THORACIC SURGERY Completion pneumonectomy and chemoradiotherapy as treatment options in local recurrence of non-small-cell lung cancer

Kasprzyk, Mariusz; Sławiński, Grzegorz; Musik, Martyna; Marciniak, Łukasz; Dyszkiewicz, Wojciech; Piwkowski, Cezary; Gałęcki, Bartłomiej

doi:10.5114/kitp.2015.50563

Cited by 8 publications

(7 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, this approach is also fraught with significant toxicity (23% grade 4 or greater toxicity). Similar results have been published elsewhere with slightly inferior outcomes [ 15 ] Therefore, the option as we have presented of SBRT alone is quite attractive. This is especially true when the patients’ recurrence is a single station N2 node SBRT as presented may be the treatment of choice (Fig.…”

Section: Discussionsupporting

confidence: 87%

Stereotactic body radiotherapy for central lung tumors, yes we can!

et al. 2018

View full text Add to dashboard Cite

BackgroundSBRT is standard therapy for early stage lung cancer. Toxicity in central tumors has been a concern. RTOG 0813 showed that central SBRT is safe and effective. We report our experience with central SBRT.MethodsWe reviewed the records of patients treated with SBRT for central lung tumors (< 2 cm of the carina). Patients included primary lung cancer and recurrence following surgery and\ or conventional radiotherapy. All patients underwent 4DCT simulation and treatment planning was done with IMRT or VMAT techniques. Dose to the PTV was prescribed to the 95% isodose line.ResultsSeventy patients, between 5/09 and 4/13, were treated. Patients had early non-small cell lung cancer (n = 13) or locally recurrent lung cancer (n = 29) and pulmonary oligometastases (n = 28). Fifty-seven percent of the patients received BED of 132 with a schedule of 60Gy in 12 Gy fractions. Median follow up time was 18.3 months, 4/70 patients experienced local failure (6%). Median OS for the whole cohort was 4.6 years (CI 3-7 years). Ten patients had grade 1-2 radiation pneumonitis. One patient developed fatal bronchial bleeding.ConclusionsSBRT for central tumors is safe and effective in patients with central disease, reiradiation, recurrence following surgery and in oligometastes.

show abstract

Section: Discussionsupporting

confidence: 87%

Stereotactic body radiotherapy for central lung tumors, yes we can!

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Survival in patients facing recurrent lung cancer is quite poor, and completion pneumonectomy can be daunting as depicted in the available literature, which describes discouraging morbidity and mortality rates (8)(9)(10)(11). Yet with improvements in local and systemic therapies for NSCLC, thoracic surgeons are likely to encounter patients with recurrent NSCLC without overt contraindications to radical re-resection by completion pneumonectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Locoregional recurrence following surgical resection for non-small cell lung cancer (NSCLC) varies according to stage, but affects upwards of 30% of patients following curative (R0) surgery (1)(2)(3)(4)(5). National Cancer Care Network (NCCN) guidelines (6) advocate surgery for locoregional recurrence in patients without evidence of distant disease, but completion pneumonectomy, specifically for recurrent cancer, is sparingly represented in available literature (7)(8)(9)(10)(11)(12)(13). Published studies demonstrate mortality rates up to 36% and substantial morbidity, but often include patients undergoing completion pneumonectomy for benign lesions, primary lung cancer and metastatic disease indications, making extrapolation to the NSCLC population challenging.…”

Section: Introductionmentioning

confidence: 99%

Completion pneumonectomy is safe and effective in select patients with recurrent non-small cell lung cancer

