scholarly journals Review article on treatment of lung cancer and newer therapeutic modalities

2021 ◽  
Vol 8 (3) ◽  
pp. 115-118
Author(s):  
Soumya Swaroop Das ◽  
J. K. Mishra ◽  
Devendra Pratap Yadav ◽  
Akhilesh Tiwari ◽  
B. Gowthami ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Thoracoscopic Surgery ◽  
International Association ◽  
Alkylating Agents ◽  
Surgical Techniques ◽  
Stereotactic Ablative Radiotherapy ◽  
Contributing Factors ◽  
Major Health Problem ◽  
Therapeutic Modalities ◽  
Chronic Smoking

Introduction- lung cancer remains to be a major health problem globally leading to mortality, the cause of which is linked to chronic smoking, and other contributing factors. Staging- The American joint committee on cancer adopted the 8 th edition of the international association for the study of Lung Cancer's (IASLC) stagingChemotherapy- Several classes of anti cancer drugs based on their mechanism of action are used such as alkylating agents, anti metabolites, antibiotics, mitotic inhibitors, second and third generation EGFR inhibitors Thoracic surgery-Modern surgical techniques, like less invasive video assisted thoracoscopic surgery can be done. Also in radical radiotherapy stereotactic ablative radiotherapy is used to deliver large doses with high precision. Conclusion- immunotherapy is the most revolutionary advance in tumour research which continues to face challenges which if overcame can be an open door for multiple possibilities in the management of lung cancer.

Stages I-II non-small cell lung cancer treated using either lobectomy by video-assisted thoracoscopic surgery (VATS) or stereotactic ablative radiotherapy (SABR): Outcomes of a propensity score-matched analysis.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 7009-7009 ◽  
Author(s):  
Suresh Senan ◽  
Naomi E Verstegen ◽  
David Palma ◽  
George Rodrigues ◽  
Frank J Lagerwaard ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Propensity Score ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
Tumor Board ◽  
Stereotactic Ablative Radiotherapy ◽  
National Guidelines ◽  
Vats Lobectomy ◽  
Regional Control

7009 Background: VATS procedures are increasingly used in early-stage NSCLC. As high local control rates are also seen with stereotactic ablative radiotherapy (SABR), we performed a propensity score-matched analysistocompare loco-regional control (LRC) after both treatments. Methods: Patients with stage I-II NSCLC treated at 6 hospitals (1 university and 5 regional hospitals) with VATS lobectomy were eligible. Details of SABR patients were obtained from a single-institutional database. All VATS-lobectomies were performed in accordance with ESTS guidelines. Patients were matched using propensity scores based on cTNM, age, gender, Charlson comorbidity score, lung function and performance score. Matching was performed blinded to all outcomes. Excluded were: synchronous lung tumors, COPD GOLD class 4 or history of prior lung cancer. A total of 86 VATS- and 527 SABR patients were eligible for matching (1:1 ratio, caliper distance of 0.025 without replacement). Loco-regional failure was defined as recurrence in/adjacent to the radiation planning target volume or surgical margins, the ipsilateral hilum or mediastinum. Recurrences were either biopsy-confirmed or PET-positive and reviewed by a tumor board. Patients upstaged during VATS and those developing recurrence were treated in accordance with national guidelines. Results: The matched cohort consisted of 128 patients with cT1-3N0 NSCLC following SABR (n=64) or VATS-lobectomy (n=64). Median follow-up was 30 and 16 months, respectively. The groups were well matched on baseline variables. SABR patients had better LRC rates at 1- and 3-years (96.8% and 93.3% vs. 86.9% and 82.6%, respectively, p= .03). Three-year progression-free survival (PFS) did not significantly differ after SABR (79.3% versus 63.2%, p = .09). Distant recurrence rates and overall survival (OS) did not significantly differ. Conclusions: Although loco-regional control was superior after SABR compared to VATS-lobectomy, PFS and OS did not differ at this time-point. Our findings support the current randomized controlled trial evaluating both treatments (ACOSOG Z4099).

