Management of locally advanced non-small cell lung cancer in the modern era: A national Italian survey on diagnosis, treatment and multidisciplinary approach
Concurrent chemotherapy and radiotherapy (cCRT) is considered the standard treatment of locally advanced non-small cell lung cancer (LA-NSCLC). Unfortunately, management is still heterogeneous across different specialists. A multidisciplinary approach is needed in this setting due to recent, promisi...
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| Veröffentlicht in: | PloS one 2019-11, Vol.14 (11), p.e0224027 |
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| creator | Bruni, Alessio Giaj-Levra, Niccolò Ciammella, Patrizia Maragna, Virginia Ferrari, Katia Bonti, Viola Grossi, Francesco Greco, Stefania Greco, Carlo Borghetti, Paolo Franceschini, Davide Capelletto, Enrica Perna, Marco Banna, Giuseppe Vagge, Stefano Baldini, Editta Bria, Emilio Botti, Andrea Tiseo, Marcello Paci, Massimiliano Taraborrelli, Maria Poletti, Venerino Granone, Pierluigi Ricardi, Umberto Novello, Silvia Scotti, Vieri |
| description | Concurrent chemotherapy and radiotherapy (cCRT) is considered the standard treatment of locally advanced non-small cell lung cancer (LA-NSCLC). Unfortunately, management is still heterogeneous across different specialists. A multidisciplinary approach is needed in this setting due to recent, promising results obtained by consolidative immunotherapy. The aim of this survey is to assess current LA-NSCLC management in Italy. From January to April 2018, a 15-question survey focusing on diagnostic/therapeutic LA-NSCLC management was sent to 1,478 e-mail addresses that belonged to pneumologists, thoracic surgeons, and radiation and medical oncologists. 421 answers were analyzed: 176 radiation oncologists, 86 medical oncologists, 92 pneumologists, 64 thoracic surgeons and 3 other specialists. More than a half of the respondents had been practicing for >10 years after completing residency training. Some discrepancies were observed in clinical LA-NSCLC management: the lack of a regularly planned multidisciplinary tumor board, the use of upfront surgery in multistation stage IIIA, and territorial diffusion of cCRT in unresectable LA-NSCLC. Our analysis demonstrated good compliance with international guidelines in the diagnostic workup of LA-NSCLC. We observed a relationship between high clinical experience and good clinical practice. A multidisciplinary approach is mandatory for managing LA-NSCLC. |
| doi_str_mv | 10.1371/journal.pone.0224027 |
| format | Article |
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Unfortunately, management is still heterogeneous across different specialists. A multidisciplinary approach is needed in this setting due to recent, promising results obtained by consolidative immunotherapy. The aim of this survey is to assess current LA-NSCLC management in Italy. From January to April 2018, a 15-question survey focusing on diagnostic/therapeutic LA-NSCLC management was sent to 1,478 e-mail addresses that belonged to pneumologists, thoracic surgeons, and radiation and medical oncologists. 421 answers were analyzed: 176 radiation oncologists, 86 medical oncologists, 92 pneumologists, 64 thoracic surgeons and 3 other specialists. More than a half of the respondents had been practicing for >10 years after completing residency training. Some discrepancies were observed in clinical LA-NSCLC management: the lack of a regularly planned multidisciplinary tumor board, the use of upfront surgery in multistation stage IIIA, and territorial diffusion of cCRT in unresectable LA-NSCLC. Our analysis demonstrated good compliance with international guidelines in the diagnostic workup of LA-NSCLC. We observed a relationship between high clinical experience and good clinical practice. A multidisciplinary approach is mandatory for managing LA-NSCLC.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0224027</identifier><identifier>PMID: 31721773</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Cancer therapies ; Cancer treatment ; Carcinoma, Non-Small-Cell Lung - diagnosis ; Carcinoma, Non-Small-Cell Lung - therapy ; Care and treatment ; Chemotherapy ; Clinical medicine ; Combined Modality Therapy ; Diagnosis ; Diagnosis, Differential ; Diagnostic systems ; Drug dosages ; Durvalumab ; Email ; Hospitals ; Humans ; Immunotherapy ; Interdisciplinary Communication ; Italy ; Lung cancer ; Lung diseases ; Lung Neoplasms - diagnosis ; Lung Neoplasms - therapy ; Management ; Medical diagnosis ; Medicine and Health Sciences ; Neoplasm Staging ; Non-small cell lung cancer ; Non-small cell lung carcinoma ; Oncologists ; Oncology ; People and Places ; Polls & surveys ; Pulmonologists ; Questionnaires ; Radiation ; Radiation (Physics) ; Radiation therapy ; Radiotherapy ; Small cell lung cancer ; Small cell lung carcinoma ; Surgeons ; Surgery ; Surveys ; Surveys and Questionnaires ; Systematic review ; Thoracic surgery ; Thorax ; Tumors ; Ultrasonic imaging</subject><ispartof>PloS one, 2019-11, Vol.14 (11), p.e0224027</ispartof><rights>COPYRIGHT 2019 Public Library of Science</rights><rights>2019 Bruni et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. 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Unfortunately, management is still heterogeneous across different specialists. A multidisciplinary approach is needed in this setting due to recent, promising results obtained by consolidative immunotherapy. The aim of this survey is to assess current LA-NSCLC management in Italy. From January to April 2018, a 15-question survey focusing on diagnostic/therapeutic LA-NSCLC management was sent to 1,478 e-mail addresses that belonged to pneumologists, thoracic surgeons, and radiation and medical oncologists. 