SBRT & WEDGE RESECTION ARE EQUIVALENT THERAPIES FOR EARLY STAGE LUNG CANCER AND OLIGOMETASTATIC DISEASE
|
|
|
- Solomon Harrell
- 5 years ago
- Views:
Transcription
1 & WEDGE RESECTION ARE EQUIVALENT THERAPIES FOR EARLY STAGE LUNG CANCER AND OLIGOMETASTATIC DISEASE David Rice AATS/STS GENERAL THORACIC SURGERY SYMPOSIUM, APRIL 26, 2015
2 Disclosure Olympus America, Inc., Consultant
3 THERE ARE NO RANDOMIZED TRIALS
4 THERE ARE NO RANDOMIZED TRIALS
5 Methods SYSTEMATIC REVIEW: MEDLINE (Ovid) literature search SEARCH TERMS: Lung neoplasms (mo, rt, su or th) [50,156] AND Radiosurgery or Stereotaxic techniques [22,830]
6 Methods 1,016 results Limits: English language, , series with 20 patients, no review articles / systematic reviews 68 studies selected for analysis
7 Methods SINGLE-ARM (retrospective): 46 studies (6 excluded - incomplete recurrence or follow-up data) SINGLE-ARM (prospective): 13 COMPARATIVE (retrospective): 9 studies (2 excluded cost effectiveness, short-term outcomes only) RANDOMIZED: 0
8 Retrospective Studies Author Year n Age (yrs) Operable (%) Stage IA (%) Uematsu Onishi Wulf Baumann Nyman Hof na 40 na Onishi Pennarthur Ricardi Scosetti Onimaru Inoue Stephans Takeda van der Voort Baba Vahdat Andratschke Nath Onishi ACA (%) Author Year n Age (yrs) Operable (%) Stage IA (%) Verstegen Chang Grillis Hamamoto Lagerwaard Senthi Shirata Taremi Allibhai Guckenberger Inoue Jeppesen Samuels Takeda Chang Lucas Ricardi Takeda Yamamoto Davis ACA (%) n Age (yrs) Operable (%) Stage IA (%) ACA (%) Total 6, yrs 25% 65% 41%
9 Prospective Studies Author Year n Age Operable (%) Stage IA (%) ACA (%) Author Year n Age Operable (%) Stage IA (%) ACA (%) Timmerman McGarry Nagata Zimmermann Koto Baumann Fakaris Fakaris Ricardi NR 32 Nagata Timmerman (RTOG 0236) Bral Shibamoto Timmerman (RTOG 0618) n Age (yrs) Operable (%) Stage IA (%) ACA (%) Total yrs 25% 64% 47%
10 Author Year Follow-up LR LC-3yr OS-3yr OS-5-yr Uematsu Onishi Wulf Baumann Nyman Hof Onishi Pennarthur Ricardi Scosetti Onimaru Inoue % <2cm; 61% >2cm 90% < 2cm; 39% > 2cm Stephans (1-yr) Takeda % (stage IA), 96% (Stage IB) 90 (Stage 1A), 63% (stage IB) 67% (IA) 51% (IB) van der Voort 2009 na Baba Vahdat Andratschke Nath Onishi Verstegen to Chang Grillis Hamamoto Lagerwaard % (stage IA), 96% (Stage IB) - 51 Senthi % (2-yr), 11% (5-yr) Shirata Taremi (4-yr) (4-yr) Allibhai Guckenberger Inoue (5-yr 78%) Jeppesen Samuels Takeda Chang Lucas Ricardi Takeda Yamamoto Davis mo 8% 84% 56% 42%
11 Author Year Follow-up LR LC-3yr OS-3yr OS-5-yr Timmerman McGarry Nagata (5-yr 1A) 83 (1A), 72(1B) 83 (1A), 72(1B) Zimmermann Koto (T1), 40 (T2) Baumann Fakaris Ricardi Nagata Timmerman (RTOG 0236) Bral Shibamoto Timmerman (RTOG 0618) mo 10% 87% 62% 50%
12 Single-Arm Studies Summary Retrospective Prospective n 6, Age Medically Inoperable 75% 75% Stage IA 65% 64% Adenocarcinoma 41% 47% Follow-up 26 months 32 months Local control (3-yr) 84% 87% Local recurrence 8% 10% Overall survival (3 / 5-yr) 56% / 42% 62% / 50%
13 Sublobar Resection
14 Sublobar Resection Author, year n Age Stage IA (%) Diameter ACA (%) LRR (%) OS 3-yr OS 5-yr Koike, cm Keenan, Stage I Martin-Uncar, cm Fernando, cm (max) Okada, (<2cm) 1.6cm El Sherif, cm Schuchert, cm Nakayama, (<2cm) 2cm (max) 60% BAC Sienel, cm Okami, % > % <2cm Wolf, (<2cm) 1.5cm Schuchert, cm Taylor, NR - 49 Schuchert, cm (max) Okada, cm Koike, % < (<2cm) 2cm (max) Varlotto, cm Fernando, %<2cm Landreneau, cm , yrs 91% 68% 9% 79% 67%
15 A Fair Comparison? Retrospective Prospective Sublobar n 6, ,014 Age Medically Inoperable 75% 75% 0% Stage IA 65% 64% 91% Adenocarcinoma 41% 47% 68% Follow-up 26 mo 32 mo 45 mo Local control (3-yr) 84% 87% - Local recurrence 8% 10% 9% Overall survival (3 / 5-yr) 56% / 42% 62% / 50% 79% / 67%
