipsilateral mediastinal nodal metastases (N2) have shown the feasibility of resection after concurrent chemotherapy and radiotherapy with promising rates of survival. We therefore did this phase III trial to compare concurrent chemotherapy and radiotherapy followed by resection with standard concurrent chemotherapy and definitive radiotherapy without resection. METHODS: Patients with stage T1-3pN2M0 non-small-cell lung cancer were randomly assigned in a 1:1 ratio to concurrent induction chemotherapy (two cycles of cisplatin [50 mg/m(2) on days 1, 8, 29, and 36] and etoposide [50 mg/m(2) on days 1-5 and 29-33]) plus radiotherapy (45 Gy) in multiple academic and community hospitals...
August 1, 2009: Lancet
A T Turrisi, K Kim, R Blum, W T Sause, R B Livingston, R Komaki, H Wagner, S Aisner, D H Johnson
BACKGROUND: For small-cell lung cancer confined to one hemithorax (limited small-cell lung cancer), thoracic radiotherapy improves survival, but the best ways of integrating chemotherapy and thoracic radiotherapy remain unsettled. Twice-daily accelerated thoracic radiotherapy has potential advantages over once-daily radiotherapy. METHODS: We studied 417 patients with limited small-cell lung cancer. All the patients received four 21-day cycles of cisplatin plus etoposide...
January 28, 1999: New England Journal of Medicine
Cécile Le Péchoux, Alexander Sun, Ben J Slotman, Dirk De Ruysscher, José Belderbos, Elizabeth M Gore
The incidence of brain metastases in patients with lung cancer has increased as a result of improved local and systemic control and better diagnosis from advances in brain imaging. Because brain metastases are responsible for life-threatening symptoms and serious impairment of quality of life, resulting in shortened survival, prophylactic cranial irradiation has been proposed in both small-cell lung cancer (SCLC) and non-small-cell lung cancer (NSCLC) to try to improve incidence of brain metastasis, survival, and eventually quality of life...
July 2016: Lancet Oncology
David Benjamin Shultz, Maximilian Diehn, Billy W Loo
Stereotactic ablative radiotherapy (SABR) is a highly effective treatment for early-stage non-small cell lung cancer. Although direct comparisons from randomized trials are not available, rates of both primary tumor control and distant metastasis are similar between SABR and surgery. Overall survival is lower after SABR compared with surgery, largely reflecting that a primary selection criterion for SABR has been medical inoperability because of decreased cardiopulmonary function and other comorbidities that lead to decreased survival independent of non-small cell lung cancer...
April 2015: Seminars in Radiation Oncology
Sue S Yom
Despite convincing evidence that the principles of accelerated repopulation would open up additional therapeutic opportunities in the treatment of advanced-stage non-small cell lung cancer, this strategy has been generally underexplored. The implementation of accelerated radiotherapy schedules has been hampered by logistical barriers, concerns about acute toxicity, and the prioritization of integrating concurrent chemotherapy into the standard treatment platform. At present, it is unclear to what extent accelerated fractionation will influence future treatment paradigms in non-small cell lung cancer, although technical advances in radiotherapy, allowing higher dose delivery with reduced toxicity, could permit the development of more convenient and tolerable forms of accelerated schedules...
April 2015: Seminars in Radiation Oncology
Ben J Slotman, Harm van Tinteren, John O Praag, Joost L Knegjens, Sherif Y El Sharouni, Matthew Hatton, Astrid Keijser, Corinne Faivre-Finn, Suresh Senan
BACKGROUND: Most patients with extensive stage small-cell lung cancer (ES-SCLC) who undergo chemotherapy, and prophylactic cranial irradiation, have persistent intrathoracic disease. We assessed thoracic radiotherapy for treatment of this patient group. METHODS: We did this phase 3 randomised controlled trial at 42 hospitals: 16 in Netherlands, 22 in the UK, three in Norway, and one in Belgium. We enrolled patients with WHO performance score 0-2 and confirmed ES-SCLC who responded to chemotherapy...
January 3, 2015: Lancet
Wilfried Ernst Erich Eberhardt, Christoph Pöttgen, Thomas Christoph Gauler, Godehard Friedel, Stefanie Veit, Vanessa Heinrich, Stefan Welter, Wilfried Budach, Werner Spengler, Martin Kimmich, Berthold Fischer, Heinz Schmidberger, Dirk De Ruysscher, Claus Belka, Sebastian Cordes, Rodrigo Hepp, Diana Lütke-Brintrup, Nils Lehmann, Martin Schuler, Karl-Heinz Jöckel, Georgios Stamatis, Martin Stuschke
PURPOSE: Concurrent chemoradiotherapy with or without surgery are options for stage IIIA(N2) non-small-cell lung cancer. Our previous phase II study had shown the efficacy of induction chemotherapy followed by chemoradiotherapy and surgery in patients with IIIA(N2) disease and with selected IIIB disease. Here, we compared surgery with definitive chemoradiotherapy in resectable stage III disease after induction. PATIENTS AND METHODS: Patients with pathologically proven IIIA(N2) and selected patients with IIIB disease that had medical/functional operability received induction chemotherapy, which consisted of three cycles of cisplatin 50 mg/m(2) on days 1 and 8 and paclitaxel 175 mg/m(2) on day 1 every 21 days, as well as concurrent chemoradiotherapy to 45 Gy given as 1...
December 10, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Charles M Rudin, Nofisat Ismaila, Christine L Hann, Narinder Malhotra, Benjamin Movsas, Kim Norris, M Catherine Pietanza, Suresh S Ramalingam, Andrew T Turrisi, Giuseppe Giaccone
PURPOSE: The American College of Chest Physicians (ACCP) produced an evidence-based guideline on treatment of patients with small-cell lung cancer (SCLC). Because of the relevance of this guideline to American Society of Clinical Oncology (ASCO) membership, ASCO reviewed the guideline, applying a set of procedures and policies used to critically examine guidelines developed by other organizations. METHODS: The ACCP guideline on the treatment of SCLC was reviewed for developmental rigor by methodologists...
December 1, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
2015-09-18 12:33:18
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