Patterns of Failure After Surgery for Non–Small-cell Lung Cancer Invading the Chest Wall

Introduction

The patterns of failure after resection of non–small-cell lung cancer (NSCLC) invading the chest wall are not well documented, and the role of adjuvant radiation therapy (RT) is unclear, prompting the present analysis.

Association of the 8473T>C Cyclooxygenase-2 (COX-2) Gene Polymorphism with Lung Cancer Risk in Asians

Objective: To evaluate the impact of the COX-2 gene 8473T>C polymorphism on lung cancer risk in Asians,we conducted a comprehensive meta-analysis. Methods: A literature search was performed using PubMed andother databases before June 2010. We pooled studies according to the variants of 8473T>C and performedseparate analyses according to ethnicity, histological type and smoking status, with attention to study qualityand publication bias. Results: A total of five case-control studies including 2,450 cases and 4,302 controls wereavailable. Overall, individuals with the C allele had a reduced lung cancer risk compared with the TT genotypeon global analysis (odds ratio [OR] =0.89, 95% confidence interval [CI] =0.81 to 0.97, P=0.01, I2 for heterogeneity=0%). Significant associations were also observed in subgroups of Asian populations (OR=0.84, 95% CI=0.72 to0.98) when stratified by ethnicity, as well as for small cell lung cancer (OR=0.54, 95% CI=0.31 to 0.95) stratifiedby pathological type. Conclusions: Our results suggest the COX-2 gene is a factor for suffering from lung cancer,especially of small cell type among Asians.     

Molecular Testing Turnaround Time for Non–Small Cell Lung Cancer in Routine Clinical Practice Confirms Feasibility of CAP/IASLC/AMP Guideline Recommendations: A Single-center Analysis

Introduction

Molecular testing to identify targetable driver mutations is the standard of care for patients with advanced-stage non–small cell lung cancer. Recent guideline recommendations by the College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association for Molecular Pathology (AMP) established a benchmark turnaround time (TAT) target of 10 working days for results to be available to the treating oncologist and ≤ 3 days for specimens to arrive at a commercial testing laboratory if testing is not performed in-house.

Second-Line Treatment Options in Non–Small-Cell Lung Cancer: Report From an International Experts Panel Meeting of the Italian Association of Thoracic Oncology

Non–small-cell lung cancer (NSCLC) patients inevitably progress to first-line therapy and further active treatments are warranted. In the past few years, new second-line therapies, beyond chemotherapy agents, have become available in clinical practice. To date, several options for the second-line treatment of non–oncogene-addicted NSCLC patients ranging from chemotherapy in combination with antivascular endothelial growth factor receptor to immunotherapeutics are available. In oncogene-driven tumors, the better knowledge of mechanisms of acquired resistance to earlier tyrosine kinase inhibitors is leading to novel active inhibitors now available/in development. The second-line algorithm treatment of NSCLC becomes very intricate and the selection of proper patients with one of the new available therapeutic options is of paramount importance to personalize and optimize the treatment. In this review we discuss the second-line treatment opportunities of addicted as well as not-addicted NSCLC.     

Comparative Analysis for Diagnostic Yield of Small Cell Lung Cancer by Cytology and Histology During the Same Bronchoscopic Procedure

Background

Biopsy, brushing, and transbronchial needle aspiration (TBNA) are the most common methods used for the diagnosis of small cell lung cancer during the same diagnostic bronchoscopic procedure. However, it is not clear which method provides better results.

Adaptive Radiotherapy for Lung Cancer

The concept of adaptive radiotherapy (ART) was proposed 20 years ago, and since then a variety of methodologies and techniques have been developed to accommodate different clinical requirements, including both online and offline plan adaptations. Compared with pre-treatment planning, plan adaptation involves more computational tasks and consequently has increased complexity and computational burden. While ART can benefit many cancer patients, challenges still exist in development and implementation of high-quality ART programs. In this short review, we will focus on the development of offline ART for lung cancer. We will also discuss the advantages and disadvantages of different clinical implementations of ART.     

