Risks of Neoadjuvant Chemotherapy and Radiation Therapy

Stamatis, Georgios

doi:10.1016/j.thorsurg.2007.11.004

Cited by 22 publications

(10 citation statements)

References 80 publications

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“…Significant overall morbidity (.40%) and mortality rates have been reported after pneumonectomy. In particular, right pneumonectomy after induction treatment may entail mortality rates of up to 26% [182,[245][246][247][248].…”

Section: Chemo-radiotherapy In Lung Cancermentioning

confidence: 99%

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Brunelli¹,

Charloux²,

Bolliger³

et al. 2009

European Respiratory Journal

752

550

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A collaboration of multidisciplinary experts on the functional evaluation of lung cancer patients has been facilitated by the European Respiratory Society (ERS) and the European Society of Thoracic Surgery (ESTS), in order to draw up recommendations and provide clinicians with clear, up-to-date guidelines on fitness for surgery and chemo-radiotherapy.The subject was divided into different topics, which were then assigned to at least two experts. The authors searched the literature according to their own strategies, with no central literature review being performed. The draft reports written by the experts on each topic were reviewed, discussed and voted on by the entire expert panel. The evidence supporting each recommendation was summarised, and graded as described by the Scottish Intercollegiate Guidelines Network Grading Review Group. Clinical practice guidelines were generated and finalised in a functional algorithm for risk stratification of the lung resection candidates, emphasising cardiological evaluation, forced expiratory volume in 1 s, systematic carbon monoxide lung diffusion capacity and exercise testing.Contrary to lung resection, for which the scientific evidences are more robust, we were unable to recommend any specific test, cut-off value, or algorithm before chemo-radiotherapy due to the lack of data. We recommend that lung cancer patients should be managed in specialised settings by multidisciplinary teams.

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Section: Chemo-radiotherapy In Lung Cancermentioning

confidence: 99%

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Brunelli¹,

Charloux²,

Bolliger³

et al. 2009

European Respiratory Journal

752

550

View full text Add to dashboard Cite

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“…An important observation in patients during neoadjuvant treatment is the asymptomatous course of pulmonary embolism. We found, during restaging on CT scan or in the perfusion scan, a partial or complete segmental failure in one or both lungs in 12% of patients [74].…”

Section: Diagnosis For Primary Tumour (T-status)mentioning

confidence: 77%

“…For centrally located tumours with endobronchial growth, flexible or rigid bronchoscopy with biopsies of the prospective resection margins is recommended [74].…”

Section: Diagnosis For Primary Tumour (T-status)mentioning

confidence: 99%

Staging of lung cancer: the role of noninvasive, minimally invasive and invasive techniques

Stamatis

2015

Eur Respir J

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Accurate staging and restaging of primary tumour and mediastinal nodes in patients with lung cancer is of significant importance. For primary tumours, computed tomography (CT) scans of the chest are recommended. Positron emission tomography (PET) imaging should be used in patients with curative intent treatment to evaluate metastatic disease. Diagnosis of the primary tumour should be performed using bronchoscopy or CT-guided transthoracic needle aspiration. In patients with enlarged mediastinal nodes and no distant metastasis, invasive staging of the mediastinum is required. For suspicious N2 or N3 disease, endoscopic needle techniques, such as endobronchial ultrasound and transbronchial needle aspiration, oesophageal ultrasound and fine needle aspiration, or a combination of both, are preferred to any surgical staging technique. In cases of suspicious nodes and negative results using needle aspiration techniques, invasive surgical staging using mediastinoscopy or video-assisted thoracic surgery should be performed. In central tumours or N1 nodes, preoperative invasive staging is indicated.Restaging after induction therapy remains a controversial topic. Today, neither CT, PET nor PET/CT scans are accurate enough to make final further therapeutic decisions for mediastinal nodal involvement. An invasive technique providing cytohistological information is still recommended.

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“…Evidence shows that induction chemotherapy or radio-chemotherapy can increase the risk of mortality after pneumonectomy, especially right pneumonectomy, up to 30% (57)(58)(59)(60)(61), although recent reports have mitigated these findings (62)(63)(64).…”

Section: Neoadjuvant Therapymentioning

confidence: 99%

Preoperative functional workup for patients with advanced lung cancer

Brunelli

2016

J. Thorac. Dis.

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Locally advanced lung cancer remains a surgical indication in selected patients. This condition often demands larger resections. As a consequence preoperative functional workup is of paramount importance to stratify the risk and choose the most appropriate treatment. We reviewed the current evidence on functional evaluation with a special focus on specific aspects related to locally advanced lung cancer stages (i.e., risk after neoadjuvant treatment, pneumonectomy). Evidence is discussed to provide information that could assist clinicians in their preoperative workup of these challenging patients.

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Risks of Neoadjuvant Chemotherapy and Radiation Therapy

Cited by 22 publications

References 80 publications

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

ERS/ESTS clinical guidelines on fitness for radical therapy in lung cancer patients (surgery and chemo-radiotherapy)

Staging of lung cancer: the role of noninvasive, minimally invasive and invasive techniques

Preoperative functional workup for patients with advanced lung cancer

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