Check the Reports and Check the Brain

There has been no recent randomized evidence justifying postoperative radiation therapy (PORT) in patients with non-small cell lung cancer who have undergone complete resection; it is not recommended for routine use, even in patients with mediastinal involvement (pN2).1,2 Adjuvant treatments such as chemotherapy and PORT should be discussed at a multidisciplinary board with complete surgical and pathologic reports, checking whether the nodal exploration was appropriate, the location and number of mediastinal nodes and hilar/intrapulmonary nodes that were resected, and whether resection was complete.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Gray Zone Source Type: research

Related Links:

Conclusions The recent, first randomized clinical trial demonstrated overall and progression free survival benefits after SBRT to oligometastatic disease which supports prior retrospective case series (6). The spine is a common site of metastatic bone disease, and as high quality data continue to mature, along with completion of additional randomized clinical trials, it is expected that utility of SBRT to the spine will increase in the future. Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
AbstractPurpose of ReviewEvaluate safety and efficacy of newer systemic therapies for intracranial metastases (IM) from non-small cell lung cancer (NSCLC) when given alone and with concurrent radiation therapy (RT) and determine which patients with IM may benefit from upfront systemic therapy while withholding RT.Recent FindingsIn NSCLC, chemotherapy regimens are associated with approximately 20% intracranial overall response rates (ORRs) and immunotherapies 30 –50% intracranial ORRs. However, tyrosine kinase inhibitor (TKI) therapies for EGFR-mutated patients provide ORRs ranging from 50 to 90%. Prospective data sug...
Source: Current Respiratory Care Reports - Category: Respiratory Medicine Source Type: research
Authors: Abdallah SM, Wong A Abstract Significant progress has been made in the treatment of stage iv non-small-cell lung cancer (nsclc); however, the prognosis of patients with brain metastases remains poor. Resection and radiation therapy remain standard options. This issue is an important one because 10% of patients with nsclc have brain metastases at diagnosis, and 25%-40% develop brain metastases during their disease. Standard chemotherapy does not cross the blood-brain barrier. However, there is new hope that tyrosine kinase inhibitors (tkis) used in patients with identified targetable mutations such as mutat...
Source: Current Oncology - Category: Cancer & Oncology Tags: Curr Oncol Source Type: research
Abstract Background: The role of postradiation systemic therapy in non-small cell lung cancer (NSCLC) patients with brain metastasis (BM) was controversial. Thus, we explored the role of Radiation Therapy Oncology Group recursive partitioning analysis (RTOG-RPA) and graded prognostic assessment (GPA) in identifying population who may benefit from postradiation systemic therapy. Methods: The clinical data of NSCLC patients with documented BM from August 2007 to April 2015 of two hospitals were studied retrospectively. Cox regression was used for multivariate analysis. Survival of patients with or without postr...
Source: Chinese Medical Journal - Category: General Medicine Authors: Tags: Chin Med J (Engl) Source Type: research
CONCLUSIONS: Patients receiving pemetrexed after brain-directed stereotactic radiation appear to benefit from improved intracranial disease control at the possible expense of radiation-related radiographic necrosis. Whether symptomatic radiation injury occurs more frequently in patients receiving pemetrexed requires further study. PMID: 29398153 [PubMed - as supplied by publisher]
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
Opinion statementManagement of non-small cell lung cancer (NSCLC) with brain metastasis (BrM) has been revolutionized by identification of molecular subsets that have targetable oncogenes. Historically, survival for NSCLC with symptomatic BrM was weeks to months. Now, many patients are surviving years with limited data to guide treatment decisions. Tumors with activating mutations in epidermal growth factor receptor (EGFRact+) have a higher incidence of BrM, but a longer overall survival. The high response rate of both systemic and BrM EGFRact+ NSCLC to tyrosine kinase inhibitors (TKIs) has led to the rapid incorporation o...
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research
Rationale: Most of nonsmall cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) activating mutations eventually acquire resistance to the first EGFR-tyrosine kinase inhibitors (TKIs) therapy after varying periods of treatment. Of note, approximately one-third of those patients develop brain metastases, which deteriorate their quality of life and survival. The effect of systemic chemotherapy on brain metastases after acquisition of EGFR-TKI resistance is limited, and thus far, whole-brain radiation therapy, which may cause the harmful effect on neurocognitive functions, has been the only esta...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
Conclusion: Pseudo progression is only seen in a small part of patients treated with immunotherapy. With little tumor burden a treatment continuation can be feasible. Also patients who are not considered fit for second line chemotherapy may continue treatment. Aggressive tumor growth or high tumor load should stay a domain of conventional second line chemotherapy.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 11.1 Lung Cancer Source Type: research
Conclusions: This paper aims to alert for this rare and aggressive tumor, affecting mostly smoking male, which remains poorly explored. The better knowledge of PSC biology and molecular profile is critical for understanding the role of immunotherapy and targeted agents in this difficult to treat disease.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: 11.1 Lung Cancer Source Type: research
Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). The aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes. Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemotherapy or targeted therapy) were identified. The rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no significant difference between two gro...
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
More News: Biology | Brain | Brain Cancers | Cancer | Cancer & Oncology | Chemotherapy | Lung Cancer | Neurology | Non-Small Cell Lung Cancer | Physics | Radiation Therapy | Radiology