16 Some Truths has evolved over the last 15 years (BED >100 Gy) Lessons learned from sublobar resection appear to hold true for (tumor stage, size) No amount of statistical matching can account for all selection biases
17 Influence of Operability Inoue, 2009 Onishi, 2007
18 Influence of Tumor Stage Inoue, 2013 Takeda, 2009
19 Inoue, 2009 Influence of Tumor Size
20 Onishi, 2004 Influence of Dose (Gy)
21 Overall Survival (%) Survival & Operability yr Medically Operable (%)
22 Overall Survival (%) Survival & Operability yr 2-yr Medically Operable (%)
23 Overall Survival (%) Survival & Operability yr 2-yr 3-yr Medically Operable (%)
24 Overall Survival (%) Survival & Operability yr 2-yr 3-yr 5-yr Medically Operable (%)
25 Overall Survival (%) Survival & Stage IA yr Stage IA (%)
26 Overall Survival (%) Survival & Stage IA yr 80 2-yr Stage IA (%)
27 Overall Survival (%) Survival & Stage IA yr yr 3-yr Stage IA (%)
28 Overall Survival (%) Survival & Stage IA yr yr 3-yr 5-yr Stage IA (%)
29 Comparative Studies (retrospective) Author Year Group Years n Study type Endpoint Grills 2010 Palma 2011 Crabtree 2010 Shirvani 2012 Robinson 2013 Varlotto 2013 Verstegen SLR 69 Non-matched 109 (60) Matched pair (not Surgery 81 (60) comorbidities) (57) Surgery (57) 124 (99) Lobectomy (99) SLR 1277 (121) 78 (76) Lobectomy 260 (76) 137 (72) Lobectomy (72) SLR VATS Lobectomy Matched pair SEER, Propensity matched T stage matched Matched pair Propensity matched OS OS
30 Comparative Studies (retrospective) Author Year Group Years n Study type Endpoint 58 Grills SLR (60) Palma 2011 Median FU months Surgery 81 (60) Crabtree 2010 Shirvani 2012 Robinson 2013 Varlotto 2013 Verstegen 2013 Local recurrence 4% vs. 20% (p=0.07), vs. SLR Non-matched OS favored SLR but CSS identical (57) Surgery (57) 124 (99) Lobectomy (99) SLR 1277 (121) 78 (76) Lobectomy 260 (76) 137 (72) Lobectomy (72) SLR VATS Lobectomy Matched pair Matched pair SEER, Propensity matched T stage matched Matched pair Propensity matched OS OS
31 Comparative Studies (retrospective) Author Year Group Years n Study type Endpoint Grills Non-matched 30-day SLR mortality 8% surgery 69 vs. 2% Palma 109 (60) year OS 60% surgery vs. 42% Matched (p=0.22) pair Surgery 81 (60) Crabtree 2010 Shirvani 2012 Robinson 2013 Varlotto 2013 Verstegen 2013 Patients >75 years (57) Surgery (57) 124 (99) Lobectomy (99) SLR 1277 (121) 78 (76) Lobectomy 260 (76) 137 (72) Lobectomy (72) SLR VATS Lobectomy Matched pair SEER, Propensity matched T stage matched Matched pair Propensity matched OS OS
32 Comparative Studies (retrospective) Author Year Group Years n Study type Endpoint Grills SLR 69 Non-matched 109 (60) Palma Matched pair OS Stage Surgery IA, 3-yr local control 81 (60) 89%, 96% surgery (57) Crabtree 2010 (p=0.04) Matched pair Surgery (57) 124 (99) Shirvani 2012 Propensity Lobectomy matched pairs 6531 (n=57) (99) SLR 1277 (121) 78 (76) Robinson Lobectomy 260 (76) 137 (72) 3-yr OS (54% vs. 38%, p=ns) Varlotto 2013 Lobectomy (72) Verstegen 2013 Stage IB, no difference SLR VATS Lobectomy SEER, Propensity matched 3-yr Local control (88% vs. 90%, p=ns) 3-yr DFS (77% vs. 86%, p=ns) T stage matched Matched pair Propensity matched OS
33 Comparative Studies (retrospective) Author Year Group Years n Study type Endpoint 58 Grills Non-matched SLR (60) Palma 2011 Propensity matched analysis survival Matched similar pair Surgery 81 (60) Crabtree 2010 Shirvani 2012 Robinson 2013 Varlotto 2013 Verstegen 2013 SEER database, patients > 66 yrs old - lowest risk of death within 6 mo (HR 0.48) (57) Surgery (57) 124 (99) Lobectomy (99) SLR 1277 (121) 78 (76) Lobectomy 260 (76) 137 (72) Lobectomy (72) SLR VATS Lobectomy Matched pair SEER, Propensity matched T stage matched Matched pair Propensity matched OS OS
