AN OBSERVATIONAL STUDY TO EVALUATE THE RESPONSE AND TOXICITY WITH CONVENTIONAL FRACTIONATION AND HYPO FRACTIONATED RADIOTHERAPY FOR LOCALLY ADVANCED NON SMALL CELL LUNG CARCINOMA FOLLOWING INDUCTION CHEMOTHERAPY

2021 ◽  
pp. 7-9
Author(s):  
Sujata Sarkar ◽  
Gautam Bhattacharjee ◽  
Tamohan Chaudhuri
Keyword(s):  
Induction Chemotherapy ◽  
Advanced Nsclc ◽  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
Hypofractionated Radiotherapy ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Fractionated Radiotherapy ◽  
Conventional Fractionation ◽  
Locally Advanced Nsclc

Aims & Objectives: To evaluate the response and toxicity with Conventional fractionation and hypofractionated radiotherapy for locally advanced NSCLC following induction chemotherapy. To assess and compare following for locally advanced NSCLC with Conventional and hypo fractionated radiotherapy following induction chemotherapy. Materials And Methods: This prospective observational study was conducted at Saroj Gupta Cancer Centre and Research Institute, Kolkata; accrual was from June 2016 to September 2017. Data was collected from all patients who had been cytological / histopathologically and radiological proven stage III Non Small Cell Lung Carcinoma; fullling eligibility criteria, were recruited after obtaining informed consent. Results And Analysis: We found that the association between response at the END OF RT in two groups was not statistically signicant (p=0.8559). Association between Dermatitis highest grade at end of RT in two groups was not statistically signicant (p=0.5201). Association between Response 6 months after RT in two groups was not statistically signicant (p=0.7667). Association between Response 9 months after RT in two groups was not statistically signicant (p=0.9255). Association between Dermatitis. Conclusion & Summary: Our study showed hypofractionated radiotherapy is non-inferior to Conventional radiotherapy with equivalent overall response and toxicity and well tolerable. In patients with poor performance status who cannot tolerate concurrent chemo radiation, induction chemotherapy with hypofractionated radiotherapy regimen can be considered as a treatment of choice with manageable toxicities.

scholarly journals HIF-1α Levels in patients receiving chemoradiotherapy for locally advanced non-small cell lung carcinoma

2019 ◽  
Vol 65 (10) ◽  
pp. 1295-1299
Author(s):  
Cigdem Usul Afsar ◽  
Pelin Uysal
Keyword(s):  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
Hypoxia Inducible Factor ◽  
Small Cell ◽  
Enzyme Linked Immunosorbent Assay ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Hypoxia Inducible Factor 1 ◽  
Locally Advanced Nsclc ◽  
Before And After

SUMMARY AIM To examine the relationship between treatment response and hypoxia-inducible factor-1 alpha (HIF-1α) levels in patients with locally advanced non-small cell lung cancer (NSCLC) who received chemoradiotherapy (CRT). METHODS Eighty patients with NSCLC were included in the study and treated at Acibadem Mehmet Ali Aydınlar University Medical Faculty. HIF-1 α levels were measured before and after CRT by the enzyme-linked immunosorbent assay (ELISA) method. RESULTS Patients’ stages were as follows; stage IIIA (65%) and stage IIIB (35%). Squamous histology was 45%, adenocarcinoma was 44%, and others were 11%. Chemotherapy and radiotherapy were given concurrently to 80 patients. Forty-five (56%) patients received cisplatin-based chemotherapy, and 35 (44%) received carboplatin-based chemotherapy. Serum HIF-1α levels (42.90 ± 10.55 pg/mL) after CRT were significantly lower than the pretreatment levels (63.10 ± 10.22 pg/mL, p<0.001) in patients with locally advanced NSCLC. CONCLUSION The results of this study revealed that serum HIF-1α levels decreased after CRT. Decrease of HIF-1α levels after the initiation of CRT may be useful for predicting the efficacy of CRT.

A randomized, multicenter phase II study investigating additional weekly cetuximab to concurrent chemoradiotherapy in locally advanced non-small cell lung carcinoma: Reporting on the efficacy.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7019-7019 ◽  
Author(s):  
Michel M van den Heuvel ◽  
Andrew D. Vincent ◽  
Wilma Uyterlinde ◽  
Joachim Aerts ◽  
Fredirike Koppe ◽  
...  
Keyword(s):  
Phase Ii ◽  
Concurrent Chemoradiotherapy ◽  
Advanced Nsclc ◽  
Phase Ii Study ◽  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
High Dose ◽  
Cell Lung Carcinoma ◽  
Multicenter Phase ◽  
Locally Advanced Nsclc