The Canadian Association of Radiation Oncology Scope of Practice Guidelines for Lung, Liver and Spine Stereotactic Body Radiotherapy

AimsThe Canadian Association of Radiation Oncology-Stereotactic Body Radiotherapy (CARO-SBRT) Task Force was established in 2010. The aim was to define the scope of practice guidelines for the profession to ensure safe practice specific for the most common sites of lung, liver and spine SBRT.Materials and methodsA group of Canadian SBRT experts were charged by our national radiation oncology organisation (CARO) to define the basic principles and technologies for SBRT practice, to propose the minimum technological requirements for safe practice with a focus on simulation and image guidance and to outline procedural considerations for radiation oncology departments to consider when establishing an SBRT programme.ResultsWe recognised that SBRT should be considered as a specific programme within a radiation department, and we provide a definition of SBRT according to a Canadian consensus. We outlined the basic requirements for safe simulation as they pertain to spine, lung and liver tumours, and the fundamentals of image guidance. The roles of the radiation oncologist, medical physicist and dosimetrist have been detailed such that we strongly recommend the development of SBRT-specific teams. Quality assurance is a key programmatic aspect for safe SBRT practice, and we outline the basic principles of appropriate quality assurance specific to SBRT.ConclusionThis CARO scope of practice guideline for SBRT is specific to liver, lung and spine tumours. The task force recommendations are designed to assist departments in establishing safe and robust SBRT programmes.     

Evaluation of the Japanese Gastric Cancer Association’s Gastric Cancer Treatment Guidelines for Popular Use

Background The Japanese Gastric Cancer Associations (JGCAs) Gastric cancer treatment guidelines for doctors reference and the guidelines (GLs) for popular use were both published in 2001. The purpose of this study was to know whether or not it is useful for patients to read the GLs for popular use.Methods We lent the GLs for popular use to patients with gastric cancer for several days and had them read the GLs before they were informed about their condition and the recommended treatment. Then they received questionnaires concerning the GLs.Results Most of the patients, even the elderly, had read and understood the GLs. Nearly 70% of the patients answered that it was very useful for them to read the GLs. On the other hand, 34% of the patients suggested negative aspects, such that reading the GLs increased their anxiety about the disease or treatment. Only 9% of the patients expected treatment that followed the GLs, whereas 54% of the patients expected treatment based on the doctors own experience without adherence to the GLs. If the doctor were to suggest treatment that did not follow the GLs, 87% of the patients answered that they would follow the doctors suggestion, and it was only 8% who answered that they would seek a second opinion. These results did not differ when patients were requested to fill out questionnaires anonymously.Conclusion Although the GLs for popular use are useful to provide patients with information concerning the disease and the treatment modalities, they may not have a great impact on patients decisions about their treatment.     

Meat Consumption,Meat Cooking and Risk of Lung Cancer Among Uruguayan Men

A case-control study was conducted in Uruguay, including 876 male cases of lung cancer and 876 malehospitalized controls, frequency matched for age (ten-year intervals), residence and hospital. The followingexplanatory variables were included in the study: fried red meat, barbecued red meat, boiled red meat, andsalted red meat. These items were log transformed and energy-adjusted by the residuals method. The followingpotential confounders were included into the models: age, residence, hospital, education, family history of lungcancer, body mass index, smoking index, alcohol drinking, mate consumption, total energy intake, non-meatfatty foods and total fruits. The main objective was to estimate the odds ratios associated with lung cancer risk.Whereas fried meat, barbecued meat, and salted meat were positively associated with risk (OR of the highestquartile of salted meat versus the lowest, 2.90, 95 % CI 1.99-4.25, p-value for trend <0.0001), boiled red meatwas mainly protective. We conclude that salted meat was the main risk factor. The mechanisms could be relatedto the content of N-nitroso compounds in salted meat.     

Molecular Adequacy of Image-Guided Rebiopsies for Molecular Retesting in Advanced Non–Small Cell Lung Cancer: A Single-Center Experience

Introduction

In the era of biomarker-driven systemic therapy for advanced NSCLC, the role of routine repeated biopsies for decision making outside EGFR-mutant disease remains unproven. We report our center’s experience of safety and adequacy for molecular retesting of tumor material obtained from image-guided lung rebiopsies in NSCLC.