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American College Of Chest Physicians And Society Of Thoracic Surgeons Consensus Statement For Evaluation And Management For High-risk Patients With Stage I Non-small Cell Lung Cancer.
J. Donington, M. Ferguson, P. Mazzone, J. Handy, M. Schuchert, H. Fernando, B. Loo, M. Lanuti, A. D. de Hoyos, F. Detterbeck, A. Pennathur, J. Howington, R. Landreneau, G. Silvestri
Published 2012 · Medicine
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BACKGROUND The standard treatment of stage I non-small cell lung cancer (NSCLC) is lobectomy with systematic mediastinal lymph node evaluation. Unfortunately, up to 25% of patients with stage I NSCLC are not candidates for lobectomy because of severe medical comorbidity. METHODS A panel of experts was convened through the Thoracic Oncology Network of the American College of Chest Physicians and the Workforce on Evidence-Based Surgery of the Society of Thoracic Surgeons. Following a literature review, the panel developed 13 suggestions for evaluation and treatment through iterative discussion and debate until unanimous agreement was achieved. RESULTS Pretreatment evaluation should focus primarily on measures of cardiopulmonary physiology, as respiratory failure represents the greatest interventional risk. Alternative treatment options to lobectomy for high-risk patients include sublobar resection with or without brachytherapy, stereotactic body radiation therapy, and radiofrequency ablation. Each is associated with decreased procedural morbidity and mortality but increased risk for involved lobe and regional recurrence compared with lobectomy, but direct comparisons between modalities are lacking. CONCLUSIONS Therapeutic options for the treatment of high-risk patients are evolving quickly. Improved radiographic staging and the diagnosis of smaller and more indolent tumors push the risk-benefit decision toward parenchymal-sparing or nonoperative therapies in high-risk patients. Unbiased assessment of treatment options requires uniform reporting of treatment populations and outcomes in clinical series, which has been lacking to date.
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Severe radiation pneumonitis after lung stereotactic ablative radiation therapy in patients with interstitial lung disease.
H. Bahig (2016)
Editor's suggested readings in interventional oncology.
Z. Haskal (2013)
Histology, Tumor Volume, and Radiation Dose Predict Outcomes in NSCLC Patients After Stereotactic Ablative Radiotherapy
Kevin Shiue (2018)
Bronchoscopic treatments for early-stage peripheral lung cancer: Are we ready for prime time?
Daniel P Steinfort (2020)
ACR Appropriateness Criteria® Early-Stage Non–Small–Cell Lung Cancer
G. Videtic (2014)
Implementación de radioterapia estereotáxica torácica en un hospital terciario: resultados preliminares
María del Pino Alcántara Carrió (2017)
Outcomes of lobectomy in patients with severely compromised lung function (predicted postoperative diffusing capacity of the lung for carbon monoxide % ≤ 40%).
S. Paul (2013)
Radiofrequency Tumor Ablation
Treatment of early stage non-small cell lung cancer: surgery or stereotactic ablative radiotherapy?
Esengül Koçak Uzel (2015)
Salvage surgery to treat tumor regrowth after stereotactic body radiotherapy in primary non-small cell lung cancer.
Takahisa Koizumi (2020)
Comparison of therapeutic results from radiofrequency ablation and stereotactic body radiotherapy in solitary lung tumors measuring 5 cm or smaller
Satoru Ochiai (2014)
New techniques for assessing response after hypofractionated radiotherapy for lung cancer.
Sarah A. Mattonen (2014)
Determinants of Cancer-specific Quality of Life in Veteran Lung Cancer Survivors Eligible for Long-Term Cure
D. Ha (2019)See more