34 Comparative Studies (retrospective) Author Year Group Years n Study type Endpoint 58 Grills yr loc. control: Surgery 99% vs. Non-matched 94%, p=0.22 SLR 69 Palma 2011 Crabtree 2010 Shirvani 2012 Robinson 2013 Varlotto 2013 Verstegen yr reg. control: Surgery 78% vs. 83%, p= (60) Surgery 81 (60) (57) Surgery (57) 124 (99) Lobectomy (99) SLR 1277 (121) 78 (76) Lobectomy 260 (76) 137 (72) Lobectomy (72) SLR VATS Lobectomy Matched pair Matched pair SEER, Propensity matched T stage matched Matched pair Propensity matched OS OS
35 Comparative Studies (retrospective) Author Year Group Years n Study type Endpoint Grills 2010 Palma 2011 Crabtree 2010 Shirvani 2012 Robinson 2013 Varlotto 2013 Verstegen SLR (57) Surgery (57) SLR 1277 (121) 78 (76) Lobectomy 260 (76) Non-matched 5-yr OS worse for 34% 109 (60) vs. 69% for matched Matched pair Lobectomy, Surgery p= (60) 137 (72) Lobectomy (72) SLR VATS Lobectomy Matched pair SEER, Propensity matched T stage matched Matched pair Propensity matched OS BUT, multivariate analysis 124 (99) showed only tumor size and Lobectomy age to predict survival 6531 (99) OS LRC similar, 88% vs. 81%, p=.382
36 Comparative Studies (retrospective) Author Year Group Years n Study type Endpoint Grills %, SLRp= Palma 109 (60) 2011 No difference in survival Surgery 81 (60) Crabtree 2010 Shirvani 2012 Robinson 2013 Varlotto 2013 Verstegen yr locoregional control: Surgery 83% vs (57) Surgery (57) 124 (99) Lobectomy (99) SLR 1277 (121) 78 (76) Lobectomy 260 (76) 137 (72) Lobectomy (72) SLR VATS Lobectomy Non-matched Matched pair Matched pair SEER, Propensity matched T stage matched Matched pair Propensity matched OS OS
37 Meta-analysis Zheng et al. Int J Radiation Oncol Biol Phys, 2015
38 Conclusions: Lung Cancer Data support excellent local control of at 3 years Data suggest that survival differences between and surgery are likely related to patient and tumor factors, rather treatment modality.
39 OLIGOMETASTASES
40 Another Truth The vast majority of surgical literature regarding resection of pulmonary metastases is retrospective. No randomized trails exist that support pulmonary metastasectomy.
41 Lung Oligometastases: Surgery Author Year Original tumor n 2-yr OS 3-yr OS 5-yr OS Pfannschmidt 2003 Colorectal ca Kanemitsu 2004 Colorectal ca Saito 2002 Colorectal ca Zampino 2014 Colorectal ca Cho 2014 Colorectal ca Chua 2012 Melanoma Petersen 2007 Melanoma (R0) Pastorino 1997 Mixed Younes 2011 Mixed Pfannschmidt 2002 Renal cell ca Choong 1995 Soft tissue sarcoma Casiraghi 2011 Mixed ,
42 Lung Oligometastases: Author Year Original tumor n Local Control 2-yr OS 3-yr OS 5-yr OS Takeda 2011 Colorectal 23 2-yr: 94% Hoyer 2006 Colorectal ca Kang 2010 Colorectal ca Bae 2012 Colorectal ca Hof 2007 Mixed 61 3-yr: 63% Rusthoven 2009 Mixed 38 2-yr: 96% Okunieff 2006 Mixed Milano 2011 Mixed 50 Salama 2011 Mixed 61 Norihisa 2008 Mixed Zhang 2011 Mixed Ricardi 2012 Mixed 61 3-yr: 84% Nuyttens 2015 Mixed 30 2-yr: % Oh 2012 Mixed 57 3-yr: 95% Osti 2013 Mixed Widder 2013 Mixed yr: 94% Wulf 2004 Mixed
43 Survival % Oligomets.: Surgery vs Surgery yr OS 3-yr OS 5-yr OS
44 Survival % Oligomets.: Surgery vs Colon (S) Other (S) Colon () Other () 0 2-yr OS 3-yr OS 5-yr OS
45 Oligomets: Surgery vs. Widder, 2013
46 Conclusions: Oligometastases Available data suggest has similar outcomes as surgery for treatment of oligometastases. However, appears to be less effective in treating pulmonary metastases from colorectal primaries.