7019 Background: Modest benefits from concurrent chemoradiotherapy (CRT) in patients with locally advanced NSCLC warrant more effective treatment regimen. Cetuximab, a monoclonal antibody against the epidermal growth factor receptor has shown activity in NSCLC. Feasibility data and toxicity have been published previously. We report treatment outcome of a multicenter phase II study of the combination of high dose accelerated RT and daily dose cisplatin with or without weekly cetuximab. Methods: Patients with locally advanced NSCLC received accelerated RT (66 Gy in 24 fractions) and concurrent daily cisplatin (6 mg/m2) with (Arm A) or without (Arm B) additional weekly cetuximab (400 mg/m2 loading dose one week prior to the RT start followed by weekly 250 mg/m2). The Objective Local Response Control (OLRC) was determined at 6 and 24 weeks after treatment using response evaluation criteria in solid tumours criteria. Results: Between Feb 2009 and May 2011, 102 patients were included. Median follow-up was 13 months. Patients and tumor characteristics are shows in the Table. Stage distribution was: II (8%), IIIa (51%), and IIIb (40%). The CRT was well tolerated. The OLRC at 24 weeks was 79% in Arm A and 80% in Arm B. The one-year progression free survival and overall survival were 58% (45%-76%) and 76% (64%-91%) for Arm A and 49% (35%-68%) and 72% (58%-89%) for Arm B respectively. Conclusions: The addition of cetuximab to low dose cisplation CRT does not improve OLRC in an unselected patient cohort but data on longterm disease control and survival are to be awaited. [Table: see text]

Cetuximab in combination with concurrent chemoradiotherapy (CRT) in locally advanced non-small cell lung carcinoma (NSCLC): A feasibility study

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 7540-7540
Author(s):  
M. M. van den Heuvel ◽  
J. Belderbos ◽  
O. Dalesio ◽  
M. van der Pol ◽  
L. Uitterhoeve ◽  
...  
Keyword(s):  
Advanced Nsclc ◽  
Metabolic Response ◽  
Small Cell Lung Carcinoma ◽  
Treatment Options ◽  
Locally Advanced ◽  
Growth Factor Receptor ◽  
Early Response ◽  
Response Monitoring ◽  
Cell Lung Carcinoma ◽  
Locally Advanced Nsclc

7540 Background: Despite modest benefits from CRT regimens in patients with locally advanced NSCLC, more efficacious treatment options are needed. Cetuximab, a monoclonal antibody that selectively binds to the epidermal growth factor receptor, has demonstrated activity in patients with metastatic NSCLC. This trial was initiated to assess the feasibility of combining cetuximab with concurrent CRT. Methods: Patients with non-operable locally advanced NSCLC received cetuximab (400 mg/m2 on day 1, 250 mg/m2 q1w from weeks 2–6) in combination with cisplatin (6 mg/m2 q1d from weeks 2–6), and RT (66 Gy in 24 fractions from weeks 2–6). Results: Between April and July 2008, 12 consecutive, eligible patients entered the study. The mean age was 61 years (range: 43–77) and 50% were male. Baseline NSCLC staging was: IIb (1 patient), IIIa (5 patients), and IIIb (6 patients). Treatment was generally well tolerated. Acne-like rash and radiation esophagitis were the most common side effects (grade ≤3 according to CTCAE v 3.0) (see table). No unexpected toxicities were observed. Early-response monitoring using PET-CT scans was performed 4 weeks after the last fraction of RT in 10/12 patients. A metabolic response was seen in 50% (complete: 3 patients; partial: 2 patients) of patients. One patient showed progressive disease. Conclusions: Cetuximab added to CRT in patients with NSCLC was generally well tolerated and produced promising early clinical responses. A randomized phase II study comparing CRT with CRT and cetuximab is ongoing. [Table: see text] [Table: see text]

scholarly journals Neoadjuvant immunotherapy combined with chemotherapy for locally advanced squamous cell lung carcinoma: A case report and literature review

2021 ◽  
Vol 16 (1) ◽  
pp. 838-844
Author(s):  
Yuan Zheng ◽  
Wei Zhu ◽  
Xinjie Huang ◽  
Dongqun Lin ◽  
Yu Lin
Keyword(s):  
Squamous Cell ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Small Cell Lung ◽  
Complete Pathological Response ◽  
Cell Lung Carcinoma ◽  
Neoadjuvant Immunotherapy ◽  
Locally Advanced Nsclc ◽  
The Right

Abstract The benefit of immunochemotherapy in treating resectable locally advanced non-small cell lung cancer (NSCLC) is not well established. Here, we report a case of resectable stage III NSCLC treated with neoadjuvant immunotherapy combined with chemotherapy before surgery. A 61 years old man was admitted to our hospital due to paroxysmal cough and was diagnosed as squamous cell carcinoma T4N2M0 in the upper lobe of the right lung, which was locally advanced and resectable. He was treated with 3 courses of paclitaxel 250 mg intravenous (IV), carboplatin 0.65 g IV, and durvalumab 620 mg IV followed by thoracoscopic upper lobectomy and lymph node dissection. There was considerable regression of the tumor before surgery, and the patient achieved a complete pathological response after surgery. Our case study demonstrates the benefit of durvalumab and chemotherapy in the treatment of resectable locally advanced NSCLC.

