Role of multimodality therapy in cIIIA-N2 non–small cell lung cancer: perspective

Horinouchi, Hidehito

doi:10.1093/jjco/hyw131

Cited by 2 publications

(2 citation statements)

References 28 publications

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“…As the treatment of stage III N2 NSCLC is multimodal (11,(23)(24)(25)(26), the reduction to radiotherapy or surgerybased treatments represents a significant simplification. For multimodal treatment based on a surgical approach, no distinction was made between neoadjuvant and adjuvant chemotherapy (19,20).…”

Section: Discussionmentioning

confidence: 99%

Stage III N2 non-small cell lung cancer treatment: decision-making among surgeons and radiation oncologists

Glatzer¹,

Leskow²,

Caparrotti³

et al. 2021

Transl Lung Cancer Res

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Background: Stage III N2 non-small cell lung cancer (NSCLC) is a very heterogeneous disease associated with a poor prognosis. A number of therapeutic options are available for patients with Stage III N2 NSCLC, including surgery [with neoadjuvant or adjuvant chemotherapy (CTx)/neoadjuvant chemoradiotherapy (CRT)] or CRT potentially followed by adjuvant immunotherapy. We have no clear evidence demonstrating a significant survival benefit for either of these approaches, the selection between treatments is not always straightforward and can come down to physician and patient preference. The very heterogeneous definition of resectability of N2 disease makes the decision-making process even more complex.Methods: We evaluated the treatment strategies for preoperatively diagnosed stage III cN2 NSCLC among Swiss thoracic surgeons and radiation oncologists. Treatment strategies were converted into decision trees and analysed for consensus and discrepancies. We analysed factors relevant to decision-making within these recommendations.Results: For resectable "non-bulky" mediastinal lymph node involvement, there was a trend towards surgery. Numerous participants recommend a surgical approach outside existing guidelines as long as

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Section: Discussionmentioning

confidence: 99%

Stage III N2 non-small cell lung cancer treatment: decision-making among surgeons and radiation oncologists

Glatzer¹,

Leskow²,

Caparrotti³

et al. 2021

Transl Lung Cancer Res

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show abstract

“…In studies that evaluated multi-modality treatment in patients with unresectable stage III NSCLC and a good performance status (PS; defined as an Eastern Cooperative Oncology Group PS 0–1), utilising modern day staging and treatment techniques, the 5-year overall survival (OS) rate was 20%. 1 New treatment regimens and techniques as well as fair and equal access to optimal treatment and expert teams, to minimise the risks and complications from treatment and to standardised practice, are key goals in addressing this critical issue.…”

Section: Introductionmentioning

confidence: 99%

The current treatment landscape in the UK for stage III NSCLC

Evison

Limited²

2020

Br J Cancer

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For stage III non-small cell lung cancer (NSCLC), approximately a third of patients survive up to 5 years, with decreasing 5-year survival rates for stage IIIB and stage IIIC disease. Although curable, stage III NSCLC encompasses a diverse range of disease presentation, with an equally complex range of multi-modal treatment options, including systemic and local therapies for distant and local disease control, respectively. This complexity results in a number of challenges for the multi-disciplinary team (MDT) in achieving optimal treatment outcomes for patients. As multi-modality treatment is the preferred treatment strategy for all stage III disease, the focus of this article is the key surgical, chemotherapy and radiotherapy clinical trials as well as guidelines that currently outline radical therapy options for patients with both potentially resectable and unresectable stage III NSCLC.

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Role of multimodality therapy in cIIIA-N2 non–small cell lung cancer: perspective

Abstract: Constant effort via well-designed and well-conducted clinical trials is needed to decipher the heterogeneity of Stage III non–small cell lung cancer.

Cited by 2 publications

References 28 publications

Stage III N2 non-small cell lung cancer treatment: decision-making among surgeons and radiation oncologists

Stage III N2 non-small cell lung cancer treatment: decision-making among surgeons and radiation oncologists

The current treatment landscape in the UK for stage III NSCLC

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