47 21 st Century Gladiator
48 21 st Century Gladiator
Is Resection Superior to SBRT for Stage I Lesions. Traves Crabtree MD Professor of Surgery Southern Illinois University School of Medicine
Is Resection Superior to SBRT for Stage I Lesions Traves Crabtree MD Professor of Surgery Southern Illinois University School of Medicine I have nothing pertinent to disclose. Patterns of Recurrence for
Stereotactic body radiation therapy versus surgery for patients with stage I non-small cell lung cancer
Review Article Page 1 of 9 Stereotactic body radiation therapy versus surgery for patients with stage I non-small cell lung cancer Tomoki Kimura Department of Radiation Oncology, Hiroshima University Hospital,
Stereotactic ablative radiotherapy in early NSCLC and metastases
Stereotactic ablative radiotherapy in early NSCLC and metastases Scheduled: 0810-0830 hrs, 10 March 2012 Professor Suresh Senan Department of Radiation Oncology SABR in stage I NSCLC A major treatment
Outline. WBRT field. Brain Metastases. Whole Brain RT Prophylactic WBRT Stereotactic radiosurgery (SRS) 1 fraction Stereotactic frame
Radiation Therapy for Advanced NSC Lung Ca Alexander Gottschalk, M.D., Ph.D. Associate Professor Director of CyberKnife Radiosurgery Department of Radiation Oncology University of California San Francisco
Applicazione Clinica: Polmone
Applicazione Clinica: Polmone Andrea Riccardo Filippi Dipar5mento di Oncologia Università di Torino A technique for delivering external beam radiotherapy i. with a high degree of accuracy to an extra-cranial
LONG-TERM SURGICAL OUTCOMES OF 1018 PATIENTS WITH EARLY STAGE NSCLC IN ACOSOG Z0030 (ALLIANCE) TRIAL
LONG-TERM SURGICAL OUTCOMES OF 1018 PATIENTS WITH EARLY STAGE NSCLC IN ACOSOG Z0030 (ALLIANCE) TRIAL Stacey Su, MD; Walter J. Scott, MD; Mark S. Allen, MD; Gail E. Darling, MD; Paul A. Decker, MS; Robert
Thoracic Recurrences. Soft tissue recurrence
Stereotactic body radiotherapy for thoracic and soft malignancies Alexander Gottschalk, M.D., Ph.D. Associate Professor Director of CyberKnife Radiosurgery Department of Radiation Oncology University of
SABR. Outline. Stereotactic Radiosurgery. Stereotactic Radiosurgery. Stereotactic Ablative Radiotherapy
CAGPO Conference October 25, 2014 Outline Stereotactic Radiation for Lung Cancer and Oligometastatic Disease What Every GPO should know Dr. David Palma, MD, MSc, PhD Radiation Oncologist, London Health
Stereotactic Body Radiation Therapy and Radiofrequency Ablation 2014 Masters of Minimally Invasive Surgery
Stereotactic Body Radiation Therapy and Radiofrequency Ablation 2014 Masters of Minimally Invasive Surgery Matthew Hartwig, M.D. Duke Cancer Institute Case Presentation I: Patient ER 74 y/o male with A1A
STAGE I INOPERABLE NSCLC RADIOFREQUENCY ABLATION OR STEREOTACTIC BODY RADIOTHERAPY?