Deep reinforcement learning for fractionated radiotherapy in non-small cell lung carcinoma

2021 ◽  
pp. 102137
Author(s):  
Matteo Tortora ◽  
Ermanno Cordelli ◽  
Rosa Sicilia ◽  
Marianna Miele ◽  
Paolo Matteucci ◽  
...  
Keyword(s):  
Reinforcement Learning ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Fractionated Radiotherapy

scholarly journals Hypofractionated Radiotherapy for Stage I Non-small Cell Lung Carcinoma in Patients Aged 75 Years and Older

2011 ◽  
Vol 02 (02) ◽  
pp. 167-171 ◽  
Author(s):  
Ajay P. Sandhu ◽  
Karen Messer ◽  
Mark M. Fuster ◽  
Lyudmilla Bazhenova ◽  
Ehatsham Ahmad ◽  
...  
Keyword(s):  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Stage I ◽  
Hypofractionated Radiotherapy ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma

scholarly journals Initial Experience of Video-Assisted Thoracic Surgery Lobectomy After Neoadjuvant Chemotherapy Plus Toripalimab in a Patient with Locally Advanced Non-Small Cell Lung Cancer: A Case Report

2021 ◽  
Author(s):  
Wei Li ◽  
Chunbo Zhai ◽  
Jianpeng Che ◽  
Weiqian Wang ◽  
Bingchun Liu
Keyword(s):  
Lung Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Thoracic Surgery ◽  
Small Cell Lung Cancer ◽  
Immune Checkpoint ◽  
Advanced Nsclc ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Locally Advanced Nsclc

Abstract Background: Immune checkpoint inhibitors were used for patients with advanced non-small cell lung cancer (NSCLC) more and more frequently and the effects were thrilling. Toripalimab as a new immune checkpoint inhibitor has been shown to be effective in patients with advanced NSCLC. However, data regarding the safety and feasibility of surgical resection after treatment with toripalimab for NSCLC remain scarce. Here, we present a case with locally advanced NSCLC that received video-assisted thoracic surgery (VATS) lobectomy after treatment with toripalimab in combination with chemotherapy.Case presentation: A 62-year-old male patient with a history of coronary artery stenting operation for two times was found a 3.4 × 3.2cm cavity mass in the upper lobe of the left lung and enlarged left hilar and mediastinal lymph nodes. Pathological results identified squamous cell carcinoma. The patient was diagnosed with a locally advanced NSCLC and received VATS left upper lobectomy and lymph node dissection after neoadjuvant chemotherapy plus toripalimab for 3 cycles. The postoperative pathological results showed complete tumor remission. Short-term follow-up results were excellent, and long-term results remain to be revealed.Conclusions: Our preliminary results showed that the use of neoadjuvant toripalimab and chemotherapy for the locally advanced NSCLC before surgical resection is safe and feasible.

scholarly journals Major Pulmonary Resection After Neoadjuvant Therapy in Potentially Resectable Stage IIIA/B Non-Small Cell Lung Carcinoma: R0 or No R0

2021 ◽  
Author(s):  
Michael Peer ◽  
Sharbel Azzam ◽  
Arnold Cyjon ◽  
Rivka Katsnelson ◽  
Henri Hayat ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Neoadjuvant Chemotherapy ◽  
Lung Carcinoma ◽  
Pulmonary Resection ◽  
Small Cell Lung Carcinoma ◽  
Locally Advanced ◽  
Small Cell ◽  
Small Cell Lung ◽  
Stage Iiia ◽  
Cell Lung Carcinoma

Abstract Objective The aim of this study was to identify predictors of postoperative outcome and survival of locally advanced non-small cell lung carcinoma (NSCLC) resections after neoadjuvant chemotherapy or chemoradiation.Methods Medical records of all patients with clinical stage III potentially resectable NSCLC initially treated by neoadjuvant chemotherapy or chemoradiation followed by major pulmonary resections between 1999 to 2019 were retrieved from the databases of four Israeli Medical Centers. Results: The 124 suitable patients included, 86 males (69.4%) and 38 females (30.6%), mean age of 64.2 years (range 37-82) and mean hospital stay of 12.6 days (range 5-123). Complete resection was achieved in 92.7% of the patients, while complete pathologic response was achieved in 35.5%. Overall readmission rate was 16.1%. The overall 5-year survival rate was 47.9%. One patient (0.8%) had local recurrence. Postoperative complications were reported in 49.2% of the patients, mainly atrial fibrillation (15.9%) and pneumonia (13.7%), empyema (10.3%), and early bronchopleural fistula (7.3%). Early in-hospital mortality rate was 6.5% and the six-month mortality rate was 5.6%. Pre-neoadjuvant bulky mediastinal disease (lymph nodes >20 mm) (p=0.034), persistent postoperative N2 disease (p=0.016), R1 resection (p=0.027) and postoperative stage IIIA (p=0.001), emerged as negative predictive factors for survival. Conclusions: Our findings demonstrate that neoadjuvant chemotherapy or chemoradiation in locally advanced potentially resectable NSCLC followed by major pulmonary resection is a beneficial approach in selected cases.

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