Combined modality therapy in Stage IIIA non-small cell lung cancer: clarity or confusion despite the highest level of evidence?

Jeremic, Branislav; Casas, Francesc; Dubinsky, Pavol; Gomez-Caamano, Antonio; Cihoric, Nikola; Videtic, Gregory; Latinovic, Miroslav (2017). Combined modality therapy in Stage IIIA non-small cell lung cancer: clarity or confusion despite the highest level of evidence? Journal of radiation research, 58(3), pp. 267-272. Oxford University Press 10.1093/jrr/rrx003

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Recent years have witnessed a number of clinical trials in Stage IIIA non-small cell lung cancer (NSCLC) comparing (A) induction chemotherapy (CHT) with induction CHT and radiotherapy (RT), each followed by surgery; (B) either induction CHT or induction RT-CHT, each followed by surgery, with definitive RT-CHT (no surgery). Due to the heterogeneity of patient, tumor and treatment characteristics across these trials, various meta-analyses (MAs) have been performed to define the optimal treatment approach in this setting for this clinical presentation. Six such MAs exist. In spite of the differences between MAs, it appears that RT does not add extra benefit to induction CHT administered before surgery, and that a trimodality (i.e. including surgery) regimen is not superior to definitive concurrent RT-CHT. While one can consider both induction CHT followed by surgery and exclusive concurrent RT-CHT as feasible in this setting, lack of pre-treatment predictive factors identifying patients who might preferentially benefit from a surgical approach limits its use to well-planned clinical trials.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Cihoric, Nikola

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1349-9157

Publisher:

Oxford University Press

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

23 Feb 2018 11:13

Last Modified:

26 Oct 2019 00:00

Publisher DOI:

10.1093/jrr/rrx003

PubMed ID:

28339761

Uncontrolled Keywords:

NSCLC Stage IIIA chemotherapy meta-analysis radiotherapy surgery

BORIS DOI:

10.7892/boris.99099

URI:

https://boris.unibe.ch/id/eprint/99099

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