STAGE I INOPERABLE NSCLC RADIOFREQUENCY ABLATION OR STEREOTACTIC BODY RADIOTHERAPY? MICHAEL LANUTI, MD American Association of Thoracic Surgeons Minneapolis, MN 2013 STAGE I INOPERABLE NSCLC RADIOFREQUENCY
20. Background. Oligometastases. Oligometastases: bone (including spine) and lymph nodes
125 20. Oligometastases Background The oligometastatic state can be defined as 1 3 isolated metastatic sites, typically occurring more than six months after successful treatment of primary disease. 1 In
Clinical Study Clinical Outcomes of Stereotactic Body Radiotherapy for Patients with Lung Tumors in the State of Oligo-Recurrence
Pulmonary Medicine Volume 2012, Article ID 369820, 5 pages doi:10.1155/2012/369820 Clinical Study Clinical Outcomes of Stereotactic Body Radiotherapy for Patients with Lung Tumors in the State of Oligo-Recurrence
4.x Oligometastases: evidence for dose-fractionation
4.x Oligometastases: evidence for dose-fractionation Background 4.x.1. The oligometastatic state can be defined as 1-3 isolated metastatic sites, typically occurring more than six months after successful
Surgery versus stereotactic body radiation therapy in medically operable NSCLC
Surgery versus stereotactic body radiation therapy in medically operable NSCLC David H Harpole Jr, MD Professor of Surgery Associate Professor in Pathology Vice Chief, Division of Surgical Services Duke
Treatment of Clinical Stage I Lung Cancer: Thoracoscopic Lobectomy is the Standard
Treatment of Clinical Stage I Lung Cancer: Thoracoscopic Lobectomy is the Standard AATS General Thoracic Surgery Symposium May 5, 2010 Thomas A. D Amico MD Professor of Surgery, Duke University Medical
Clinical outcomes of patients with malignant lung lesions treated with stereotactic body radiation therapy (SBRT) in five fractions
J Radiat Oncol (2012) 1:57 63 DOI 10.1007/s13566-012-0008-0 ORIGINAL RESEARCH Clinical outcomes of patients with malignant lung lesions treated with stereotactic body radiation therapy (SBRT) in five fractions
Response Evaluation after Stereotactic Ablative Radiotherapy for Lung Cancer
Original Article PROGRESS in MEDICAL PHYSICS Vol. 26, No. 4, December, 2015 http://dx.doi.org/10.14316/pmp.2015.26.4.229 Response Evaluation after Stereotactic Ablative Radiotherapy for Lung Cancer Ji
Therapy of Non-Operable early stage NSCLC
SBRT Stage I NSCLC Therapy of Non-Operable early stage NSCLC Dr. Adnan Al-Hebshi MD, FRCR(UK), FRCP(C), ABR King Faisal Specialist Hospital & Research Centre This is our territory Early Stages NSCLC Surgical
Adjuvant Radiotherapy for completely resected NSCLC
Adjuvant Radiotherapy for completely resected NSCLC ESMO Preceptorship on lung Cancer Manchester February 2017 Cécile Le Péchoux Radiation Oncology Department IOT Institut d Oncologie Thoracique Local
Adjuvant radiotherapy for completely resected early stage NSCLC
Adjuvant radiotherapy for completely resected early stage NSCLC ESMO Preceptorship on lung Cancer Manchester March 2018 Cécile Le Péchoux Radiation Oncology Department IOT Institut d Oncologie Thoracique
Xin Wang 1,2*, Leonid Zamdborg 3, Hong Ye 3, Inga S. Grills 3,4 and Di Yan 3,4
Wang et al. BC Cancer (2018) 18:962 https://doi.org/10.1186/s12885-018-4865-9 RESEARCH ARTICLE A matched-pair analysis of stereotactic body radiotherapy (SBRT) for oligometastatic lung tumors from colorectal
Accomplishes fundamental surgical tenets of R0 resection with systematic nodal staging for NSCLC Equivalent survival for Stage 1A disease
Segmentectomy Made Simple Matthew J. Schuchert and Rodney J. Landreneau Department of Cardiothoracic Surgery University of Pittsburgh Medical Center Financial Disclosures none Why Consider Anatomic Segmentectomy?
Surgical Approaches to Pulmonary Metastases
Surgical Approaches to Pulmonary Metastases Raja M Flores MD Professor and Chief Thoracic Surgery Mount Sinai School of Medicine New York, New York History of Lung Metastasectomy 1882 Weinlechner +CW 1926
Treatment of Peripheral Non Small Cell Lung Carcinoma with Stereotactic Body Radiation Therapy
State of the Art: Concise Review Treatment of Peripheral Non Small Cell Lung Carcinoma with Stereotactic Body Radiation Therapy Michael C. Roach, MD,* Gregory M. M. Videtic, MD, CM, FRCPC, and Jeffrey
Oncology Clinical Service Line System-wide Consensus Guidelines: Treatment of Stage I Lung Cancer
Oncology Clinical Service Line System-wide Consensus Guidelines: Treatment of Stage I Lung Cancer These guidelines apply to clinical interventions that have well-documented outcomes, but whose outcomes
N.E. Verstegen A.P.W.M. Maat F.J. Lagerwaard M.A. Paul M.I. Versteegh J.J. Joosten. W. Lastdrager E.F. Smit B.J. Slotman J.J.M.E. Nuyttens S.
