The Trimodality Treatment Approach in Stage III/pN2 Non–Small Cell Lung Cancer

Jeremić, Branislav; Casas, Francesc; Dubinský, P.; Čihorić, Nikola; Gómez-Caamaño, Antonio

doi:10.1097/coc.0000000000000223

Cited by 2 publications

(1 citation statement)

References 6 publications

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“…Recent data on the use of modern postoperative TRT [22] seem to overcame negative impact of historic data [23,24], since it enabled effectively concentrating on patients harboring high risk features. In Stage IIIA NSCLC, less than a half of the institutions would still consider surgical multimodality approach likely due to a number of group/society guidelines and recommendations [25,26] in spite of the fact that serious criticism and a number of aws and fallacies have been highlighted in recent years [27][28][29][30]. In, inoperable cases, the vast majority of departments would prefer concurrent RT-CHT, following highest level of evidence existing for more than a decade [31][32][33].…”

Section: Discussionmentioning

confidence: 99%

Real-world Treatment Patterns of Lung Cancer- experience of Resource Restricted Country

Kiladze

Mariamidze

Jeremić

2020

Preprint

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Background:Lung cancer (LC) continues to be a significant worldwide public health issue. In recent years there have been several publications addressing specifics of LC worldwide, but none concerning Georgia- country with high number of smoking population and LC cases. We conducted the first study in Georgian population, that aims current LC practice.Methods: The aim of the study was to provide an overview of treatment of LC, with discussion situation in this field and indicating the future strategies for improved cancer care in the country. Medical, radiation and surgical oncologists providing treatment of LC in main hospitals (n=13) over the country, filled questionnaire that addressed specific information regarding the treatment aspects of LC reflecting current surgical aspects, systemic treatment and radiotherapy (RT). ResultsThere is no national screening program, while radiologic imaging is readily available. The vast majority of patients in the country present with advanced stages at diagnosis and they are treated with systemic therapy and/or RT. The surgical treatment is largely underutilized with the differences being observed among surgeons on the optimal timing and the extent of surgery, as well as role of surgery in specific clinical situations.Improved health care system, well equipped hospitals, availability of many anticancer drugs and existence of modern RT technology, are coupled with slow appearance of country-adapted guidelines and protocols as well as enforcing MDT meetings.There is limited access to expensive novel agents, psychological support and high quality palliative care. ConclusionsThere is still much work to be done, with all above steps considered mandatory to improve effectiveness and quality of care of LC patients.

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Section: Discussionmentioning

confidence: 99%

Real-world Treatment Patterns of Lung Cancer- experience of Resource Restricted Country

Kiladze

Mariamidze

Jeremić

2020

Preprint

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Real-World Treatment Patterns of Lung Cancer in a Resource-Restricted Country: the Experience of Georgia

Kiladze

Mariamidze

Jeremić

2021

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Lung cancer (LC) is the most common malignancy responsible for 1.8 million of deaths worldwide. Lung and bronchus cancer represents 13% (n = 1217) of all new cancer cases in Georgia. In 2018, in Georgian males lung cancer age-standardized incidence rate was 35.7/per 100 000, less compared to regional countries as Turkey (70.6), Russia (48.2), Ukraine (41.7), and Armenia (58.5), but higher than in neighbor Azerbaijan (25.5). Incidence is higher compared to central and eastern Europe (27.3) and near similar to North America (34.5). Georgia is an Eastern European, middleincome country with 3.7 million residents and one of the highest numbers of active smokers in the European Region. The Georgian health care system is divided into a public and a private sector, with coverage of nearly 100% of the population. There is a national healthcare system as well as private insurance and all patients, irrespective of insurance (private or governmental) can choose the hospital for treatment by themselves all over the country. The Basic Package of the Universal Health Care Program includes the treatment of oncologic patients, specifically surgery, chemotherapy, hormone therapy and radiotherapy and investigations and medications related to these procedures. The program covers all types of laboratory and instrumental investigations related to planned treatment. Georgia lacks an LC screening program for smokers and partially because of this, the majority of patients with lung cancer present at an advanced stage. The National Centre for the Disease Control (NCDC) showed that almost 90% of LC patients in the country present with advanced stages (III-IV) with 60% of patients having stage IV disease at diagnosis . Lung cancer is generally diagnosed at an advanced stage. For non-small cell lung cancer (NSCLC), the proportion with metastatic disease (TNM stage IV) ranged from 46.8% to 61.2% in developed countries. In recent years, there have been several publications addressing specifics of LC worldwide, but none concerning Georgia. In light of the rapidly changing landscape in the diagnosis, staging, and treatment of LC, we thought to define the state of practice in Georgia by convening specialists who treat LC across 13 institutions in our country with the goal to describe differences in access and approaches to LC.

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The Trimodality Treatment Approach in Stage III/pN2 Non–Small Cell Lung Cancer

Cited by 2 publications

References 6 publications

Real-world Treatment Patterns of Lung Cancer- experience of Resource Restricted Country

Real-world Treatment Patterns of Lung Cancer- experience of Resource Restricted Country

Real-World Treatment Patterns of Lung Cancer in a Resource-Restricted Country: the Experience of Georgia

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