Management of locally advanced non-small cell lung cancer in the modern era: A national Italian survey on diagnosis, treatment and multidisciplinary approach


Autoři: Alessio Bruni aff001;  Niccolò Giaj-Levra aff002;  Patrizia Ciammella aff003;  Virginia Maragna aff004;  Katia Ferrari aff005;  Viola Bonti aff005;  Francesco Grossi aff006;  Stefania Greco aff007;  Carlo Greco aff008;  Paolo Borghetti aff009;  Davide Franceschini aff010;  Enrica Capelletto aff011;  Marco Perna aff004;  Giuseppe Banna aff012;  Stefano Vagge aff013;  Editta Baldini aff014;  Emilio Bria aff015;  Andrea Botti aff016;  Marcello Tiseo aff017;  Massimiliano Paci aff018;  Maria Taraborrelli aff019;  Venerino Poletti aff020;  Pierluigi Granone aff022;  Umberto Ricardi aff023;  Silvia Novello aff011;  Vieri Scotti aff004
Působiště autorů: Radiotherapy Unit, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy aff001;  Department of Advanced Radiation Oncology, IRCCS Sacro Cuore–Don Calabria Hospital, Negrar, Verona, Italy aff002;  Radiation Therapy Unit, Department of Oncology and Advanced Technology, AUSL-IRCCS, Reggio Emilia, Italy aff003;  Radiation Therapy Unit, Department of Oncology, Careggi University Hospital, Firenze, Italy aff004;  Section of Respiratory Medicine, Careggi University Hospital, Firenze, Italy aff005;  UOC Oncologia Medica Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy aff006;  UOSD of Oncologic Pneumology, San Camillo Forlanini Hospital, Rome, Italy aff007;  Department of Radiation Oncology, Campus Bio-Medico University, Rome, Italy aff008;  Radiation Oncology Department University and Spedali Civili, Brescia, Italy aff009;  Department of Radiotherapy and Radiosurgery, Humanitas Cancer Center and Research Hospital, Rozzano, Milan, Italy aff010;  Oncology Department, University of Turin, AOU San Luigi, Orbassano (TO), Italy aff011;  Oncology Department, Ospedale Cannizzaro, Catania, Italy aff012;  Department of Radiation Oncology, Azienda Ospedaliera Universitaria San Martino di Genova—IST, Istituto Nazionale Ricerca sul Cancro, Genoa, Italy aff013;  UOC Oncologia Medica Ospedale San Luca, Lucca, Italy aff014;  U.O.C. Oncologia Medica, Comprehensive Cancer Center—Fondazione Policlinico Universitario A. Gemelli, IRCCS—Università Cattolica del Sacro Cuore, Roma, Italy aff015;  Medical Physics Unit, Department of Oncology and Advanced Technology, AUSL-IRCCS, Reggio Emilia, Italy aff016;  Department of Medicine and Surgery, University of Parma and Medical Oncology Unit, University Hospital of Parma, Parma, Italy aff017;  Division of Thoracic Surgery, Azienda USL-IRCCS of Reggio Emilia, Italy aff018;  Radiotherapy Unit, SS Annunziata Hospital—G. D'annunzio University, Chieti, Italy aff019;  Department of Diseases of the Thorax, Ospedale GB Morgagni, Forlì (I), Italy aff020;  Department of Respiratory Diseases & Allergy, Aarhus University Hospital, Aarhus, Denmark aff021;  Department of General Thoracic Surgery, Catholic University, Rome, Italy aff022;  Department of Oncology, University of Turin, Torino, Italy aff023
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224027

Souhrn

Concurrent chemotherapy and radiotherapy (cCRT) is considered the standard treatment of locally advanced non-small cell lung cancer (LA-NSCLC). Unfortunately, management is still heterogeneous across different specialists. A multidisciplinary approach is needed in this setting due to recent, promising results obtained by consolidative immunotherapy. The aim of this survey is to assess current LA-NSCLC management in Italy. From January to April 2018, a 15-question survey focusing on diagnostic/therapeutic LA-NSCLC management was sent to 1,478 e-mail addresses that belonged to pneumologists, thoracic surgeons, and radiation and medical oncologists. 421 answers were analyzed: 176 radiation oncologists, 86 medical oncologists, 92 pneumologists, 64 thoracic surgeons and 3 other specialists. More than a half of the respondents had been practicing for >10 years after completing residency training. Some discrepancies were observed in clinical LA-NSCLC management: the lack of a regularly planned multidisciplinary tumor board, the use of upfront surgery in multistation stage IIIA, and territorial diffusion of cCRT in unresectable LA-NSCLC. Our analysis demonstrated good compliance with international guidelines in the diagnostic workup of LA-NSCLC. We observed a relationship between high clinical experience and good clinical practice. A multidisciplinary approach is mandatory for managing LA-NSCLC.

Klíčová slova:

Cancer detection and diagnosis – Cancer treatment – Diagnostic medicine – Lung and intrathoracic tumors – Non-small cell lung cancer – Oncology – Physicians – Surgical and invasive medical procedures


Zdroje

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Článek vyšel v časopise

PLOS One


2019 Číslo 11