N.E. Verstegen A.P.W.M. Maat F.J. Lagerwaard M.A. Paul M.I. Versteegh J.J. Joosten W. Lastdrager E.F. Smit B.J. Slotman J.J.M.E. Nuyttens S.Senan Submitted 10 Salvage surgery for local failures after stereotactic
Stereotactic radiotherapy
Stereotactic radiotherapy Influence of patient positioning and fixation on treatment planning - clinical results Frank Zimmermann Institut für Radioonkologie Universitätsspital Basel Petersgraben 4 CH
Oncology Clinical Service Line System-wide Consensus Guidelines: Treatment of Stage I Lung Cancer
Oncology Clinical Service Line System-wide Consensus Guidelines: Treatment of Stage I Lung Cancer These guidelines apply to clinical interventions that have well-documented outcomes, but whose outcomes
ACOSOG Thoracic Committee. Kemp H. Kernstine, MD PhD
ACOSOG Thoracic Committee Kemp H. Kernstine, MD PhD ACOSOG Thoracic Committee Chair: Bryan Meyers, M.D., MPH Vice Chairs: Malcolm Brock, MD Tom DiPetrillo, M.D. Ramaswamy Govindan, M.D. Carolyn Reed, MD
Racial Disparities In The Treatment Of Non-Surgical Patients With Lung Cancer. S Annangi, M G Foreman, H P Ravipati, S Nutakki, E Flenaugh
ISPUB.COM The Internet Journal of Pulmonary Medicine Volume 18 Number 1 Racial Disparities In The Treatment Of Non-Surgical Patients With Lung Cancer S Annangi, M G Foreman, H P Ravipati, S Nutakki, E
Lung stereotactic body radiotherapy (SBRT) delivers an
Original Article Stereotactic Body Radiotherapy in Patients with Previous Pneumonectomy Safety and Efficacy Robert Thompson, MD,* Meredith Giuliani, MBBS,* Mei Ling Yap, MD,* Soha Atallah, MD,* Lisa W.
Role of SBRT in the management of lung and liver metastases. Ronan TANGUY, M.D. Radiation Oncologist
Role of SBRT in the management of lung and liver metastases Ronan TANGUY, M.D. Radiation Oncologist Oligometastatic RCC mrcc: Lung, Bone, Liver, Brain (Schlesinger-Raab, EJC2008) Targeted therapies Objective
STEREOTACTIC BODY RADIATION THERAPY FOR THE TREATMENT OF EARLY STAGE NON SMALL CELL LUNG CANCER
STEREOTACTIC BODY RADIATION THERAPY FOR THE TREATMENT OF EARLY STAGE NON SMALL CELL LUNG CANCER A Technology Assessment INTRODUCTION The California Technology Assessment Forum was requested to review the
ACOSOG (NCCTG, CALGB) Alliance Thoracic Committee Kemp H. Kernstine, MD PhD
ACOSOG (NCCTG, CALGB) Alliance Thoracic Committee Kemp H. Kernstine, MD PhD 7-12-12 ACOSOG Thoracic Committee Chair: Bryan Meyers, M.D., MPH Vice Chairs: Malcolm Brock, MD Tom DiPetrillo, M.D. Ramaswamy
After primary tumor treatment, 30% of patients with malignant
ESTS METASTASECTOMY SUPPLEMENT Alberto Oliaro, MD, Pier L. Filosso, MD, Maria C. Bruna, MD, Claudio Mossetti, MD, and Enrico Ruffini, MD Abstract: After primary tumor treatment, 30% of patients with malignant
Non small cell Lung Cancer
Non small cell Lung Cancer The 13th refresher course for residents in radiation oncology Jiraporn Setakornnukul, M.D. Radiation oncology division, Radiology department Siriraj Hospital, Mahidol University
News Briefing: Treatment Considerations for Focused Populations
News Briefing: Treatment Considerations for Focused Populations Moderator: Pranshu Mohindra, MD, University of Maryland, Baltimore Reirradiation of Thoracic Cancers with Intensity Modulated Proton Therapy
Meta-analysis of intentional sublobar resections versus lobectomy for early stage non-small cell lung cancer
Systematic Review Meta-analysis of intentional sublobar resections versus lobectomy for early stage non-small cell lung cancer Christopher Cao 1,2, Sunil Gupta 1, David Chandrakumar 1, David H. Tian 1,
Radiation Therapy for Liver Malignancies
Outline Radiation Therapy for Liver Malignancies Albert J. Chang, M.D., Ph.D. Department of Radiation Oncology, UCSF March 23, 2014 Rationale for developing liver directed therapies Liver directed therapies
Additional data in the debate on stage I non-small cell lung cancer: surgery versus stereotactic ablative radiotherapy
Editorial Page 1 of 8 Additional data in the debate on stage I non-small cell lung cancer: surgery versus stereotactic ablative radiotherapy Charles B. Simone II, Jay F. Dorsey Department of Radiation