et al. 2020

View full text Add to dashboard Cite

Background: Locoregional recurrence rates for non-small cell lung cancer (NSCLC) remain high, even following curative surgical resection. While national guidelines advocate surgical resection for locoregional recurrence, it is rarely offered when resection would require completion pneumonectomy, which available literature associates with a 12-36% perioperative mortality and 40-80% morbidity. Additionally, survival advantages to radical surgery in this scenario are largely unknown, particularly because available series often include patients undergoing completion pneumonectomy for benign indications or metastatic disease from other primary sites, making extrapolation to primary lung cancer patients challenging. As systemic therapy options continue to evolve, particularly as it relates to immunotherapy, we expect that there will be more and more opportunities for locoregional surgical control. The aim of this study was to evaluate outcomes following completion pneumonectomy for recurrent NSCLC. Methods: We retrospectively reviewed all patients who underwent completion pneumonectomy for recurrent NSCLC at our institution between 2000 and 2015. Factors affecting perioperative morbidity and mortality, as well as overall survival, were analyzed. Results: Between 2000 and 2015, 28 patients underwent completion pneumonectomy for recurrent lung cancer (14 female, 14 male). The median age was 64.2 years (range, 36.7-84.0). There were 11 left-sided and 17 right-sided operations. Fourteen patients (50.0%) underwent chemotherapy or chemoradiotherapy prior to surgery. Perioperative morbidity was seen in 13 of 28 (46.4%) patients, and atrial fibrillation was the most common complication. Mortality at 30-and 90-day intervals was 3.6%, and 14.3% respectively. Five-year overall survival was 43.1% and was not associated with preoperative chemotherapy or chemoradiotherapy use. Patients over 70 years old (n=5) experienced a statistically higher rate of postoperative complications (100.0% vs. 34.8%, P=0.013), and this translated into a higher mortality rate at 60 and 90 days. Left-sided resections were associated with increased risk of recurrent laryngeal nerve injury (RLN) compared to rightsided resections (36.4% vs. 0%, P=0.016), and those patients with RLN injury were more likely to be reintubated (50.0% vs. 4.2%, P=0.04). Bronchopleural fistula occurred in 1 patient (3.6%). Conclusions: Completion pneumonectomy is a viable treatment option for patients with recurrent NSCLC. We attribute our low risks of major morbidity, such as bronchopleural fistula, to careful patient selection and technique. In patients over 70 years, morbidity is higher which should inform discussion regarding surgical options.

show abstract

“…Early-stage NSCLC patients lack obvious symptoms, and more than half of the patients are diagnosed at an advanced stage with metastasis of distant organs [26]. Despite the rapid development of clinical medicine and experimental oncology, the overall five-year survival rate of NSCLC patients remains low [27]. Therefore, it is particularly important to find molecular targets for the treatment and outcome prediction of NSCLC.…”

Section: Discussionmentioning

confidence: 99%

MiR-187 suppresses non-small-cell lung cancer cell proliferation by targeting FGF9

Liang

et al. 2019

Bioengineered

View full text Add to dashboard Cite

Non-small-cell lung cancer (NSCLC) is the main pathological type of lung cancer and has a low overall five-year survival rate. miR-187 has been reported to play major roles in various tumor types. In this study, we explored the impact of miR-187 on NSCLC. qRT-PCR results demonstrated that miR-187 expression is lower in NSCLC and cancer cells than normal tissues and normal lung cells. miR-187 expression levels are associated with tumor size, TNM stage and overall survival rate. MTS and colony formation assays showed that high miR-187 expression inhibits NSCLC cell proliferation and colony formation ability, and flow cytometry showed that miR-187 overexpression induces cell cycle arrest at the G0/G1 phase. A luciferase reporter assay showed that FGF9 is a target of miR-187. miR-187 overexpression reduces the expression of FGF9, cyclin D1 CDK4 and CDK6. Therefore, miR-187 may present a new NSCLC treatment target by regulates cyclins-related protein expression.

show abstract

THORACIC SURGERY Completion pneumonectomy and chemoradiotherapy as treatment options in local recurrence of non-small-cell lung cancer

Cited by 8 publications

References 19 publications

Stereotactic body radiotherapy for central lung tumors, yes we can!

Stereotactic body radiotherapy for central lung tumors, yes we can!

Completion pneumonectomy is safe and effective in select patients with recurrent non-small cell lung cancer

MiR-187 suppresses non-small-cell lung cancer cell proliferation by targeting FGF9

Contact Info

Product

Resources

About