421 answers were analyzed: 176 radiation oncologists, 86 medical oncologists, 92 pneumologists, 64 thoracic surgeons and 3 other specialists. More than a half of the respondents had been practicing for >10 years after completing residency training. Some discrepancies were observed in clinical LA-NSCLC management: the lack of a regularly planned multidisciplinary tumor board, the use of upfront surgery in multistation stage IIIA, and territorial diffusion of cCRT in unresectable LA-NSCLC. Our analysis demonstrated good compliance with international guidelines in the diagnostic workup of LA-NSCLC. We observed a relationship between high clinical experience and good clinical practice. A multidisciplinary approach is mandatory for managing LA-NSCLC.</description><subject>Cancer therapies</subject><subject>Cancer treatment</subject><subject>Carcinoma, Non-Small-Cell Lung - diagnosis</subject><subject>Carcinoma, Non-Small-Cell Lung - therapy</subject><subject>Care and treatment</subject><subject>Chemotherapy</subject><subject>Clinical medicine</subject><subject>Combined Modality Therapy</subject><subject>Diagnosis</subject><subject>Diagnosis, Differential</subject><subject>Diagnostic systems</subject><subject>Drug dosages</subject><subject>Durvalumab</subject><subject>Email</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Interdisciplinary Communication</subject><subject>Italy</subject><subject>Lung cancer</subject><subject>Lung diseases</subject><subject>Lung Neoplasms - diagnosis</subject><subject>Lung Neoplasms - therapy</subject><subject>Management</subject><subject>Medical diagnosis</subject><subject>Medicine 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Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bruni, Alessio</au><au>Giaj-Levra, Niccolò</au><au>Ciammella, Patrizia</au><au>Maragna, Virginia</au><au>Ferrari, Katia</au><au>Bonti, Viola</au><au>Grossi, Francesco</au><au>Greco, Stefania</au><au>Greco, Carlo</au><au>Borghetti, Paolo</au><au>Franceschini, Davide</au><au>Capelletto, Enrica</au><au>Perna, Marco</au><au>Banna, Giuseppe</au><au>Vagge, Stefano</au><au>Baldini, Editta</au><au>Bria, Emilio</au><au>Botti, Andrea</au><au>Tiseo, Marcello</au><au>Paci, Massimiliano</au><au>Taraborrelli, Maria</au><au>Poletti, Venerino</au><au>Granone, Pierluigi</au><au>Ricardi, Umberto</au><au>Novello, Silvia</au><au>Scotti, Vieri</au><au>Chun, Stephen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of locally advanced non-small cell lung cancer in the modern era: A national Italian survey on diagnosis, treatment and multidisciplinary approach</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2019-11-13</date><risdate>2019</risdate><volume>14</volume><issue>11</issue><spage>e0224027</spage><pages>e0224027-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Concurrent chemotherapy and radiotherapy (cCRT) is considered the standard treatment of locally advanced non-small cell lung cancer (LA-NSCLC). Unfortunately, management is still heterogeneous across different specialists. A multidisciplinary approach is needed in this setting due to recent, promising results obtained by consolidative immunotherapy. The aim of this survey is to assess current LA-NSCLC management in Italy. From January to April 2018, a 15-question survey focusing on diagnostic/therapeutic LA-NSCLC management was sent to 1,478 e-mail addresses that belonged to pneumologists, thoracic surgeons, and radiation and medical oncologists. 421 answers were analyzed: 176 radiation oncologists, 86 medical oncologists, 92 pneumologists, 64 thoracic surgeons and 3 other specialists. More than a half of the respondents had been practicing for >10 years after completing residency training. Some discrepancies were observed in clinical LA-NSCLC management: the lack of a regularly planned multidisciplinary tumor board, the use of upfront surgery in multistation stage IIIA, and territorial diffusion of cCRT in unresectable LA-NSCLC. Our analysis demonstrated good compliance with international guidelines in the diagnostic workup of LA-NSCLC. We observed a relationship between high clinical experience and good clinical practice. A multidisciplinary approach is mandatory for managing LA-NSCLC.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>31721773</pmid><doi>10.1371/journal.pone.0224027</doi><tpages>e0224027</tpages><orcidid>https://orcid.org/0000-0002-9553-8465</orcidid><orcidid>https://orcid.org/0000-0003-1142-2439</orcidid><orcidid>https://orcid.org/0000-0002-2333-704X</orcidid><orcidid>https://orcid.org/0000-0003-1068-5958</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2019-11, Vol.14 (11), p.e0224027 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2314313135 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Cancer therapies Cancer treatment Carcinoma, Non-Small-Cell Lung - diagnosis Carcinoma, Non-Small-Cell Lung - therapy Care and treatment Chemotherapy Clinical medicine Combined Modality Therapy Diagnosis Diagnosis, Differential Diagnostic systems Drug dosages Durvalumab Hospitals Humans Immunotherapy Interdisciplinary Communication Italy Lung cancer Lung diseases Lung Neoplasms - diagnosis Lung Neoplasms - therapy Management Medical diagnosis Medicine and Health Sciences Neoplasm Staging Non-small cell lung cancer Non-small cell lung carcinoma Oncologists Oncology People and Places Polls & surveys Pulmonologists Questionnaires Radiation Radiation (Physics) Radiation therapy Radiotherapy Small cell lung cancer Small cell lung carcinoma Surgeons Surgery Surveys Surveys and Questionnaires Systematic review Thoracic surgery Thorax Tumors Ultrasonic imaging |
| title | Management of locally advanced non-small cell lung cancer in the modern era: A national Italian survey on diagnosis, treatment and multidisciplinary approach |
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