Stereotactic body radiation therapy (SBRT) for early stage nonsmall cell lung cancer (NSCLC): contemporary insights and advances
Review Article Stereotactic body radiation therapy (SBRT) for early stage nonsmall cell lung cancer (NSCLC): contemporary insights and advances Nikhil T. Sebastian, Meng Xu-Welliver, Terence M. Williams
Indications for sublobar resection for localized NSCLC
Indications for sublobar resection for localized NSCLC David H Harpole Jr, MD Professor of Surgery Associate Professor in Pathology Vice Chief, Division of Surgical Services Duke University School of Medicine
Changes in TNM-classification 7 th edition T T1 2 cm T1a
Introduction 1 Chapter 1 Introduction 9 Currently, cancer is the second leading cause of death in Europe 1. Globally, lung cancer is by far the most common cause of cancer-related deaths, and is by itself
Clinical outcomes of CyberKnife stereotactic radiosurgery for elderly patients with presumed primary stage I lung cancer
Original Article Clinical outcomes of CyberKnife stereotactic radiosurgery for elderly patients with presumed primary stage I lung cancer Zhen Wang 1, Ao-Mei Li 1, Jie Gao 1, Jing Li 1, Bing Li 1, Percy
Workshop LA RADIOTERAPIA DEI TUMORI RARI I TIMOMI : INDICAZIONI
XXI CONGRESSO NAZIONALE AIRO Genova, 19-22 novembre 2011 Workshop LA RADIOTERAPIA DEI TUMORI RARI I TIMOMI : INDICAZIONI PIERA NAVARRIA Unità Operativa di Radioterapia e Radiochirurgia Humanitas Cancer
Journal of Medical Imaging and Radiation Oncology
Journal of Medical Imaging and Radiation Oncology 61 (2017) 652 659 MEDICAL IMAGING RADIATION ONCOLOGY ORIGINAL ARTICLE Prognositc significance of SUV max on pretreatment 18 F-FDG PET/CT in early-stage
Radioterapia nella malattia oligometastatica. Fiorenza De Rose, M.D., Radiotherapy and Radiosurgery Dep. Humanitas Clinical and Research Hospital
Radioterapia nella malattia oligometastatica Fiorenza De Rose, M.D., Radiotherapy and Radiosurgery Dep. Humanitas Clinical and Research Hospital OUTLINE Definition of oligometastatic state Local ablative
San Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy
San Antonio Breast Cancer Symposium 2010 Highlights Radiotherapy Kathleen C. Horst, M.D. Assistant Professor Department of Radiation Oncology Stanford University The Optimal SEquencing of Adjuvant Chemotherapy
Radiotherapy and Oncology
Radiotherapy and Oncology xxx (2013) xxxxxx Contents lists available at SciVerse ScienceDirect Radiotherapy and Oncology journal homepage: www.thegreenjournal.com Original article Outcomes of stereotactic
Stereotactic Ablative Radiotherapy for Non Small Cell Lung Cancer: Rationale and Outcomes
1514 Original Article Stereotactic Ablative Radiotherapy for Non Small Cell Lung Cancer: Rationale and Outcomes Puneeth Iyengar, MD, PhD, a and Robert D. Timmerman, MD a,b Abstract Stereotactic ablative
Tecniche Radioterapiche U. Ricardi
Tecniche Radioterapiche U. Ricardi UNIVERSITA DEGLI STUDI DI TORINO Should we always rely on stage? T4N0M0 Stage IIIB T2N3M0 Early stage NSCLC The treatment of choice for early-stage NSCLC is anatomic
Disclosures. Preoperative Treatment: Chemotherapy or ChemoRT? Adjuvant chemotherapy helps. so what about chemo first?
Disclosures Preoperative Treatment: Chemotherapy or ChemoRT? Advisory boards Genentech (travel only), Pfizer Salary support for clinical trials Celgene, Merck, Merrimack Matthew Gubens, MD, MS Assistant
The Role of Radiation Therapy in the Treatment of Brain Metastases. Matthew Cavey, M.D.
The Role of Radiation Therapy in the Treatment of Brain Metastases Matthew Cavey, M.D. Objectives Provide information about the prospective trials that are driving the treatment of patients with brain
Pulmonary laser resections: Technical aspects and results in colorectal cancer
Pulmonary laser resections: Technical aspects and results in colorectal cancer Bernward Passlick Professor of Thoracic Surgery Dept. of Thoracic Surgery University of Freiburg Germany Pulmonary laser resections
Where are we with radiotherapy for biliary tract cancers?
