Lung Cancer Management最新文献

Clinical use of stereotactic body radiation therapy (SBRT) has increased dramatically over the last 2 decades and is the current standard-of-care in cases of inoperable early stage non-small-cell lung cancer. While surgical resection remains the standard-of-care for operable patients, several ongoing clinical trials are investigating the role of SBRT in these operative candidates as well. Taking into consideration the expanding role and utility of SBRT, this paper will: review the historical basis of SBRT; examine landmark trials establishing the framework for the current body of evidence; discuss areas of active and future research; and identify epidemiological trends that are likely to further increase the use of SBRT.

Aim: To determine the role of claudin-3 in cancer stemness in nonsquamous non-small-cell lung carcinoma (NSCLC).

Materials & methods: In vitro/vivo extreme limiting dilution analysis and the side population assay were used to investigate the role of claudin-3 in regulating cancer stemness in nonsquamous NSCLC.

Results & conclusion: Claudin-3 depletion decreased the formation rates of spheres and tumors and increased cisplatin sensitivity. Claudin-3 was also identified as one downstream target of estrogen receptor-α in regulating cancer stemness. Moreover, targeting CLDN-3 transcription by small molecules including withaferin A, estradiol and fulvestrant suppressed cancer stemness and reversed chemoresistance. These results demonstrated claudin-3 is one positive regulator of cancer stemness in nonsuqamous NSCLC.

Aim: Non-small-cell lung cancer recurs locally 10-40% of the time after local therapy, presenting a therapeutic challenge given poor pulmonary reserve. Herein, we seek to evaluate the safety and efficacy of stereotactic body radiotherapy (SBRT) for retreatment of such patients.

Methods: We identified and reviewed clinical outcomes in ten patients with recurrent non-small-cell lung cancer after past vicryl mesh brachytherapy.

Results: Ten patients with a median age of 77 were treated to a median dose of 48 Gy in five fractions. Local control at 1 year was 88%. There was one distant failure at 29 months. There was no significant toxicity after SBRT.

Conclusion: SBRT is safe and effective when used for re-irradiation after past ablative therapies.

Sanjoy Roy speaks to Alfie Gleeson, Commissioning Editor: Sanjoy Roy is the Director of Franchise Health Economics and Market Access at Ethicon, Inc. - part of the Johnson and Johnson Medical Device Companies (OH, USA). He has a Bachelor's degree in Pharmacy from Jadavpur University (West Bengal, India), a Master's degree in Health Outcomes and Policy from West Virginia University (WV, USA) and a Professional Certificate in Strategic Marketing from Harvard University (MA, USA). He is a health economist and outcomes researcher with over two decades of work experience in the pharmaceutical and medical devices industry - both in commercial and in research functions. Ethicon has been making significant contributions to surgery, particularly in the suture field, for over 60 years. From the first sutures to the development of minimally invasive procedures they have revolutionized surgery more than once. Sanjoy Roy talks to Lung Cancer Management about how Ethicon has shaped surgery, and how new tools that Ethicon has developed have improved lung cancer surgery outcomes and reduced the economic burden of lung cancer treatment. Finally, we look at the future of lung cancer surgery and how it may change in the light of new technologies and the global burden of disease and healthcare costs.

Aim: To determine whether PET/CT and brain MRI used in staging NSCLC can be accurate, reliable and cost-effective tools. NSCLC represents 80-85% of lung cancer and adequate information on the initial tumor staging is critical for planning an optimal therapeutic strategy.

Patients & methods: Data from 30 newly diagnosed NSCLC patients in Greece were collected and prospectively recorded. Patients with potential resectable disease were evaluated to ensure that there are no detectable metastases that would rule out the possibility of a curative surgery.

Results: Divergence occurred in 50% of cases of staging with CT or PET/CT alone, while metastases undetectable by the CT were revealed using PET/CT. Unnecessary thoracotomies were avoided by 10% of patients and another 10% was operated on after chemotherapy with a better prognosis.

Conclusion: PET/CT and brain MRI combined are reliable for correct staging, reducing avoidable thoracotomies, morbidity rates and costs.

Aim: Herein, we compare outcomes in patients treated with lung stereotactic body radiotherapy (SBRT) with and without tissue confirmation.

Methods: We reviewed 196 patients that underwent lung SBRT for presumed (100 patients) or proven non-small-cell lung cancer (96 patients) over a 10-year period and compared outcomes.

Results: A total of 196 patients with a median age of 76 underwent lung SBRT to a median dose of 48 Gy in four fractions. Median follow up was 17 months. Local control and overall survival at 3 years was 94 and 58% for the entire group. There was no difference in overall survival, local control, regional control or distant control between the cohorts.

Conclusion: SBRT is a safe and effective treatment for patients with non-small-cell lung cancer that are medically inoperable with comparable results in empirically treated patients.