scholarly journals Current status of stereotactic ablative body radiotherapy in the UK: six years of progress

BJR|Open ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 20190022 ◽  
Author(s):  
Gail Distefano ◽  
Satya Garikipati ◽  
Helen Grimes ◽  
Matthew Hatton
Keyword(s):  
Quality Assurance ◽  
Image Guidance ◽  
Early Stage ◽  
Development Aid ◽  
Current Status ◽  
Patient Specific ◽  
Early Stage Lung Cancer ◽  
Stereotactic Ablative Body Radiotherapy ◽  
The Uk ◽  
Future Plans

Objective: To update the 2012 UK stereotacticablative radiotherapy (SABR) Consortium survey and assess the development of SABR services across the UK over the past 6 years. Use the results to share practice and continue to drive forward technique development, aid standardization and by highlighting issues, improve access to SABR services and trials across the UK. Methods: In January 2018, an online questionnaire was sent by the UK SABR Consortium to 65 UK radiotherapy institutions covering current service provision and collecting data on immobilization, motion management, scanning protocols, target/OAR delineation, planning, image-guidance, quality assurance and future plans. Results: 50 (77%) institutions responded, 38 ( vs 15 in 2012) indicated they had an active SABR programme with the remaining 12 centres intending to develop a SABR programme Documented changes include the development of Linac delivered SABR to non-lung sites, an increase in centres using abdominal compression (14 vs 2) and the introduction of four-dimensional cone beam CBCT. Current practice is broadly in line with UK SABR Consortium and European guidelines. Conclusion: This 2018 survey shows a welcome increase in SABR provision, surpassing 2012 projections. However, it is clear that the UK SABR program needs to continue to expand to ensure that patients with oligometastatic disease have access and SABR for early stage lung cancer is available in all centres. Updated guidance that addresses variability in target delineation, image guidance and reduces patient specific quality assurance is warranted. Advances in knowledge: Documented progress of UK SABR across all treatment sites over the last six years, barriers to implementation and future plans.

scholarly journals The Role of VATS in Lung Cancer Surgery: Current Status and Prospects for Development

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Dariusz Dziedzic ◽  
Tadeusz Orlowski
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Lung Resection ◽  
Lung Cancer Surgery ◽  
Cancer Surgery ◽  
Current Status ◽  
Invasive Technique ◽  
Early Stage Lung Cancer ◽  
Surgical Modality

Since the introduction of anatomic lung resection by video-assisted thoracoscopic surgery (VATS) 20 years ago, VATS has experienced major advances in both equipment and technique, introducing a technical challenge in the surgical treatment of both benign and malignant lung disease. The demonstrated safety, decreased morbidity, and equivalent efficacy of this minimally invasive technique have led to the acceptance of VATS as a standard surgical modality for early-stage lung cancer and increasing application to more advanced disease. Formerly there was much debate about the feasibility of the technique in cancer surgery and proper lymph node handling. Although there is a lack of proper randomized studies, it is now generally accepted that the outcome of a VATS procedure is at least not inferior to a resection via a traditional thoracotomy.

Initial outcome and toxicity of stereotactic ablative body radiotherapy (SABR) for early stage lung cancer in a single UK centre

2017 ◽  
Vol 29 (11) ◽  
pp. e204-e205
Author(s):  
Ian S. Boon ◽  
Jenny E. Marsden ◽  
Nilesh S. Tambe ◽  
Andrzej Wieczorek ◽  
Nabil El-Mahdawi
Keyword(s):  
Lung Cancer ◽  
Early Stage ◽  
Early Stage Lung Cancer ◽  
Stereotactic Ablative Body Radiotherapy ◽  
Initial Outcome ◽  
Stage Lung Cancer

scholarly journals Optimal resection rate for lung cancer in the UK: how high should we go?

2021 ◽  
Vol 8 (1) ◽  
pp. e000771
Author(s):  
Elizabeth Belcher ◽  
Jenny Mitchell ◽  
Dionisios Stavroulias ◽  
Francesco Di Chiara ◽  
Najib Rahman
Keyword(s):  
Lung Cancer ◽  
Median Survival ◽  
Cancer Progression ◽  
Early Stage ◽  
Primary Lung Cancer ◽  
Patient Choice ◽  
Resection Rate ◽  
Early Stage Lung Cancer ◽  
The Uk ◽  
Stage Lung Cancer

BackgroundThe optimal resection rate for institutions managing early-stage primary lung cancer is not known. Whether the prognosis of patients who do not proceed to operation is determined by their comorbidities for which they were deemed at prohibitively high-operative risk, or disease progression, is uncertain. We investigated the outcomes of patients with early-stage lung cancer who were considered for surgical management.MethodsWe reviewed the outcomes of consecutive patients who were considered for resection of early-stage primary lung cancer at Oxford University Hospitals National Health Service Foundation Trust between 2012 and 2017.ResultsBetween 29 November 2012 and 31 March 2017, 467 consecutive patients underwent resection with curative intent for primary lung cancer (operative group), while 81 patients were deemed resectable but either inoperable or did not wish to proceed to operation (non-operative group). Reason for not proceeding to resection was cardiovascular in 16 patients (19.8%), respiratory in 21 (25.9%), cardiorespiratory in 11 (13.6%), performance status in 8 (9.9%) and patient choice in 25 (30.9%) patients. Sixty-six patients (81.5%) received an alternative radical treatment. Median follow-up was 169 weeks (IQR 119–246 weeks) in the operative group and 118 weeks (IQR 74–167 weeks) in the non-operative group. Median survival of patients with early-stage lung cancer who did not proceed to operation was 2.5 years; median survival of patients undergoing lung cancer resection was undefined (p<0.0001). Lung cancer was documented as directly or indirectly leading to or contributing to death in 40 patients (76.9%). In 11 patients, the cause of death was due to comorbidities (21.2%).ConclusionsPatients turned down for operation in a high-resection rate UK unit have limited survival due to lung cancer progression. We conclude that ‘optimal’ resection rates may not have been reached in the UK even in high-resection rate centres.

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