Palliative Thoracic Radiotherapy for Lung Cancer: A Systematic Review

Fairchild, Alysa; Harris, Kristin; Barnes, Elizabeth; Wong, Rebecca; Lutz, S; Bezjak, Andrea; Cheung, Patrick; Chow, Edward

doi:10.1200/jco.2007.15.3312

Cited by 221 publications

(109 citation statements)

References 29 publications

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“…Subsequently, archived tissue from 77 of 89 randomized patients was analyzed for KRAS mutational status, with the aim of investigating both the effect of KRAS status on treatment outcome and the association between skin toxicity and KRAS status [48]. While escalation of the cetuximab dose resulted in a non-significant trend toward higher RR in wild-type KRAS patients (41.9 vs. 30.4% for the standard dose; p = 0.396), there was a sharp distinction between outcomes according to KRAS status in both treatment arms.…”

Section: Clinical Role Of Kras and Braf Mutationsmentioning

confidence: 99%

The Long and Winding Road to Useful Predictive Factors for Anti-EGFR Therapy in Metastatic Colorectal Carcinoma: The KRAS/BRAF Pathway

et al. 2009

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Monoclonal antibodies targeting the epidermal growth factor receptor (EGFR) have improved outcomes for patients with metastatic colorectal carcinoma. Among patients not carrying activating mutations in the KRAS gene, only a limited number will experience tumor response to these therapeutic agents. The role of BRAF mutations in determining resistance to this treatment is emerging through preclinical and clinical studies. Standardization and validation of laboratory mutation analysis is needed to allow an optimal use of anti-EGFR therapies in the management of colorectal carcinoma. Clinical single-arm and randomized studies were conducted both in first-line and refractory settings to evaluate the correlation of KRAS mutational status and efficacy of cetuximab and panitumumab. The main trials on first-line regiments are CRYSTAL, which is looking at FOLFIRI (folinic acid, fluorouracil, irinotecan) + cetuximab, and OPUS, which is evaluating FOLFOX (folinic acid, fluorouracil, oxaliplatin) + cetuximab. The results of these trials have induced the European Medicines Agency to apply restrictions to its approval of cetuximab and panitumumab for use in metastatic colorectal cancer patients with wild-type KRAS tumors. However, the absence of KRAS mutations is not sufficient to assure clinical response to cetuximab and panitumumab. We need to discover further molecular biomarkers of impairment in this or other signaling pathways to identify responders more specifically. Preclinical rationale is available for combined therapies, which simultaneously target EGFR and the RAS/RAF/MAPK signaling pathways for metastatic colorectal cancer.

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Section: Clinical Role Of Kras and Braf Mutationsmentioning

confidence: 99%

The Long and Winding Road to Useful Predictive Factors for Anti-EGFR Therapy in Metastatic Colorectal Carcinoma: The KRAS/BRAF Pathway

et al. 2009

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“…In the palliative thoracic RT meta -analysis, three trials reported confi rmed cases of myelopathy. Estimates of incidence rates were < 0.5% and did not correlate with RT dose [34] .…”

Section: Central Nervous Systemmentioning

confidence: 97%

“…A meta -analysis of 13 randomized controlled trials evaluating different dosefractionation schedules for palliation of incurable lung cancer included 3473 patients [34] . Dysphagia secondary to esophagitis was the most common acute side effect described, but timing and method of assessment varied.…”

Section: Thoraxmentioning

confidence: 99%

“…Dysphagia secondary to esophagitis was the most common acute side effect described, but timing and method of assessment varied. Physician-assessed dysphagia was more common after higher versus lower RT dose (20.5% vs 14.9%; P = 0.01), yet pooling of patient self -report data could not be performed [34] . Dysphagia can lead to complications such as malnutrition, dehydration, and aspiration [6] .…”

Section: Thoraxmentioning

confidence: 99%

“…Pneumonitis affected 3.6% of patients after higher dose RT compared with 1.8% of patients who received lower dose in the meta -analysis [34] . Symptoms include acute worsening of dyspnea, cough, and low grade fever, with signs of wheeze, rub, or consolidation.…”

Section: Thoraxmentioning

confidence: 99%

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Side Effects of Palliative Radiotherapy

Fairchild

2013

Radiation Oncology in Palliative Cancer Care

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Palliative Radiation for Advanced Central Lung Tumors With Intentional Avoidance of the Esophagus (PROACTIVE)

et al. 2022

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IMPORTANCE Palliative thoracic radiotherapy (RT) can alleviate local symptoms associated with advanced non-small cell lung cancer (NSCLC), but esophagitis is a common treatment-related adverse event. Whether esophageal-sparing intensity-modulated RT (ES-IMRT) achieves a clinically relevant reduction in esophageal symptoms remains unclear. OBJECTIVE To examine whether ES-IMRT achieves a clinically relevant reduction in esophageal symptoms compared with standard RT. DESIGN, SETTING, AND PARTICIPANTS Palliative Radiation for Advanced Central Lung Tumors With Intentional Avoidance of the Esophagus (PROACTIVE) is a multicenter phase 3 randomized clinical trial that enrolled patients between

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Palliative Thoracic Radiotherapy for Lung Cancer: A Systematic Review

Cited by 221 publications

References 29 publications

The Long and Winding Road to Useful Predictive Factors for Anti-EGFR Therapy in Metastatic Colorectal Carcinoma: The KRAS/BRAF Pathway

The Long and Winding Road to Useful Predictive Factors for Anti-EGFR Therapy in Metastatic Colorectal Carcinoma: The KRAS/BRAF Pathway

Side Effects of Palliative Radiotherapy

Palliative Radiation for Advanced Central Lung Tumors With Intentional Avoidance of the Esophagus (PROACTIVE)

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