scholarly journals The Utility of Rapid On-Site Evaluation during Bronchoscopic Biopsy: A 2-Year Respiratory Endoscopy Central Experience

2019 ◽  
Vol 2019 ◽  
pp. 1-7
Author(s):  
Hansheng Wang ◽  
Na Wei ◽  
Yijun Tang ◽  
Yunyun Wang ◽  
Guoshi Luo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
International Association ◽  
Final Diagnosis ◽  
Needle Aspiration ◽  
European Respiratory Society ◽  
Macroscopic Appearance ◽  
Visible Lesion ◽  
Bronchoscopic Biopsy ◽  
Site Evaluation

Background. Rapid on-site evaluation (ROSE) is commonly used to evaluate the adequacy of biopsy materials in fine-needle aspiration; however, the diagnostic performance of ROSE during fiber optic bronchoscopy (FOB) biopsy under direct vision is rarely reported. Here, we evaluated the role of ROSE during FOB biopsy of visible lesion in trachea or bronchi. Methods. The role of ROSE was prospectively evaluated in consecutive bronchoscopy specimens obtained between January 2016 and January 2018. The agreement and accuracy between ROSE and final histopathological interpretation were assessed. The frequency and possible reasons for discrepancy between ROSE and definitive histopathology results were identified. Histological and cytological classification was performed according to the International Association for the Study of Lung Cancer, the American Thoracic Society, and the European Respiratory Society (IASLC/ATS/ERS) criteria of lung ADCs classification. Results. The study enrolled 651 patients, of which 33 were excluded because of insufficient cells. Final diagnosis of malignancy was achieved in 462 cases (74.8%), whereas 156 cases (25.2%) were nonmalignant. ROSE and pathology were well correlated for the diagnosis of squamous cell carcinoma (SCC) (Kappa = 0.718, p<0.05), adenocarcinoma (AdC) (Kappa = 0.662; p<0.05) and small cell lung cancer (SCLC) (Kappa = 0.955; p<0.05). In 24 cases diagnosed as malignant by ROSE and nonmalignant by pathology, the lesion tissues were surgically excised and re-analyzed, and the 24 cases were finally confirmed as malignant by pathology. Conclusions. ROSE technique allows bronchoscopists to obtain viable and adequate material for the diagnosis of histopathology, and provides them with an onsite preliminary diagnosis especially in cases with inconclusive macroscopic appearance. ROSE and pathology should be used in combination to increase the accuracy of diagnosis.

scholarly journals Chronic Obstructive Pulmonary Disease: Epidemiology, Biomarkers, and Paving the Way to Lung Cancer

2021 ◽  
Vol 10 (13) ◽  
pp. 2889
Author(s):  
Klára Szalontai ◽  
Nikolett Gémes ◽  
József Furák ◽  
Tünde Varga ◽  
Patrícia Á. Neuperger ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Alveolar Wall ◽  
Obstructive Pulmonary Disease ◽  
Major Health Problem ◽  
Chronic Inflammatory Response ◽  
Disease Epidemiology

Chronic obstructive pulmonary disease (COPD), the frequently fatal pathology of the respiratory tract, accounts for half a billion cases globally. COPD manifests via chronic inflammatory response to irritants, frequently to tobacco smoke. The progression of COPD from early onset to advanced disease leads to the loss of the alveolar wall, pulmonary hypertension, and fibrosis of the respiratory epithelium. Here, we focus on the epidemiology, progression, and biomarkers of COPD with a particular connection to lung cancer. Dissecting the cellular and molecular players in the progression of the disease, we aim to shed light on the role of smoking, which is responsible for the disease, or at least for the more severe symptoms and worse patient outcomes. We summarize the inflammatory conditions, as well as the role of EMT and fibroblasts in establishing a cancer-prone microenvironment, i.e., the soil for ‘COPD-derived’ lung cancer. We highlight that the major health problem of COPD can be alleviated via smoking cessation, early diagnosis, and abandonment of the usage of biomass fuels on a global basis.

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