scholarly journals Cancer Care Ontario and American Society of Clinical Oncology Adjuvant Chemotherapy and Adjuvant Radiation Therapy for Stages I-IIIA Resectable Non–Small-Cell Lung Cancer Guideline

2007 ◽  
Vol 3 (6) ◽  
pp. 332-335 ◽  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Adjuvant Chemotherapy ◽  
Small Cell Lung Cancer ◽  
Cancer Care ◽  
Small Cell ◽  
Adjuvant Radiation ◽  
Small Cell Lung ◽  
Adjuvant Radiation Therapy ◽  
American Society

scholarly journals SURG-04. Surgical resection of symptomatic brain metastasis in patients with non-small cell lung cancer irrespective from lesion count

2021 ◽  
Vol 3 (Supplement_3) ◽  
pp. iii24-iii24
Author(s):  
Stephanie T Jünger ◽  
David Reinecke ◽  
Anna-Katharina Meißner ◽  
Roland Goldbrunner ◽  
Stefan Grau
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Systemic Treatment ◽  
Small Cell ◽  
Adjuvant Radiation ◽  
Lesion Count ◽  
Small Cell Lung ◽  
Adjuvant Radiation Therapy ◽  
Adjuvant Systemic Treatment

Abstract Background and Purpose Current guidelines primarily suggest the resection in case of a limited number of brain metastases (BM). With an increasing number of local and systemic treatment options this approach needs reconsideration. Therefore, we aimed to evaluate the role of metastectomy in patients with non-small cell lung cancer (NSCLC) treated in a comprehensive setting disregarding lesion count. Patients and Methods In this monocentric retrospective analysis, patients receiving surgery for 1–3 BM with available demographic, clinical, and tumor-associated parameters were included. Prognostic factors for local control (LC) and overall survival (OS) were analyzed by Log rank test and Cox proportional hazards. Results Two-hundred-sixteen patients were included: 129 (59.7%) with single/solitary, 64 (29.6%) with 2–3, and 23 (10.6%) with more than three BM. Resection of the symptomatic BM(s) improved the patients’ Karnofsky performance index (KPI) significantly (p<0.001), enabling adjuvant radiotherapy in 199 (92.1%) and systemic treatment in 119 (55.1%) patients. After a mean radiological follow-up of eight (1–79) months, LC was observed in 83 (38.4%) patients and was not significantly influenced by BM count (p=0.064). After a mean OS after surgery of 12.7 (0–88) months, 120 (55.6%) patients had died. In univariate analysis, BM count showed no impact on OS (p=0.844), while age ≥/< 65 years (p=0.007), pre- and postoperative KPI ≥70 (p=0.002 and p=0.005, respectively), extra-cranial metastases (p=0.004), adjuvant radiation therapy (p<0.001), and adjuvant systemic treatment (p<0.001) did. In regression analysis the presence of extra-cranial metastases (HR 2.30 95%CI 1.53–3.48; p<0.001), adjuvant radiation therapy (HR 0.97 95%CI 0.23–0.86; p=0.016), and adjuvant systemic treatment (HR 0.37 95%CI 0.25–0.55; p<0.001) remained independent factors for survival. Conclusions The indication for resection of symptomatic BM in patients with NSCLC is justified even in case of multiple lesions to alleviate their neurological symptoms and to enable further treatment.

scholarly journals Survival after adjuvant radiation therapy in localized small cell lung cancer treated with complete resection

2019 ◽  
Vol 158 (6) ◽  
pp. 1665-1677.e2 ◽  
Author(s):  
Kathryn E. Engelhardt ◽  
Julia M. Coughlin ◽  
Malcolm M. DeCamp ◽  
Chadrick E. Denlinger ◽  
Shari L. Meyerson ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Radiation Therapy ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Complete Resection ◽  
Small Cell ◽  
Adjuvant Radiation ◽  
Small Cell Lung ◽  
Adjuvant Radiation Therapy

Adjuvant Systemic Therapy and Adjuvant Radiation Therapy for Stage I to IIIA Completely Resected Non–Small-Cell Lung Cancers: American Society of Clinical Oncology/Cancer Care Ontario Clinical Practice Guideline Update

2017 ◽  
Vol 35 (25) ◽  
pp. 2960-2974 ◽  
Author(s):  
Mark G. Kris ◽  
Laurie E. Gaspar ◽  
Jamie E. Chaft ◽  
Erin B. Kennedy ◽  
Christopher G. Azzoli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Radiation Therapy ◽  
Adjuvant Chemotherapy ◽  
Small Cell ◽  
Adjuvant Radiation ◽  
Small Cell Lung ◽  
Lung Cancers ◽  
Adjuvant Radiation Therapy ◽  
N2 Disease ◽  
American Society

Purpose The panel updated the American Society of Clinical Oncology (ASCO) adjuvant therapy guideline for resected non–small-cell lung cancers. Methods ASCO convened an update panel and conducted a systematic review of the literature, investigating adjuvant therapy in resected non–small-cell lung cancers. Results The updated evidence base covered questions related to adjuvant systemic therapy and included a systematic review conducted by Cancer Care Ontario current to January 2016. A recent American Society for Radiation Oncology guideline and systematic review, previously endorsed by ASCO, was used as the basis for recommendations for adjuvant radiation therapy. An update of these systematic reviews and a search for studies related to radiation therapy found no additional randomized controlled trials. Recommendations Adjuvant cisplatin-based chemotherapy is recommended for routine use in patients with stage IIA, IIB, or IIIA disease who have undergone complete surgical resections. For individuals with stage IB, adjuvant cisplatin-based chemotherapy is not recommended for routine use. However, a postoperative multimodality evaluation, including a consultation with a medical oncologist, is recommended to assess benefits and risks of adjuvant chemotherapy for each patient. The guideline provides information on factors other than stage to consider when making a recommendation for adjuvant chemotherapy, including tumor size, histopathologic features, and genetic alterations. Adjuvant chemotherapy is not recommended for patients with stage IA disease. Adjuvant radiation therapy is not recommended for patients with resected stage I or II disease. In patients with stage IIIA N2 disease, adjuvant radiation therapy is not recommended for routine use. However, a postoperative multimodality evaluation, including a consultation with a radiation oncologist, is recommended to assess benefits and risks of adjuvant radiation therapy for each patient with N2 disease. Additional information is available at www.asco.org/lung-cancer-guidelines and www.asco.org/guidelineswiki .

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