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Locally advanced non-small cell lung cancer: current issues and recent trends
The focus of this paper was to review and summarise the current issues and recent trends within the framework of locally advanced (LA) non-small cell lung cancer (NSCLC). The recently proposed 8(th) tumour–node–metastases (TNM) staging system exhibited significant amendments in the distribution of t...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Via Medica
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348324/ https://www.ncbi.nlm.nih.gov/pubmed/37456701 http://dx.doi.org/10.5603/RPOR.a2023.0019 |
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author | Alaswad, Mohammed |
author_facet | Alaswad, Mohammed |
author_sort | Alaswad, Mohammed |
collection | PubMed |
description | The focus of this paper was to review and summarise the current issues and recent trends within the framework of locally advanced (LA) non-small cell lung cancer (NSCLC). The recently proposed 8(th) tumour–node–metastases (TNM) staging system exhibited significant amendments in the distribution of the T and M descriptors. Every revision to the TNM classification should contribute to clinical improvement. This is particularly necessary regarding LA NSCLC stratification, therapy and outcomes. While several studies reported the superiority of the 8(th) TNM edition in comparison to the previous 7(th) TNM edition, in terms of both the discrimination ability among the various T subgroups and clinical outcomes, others argued against this interpretation. Synergistic cytotoxic chemotherapy with radiotherapy is most prevalent in treating LA NSCLC. Clinical trial experience from multiple references has reported that the risk of locoregional relapse and distant metastasis was less evident for patients treated with concomitant radiochemotherapy than radiotherapy alone. Nevertheless, concern persists as to whether major incidences of toxicity may occur due to the addition of chemotherapy. Cutting-edge technologies such as four-dimensional computed tomography (4D-CT) and volumetric modulated arc therapy (VMAT) should yield therapeutic gains due to their capability to conform radiation doses to tumours. On the basis of the preceding notion, the optimum radiotherapy technique for LA NSCLC has been a controversial and much-disputed subject within the field of radiation oncology. Notably, no single-perspective research has been undertaken to determine the optimum radiotherapy modality for LA NSCLC. The landscape of immunotherapy in lung cancer is rapidly expanding. Currently, the standard of care for patients with inoperable LA NSCLC is concurrent chemoradiotherapy followed by maintenance durvalumab according to clinical outcomes from the PACIFIC trial. An estimated 42.9% of patients randomly assigned to durvalumab remained alive at five years, and free of disease progression, thereby establishing a new benchmark for the standard of care in this setting. |
format | Online Article Text |
id | pubmed-10348324 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Via Medica |
record_format | MEDLINE/PubMed |
spelling | pubmed-103483242023-07-15 Locally advanced non-small cell lung cancer: current issues and recent trends Alaswad, Mohammed Rep Pract Oncol Radiother Review Article The focus of this paper was to review and summarise the current issues and recent trends within the framework of locally advanced (LA) non-small cell lung cancer (NSCLC). The recently proposed 8(th) tumour–node–metastases (TNM) staging system exhibited significant amendments in the distribution of the T and M descriptors. Every revision to the TNM classification should contribute to clinical improvement. This is particularly necessary regarding LA NSCLC stratification, therapy and outcomes. While several studies reported the superiority of the 8(th) TNM edition in comparison to the previous 7(th) TNM edition, in terms of both the discrimination ability among the various T subgroups and clinical outcomes, others argued against this interpretation. Synergistic cytotoxic chemotherapy with radiotherapy is most prevalent in treating LA NSCLC. Clinical trial experience from multiple references has reported that the risk of locoregional relapse and distant metastasis was less evident for patients treated with concomitant radiochemotherapy than radiotherapy alone. Nevertheless, concern persists as to whether major incidences of toxicity may occur due to the addition of chemotherapy. Cutting-edge technologies such as four-dimensional computed tomography (4D-CT) and volumetric modulated arc therapy (VMAT) should yield therapeutic gains due to their capability to conform radiation doses to tumours. On the basis of the preceding notion, the optimum radiotherapy technique for LA NSCLC has been a controversial and much-disputed subject within the field of radiation oncology. Notably, no single-perspective research has been undertaken to determine the optimum radiotherapy modality for LA NSCLC. The landscape of immunotherapy in lung cancer is rapidly expanding. Currently, the standard of care for patients with inoperable LA NSCLC is concurrent chemoradiotherapy followed by maintenance durvalumab according to clinical outcomes from the PACIFIC trial. An estimated 42.9% of patients randomly assigned to durvalumab remained alive at five years, and free of disease progression, thereby establishing a new benchmark for the standard of care in this setting. Via Medica 2023-06-26 /pmc/articles/PMC10348324/ /pubmed/37456701 http://dx.doi.org/10.5603/RPOR.a2023.0019 Text en © 2023 Greater Poland Cancer Centre https://creativecommons.org/licenses/by-nc-nd/4.0/This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially |
spellingShingle | Review Article Alaswad, Mohammed Locally advanced non-small cell lung cancer: current issues and recent trends |
title | Locally advanced non-small cell lung cancer: current issues and recent trends |
title_full | Locally advanced non-small cell lung cancer: current issues and recent trends |
title_fullStr | Locally advanced non-small cell lung cancer: current issues and recent trends |
title_full_unstemmed | Locally advanced non-small cell lung cancer: current issues and recent trends |
title_short | Locally advanced non-small cell lung cancer: current issues and recent trends |
title_sort | locally advanced non-small cell lung cancer: current issues and recent trends |
topic | Review Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10348324/ https://www.ncbi.nlm.nih.gov/pubmed/37456701 http://dx.doi.org/10.5603/RPOR.a2023.0019 |
work_keys_str_mv | AT alaswadmohammed locallyadvancednonsmallcelllungcancercurrentissuesandrecenttrends |