Where are we with radiotherapy for biliary tract cancers? Professor Maria A. Hawkins Associate Professor in Clinical Oncology MRC Group Leader/Honorary Consultant Clinical Oncologist CRUK MRC Oxford Institute
Rob Glynne-Jones Mount Vernon Cancer Centre
ESMO Preceptorship Programme Colorectal Cancer Barcelona October 2017 Interventional radiology and stereotactic radiotherapy Rob Glynne-Jones Mount Vernon Cancer Centre My Disclosures: last 5 years Speaker:
Case Conference: SBRT for spinal metastases D A N I E L S I M P S O N M D 3 / 2 7 / 1 2
Case Conference: SBRT for spinal metastases D A N I E L S I M P S O N M D 3 / 2 7 / 1 2 Case 79 yo M with hx of T3N0 colon cancer diagnosed in 2008 metastatic liver disease s/p liver segmentectomy 2009
Oligometastatic Disease
Oligometastatic Disease Fact or Fantasy? Jennifer R Bellon MD, FASTRO Dana-Farber Cancer Institute Harvard Medical School Alexander V Louie MD PhD, FRCPC London Health Sciences Center Western University
Sagar Damle, MD University of Colorado Denver May 23, 2011
Sagar Damle, MD University of Colorado Denver May 23, 2011 We have debated many times. Here are the topics, and a recap of the last few Pre-operative nutrition Babu pro; Damle con Utility of ECMO Babu
SBRT in early stage NSCLC
SBRT in early stage NSCLC Optimal technique and tumor dose Frank Zimmermann Clinic of Radiotherapy and Radiation Oncology University Hospital Basel Petersgraben 4 CH 4031 Basel radioonkologiebasel.ch Techniques
The role of Radiation Oncologist: Hi-tech treatments for liver metastases
The role of Radiation Oncologist: Hi-tech treatments for liver metastases Icro Meattini, MD Radiotherapy-Oncology Unit AOU Careggi Hospital Florence University, Italy Liver Metastases - Background The
Lung cancer is a major cause of cancer deaths worldwide.
ORIGINAL ARTICLE Prognostic Factors in 3315 Completely Resected Cases of Clinical Stage I Non-small Cell Lung Cancer in Japan Teruaki Koike, MD,* Ryosuke Tsuchiya, MD, Tomoyuki Goya, MD, Yasunori Sohara,
TREATMENT DELIVERY AND CLINICAL EVIDENCE FOR THE TREATMENT OF OLIGOMETASTASIS
TREATMENT DELIVERY AND CLINICAL EVIDENCE FOR THE TREATMENT OF OLIGOMETASTASIS Dr Gerry Hanna Clinical Senior Lecturer in Radiation Oncology Centre for Cancer Research and Cell Biology Queens University
Hot topics in Radiation Oncology for the Primary Care Providers
Hot topics in Radiation Oncology for the Primary Care Providers Steven Feigenberg, MD Professor Chief, Thoracic Oncology Vice Chair of Clinical Research April 19, 2018 Disclosures NONE 2 Early Stage Disease
Surgical treatment in non-small cell lung cancer with pulmonary oligometastasis
He et al. World Journal of Surgical Oncology (2017) 15:36 DOI 10.1186/s12957-017-1105-8 RESEARCH Open Access Surgical treatment in non-small cell lung cancer with pulmonary oligometastasis Jinyuan He,
Lung segmentectomy: does it offer a real functional benefit over lobectomy?
REVIEW LUNG CANCER Lung segmentectomy: does it offer a real functional benefit over lobectomy? Anne Charloux 1,2 and Elisabeth Quoix 3 Affiliations: 1 Physiology and Functional Explorations Dept, University
Pattern of recurrence after CyberKnife stereotactic body radiotherapy for peripheral early non-small cell lung cancer
Original Article Pattern of recurrence after CyberKnife stereotactic body radiotherapy for peripheral early non-small cell lung cancer Masaki Nakamura 1,2, Ryo Nishikawa 1,3, Hiroshi Mayahara 1, Haruka
and Strength of Recommendations
ASTRO with ASCO Qualifying Statements in Bold Italics s patients with T1-2, N0 non-small cell lung cancer who are medically operable? 1A: Patients with stage I NSCLC should be evaluated by a thoracic surgeon,
Lung Cancer Role of Surgery. Ricardo M. Terra Associate Professor of Thoracic Surgery University of Sao Paulo Medical School
Lung Cancer Role of Surgery Ricardo M. Terra Associate Professor of Thoracic Surgery University of Sao Paulo Medical School Disclosure Scientific Consultant/Advisory Board: Johnson&Johnson Educational
Protocolos de consenso: MTS Cerebrales Resumen ASTRO. Javier Aristu y Germán Valtueña Servicio Oncología Rad. Depart.
Protocolos de consenso: MTS Cerebrales Resumen ASTRO Javier Aristu y Germán Valtueña Servicio Oncología Rad. Depart. ASTRO 2013 Brain met SRS Abstracts 97. Comparative Effectiveness of SRS versus WBRT
Treatment of oligometastases: Lung
Treatment of oligometastases: Lung Themadag Catharina ZH 30 March 2017 Max Dahele Radiation Oncologist Vumc, Amsterdam m.dahele@vumc.nl Do you all treat lung oligometastases? What is your definition of
In Japan, due to the routine use of computed tomography
STEREOTACTIC RADIATION THERAPY WORKSHOP Hypofractionated Stereotactic Radiotherapy (HypoFXSRT) for Stage I Non-small Cell Lung Cancer: Updated Results of 257 Patients in a Japanese Multi-institutional
Stereotactic body radiation therapy versus surgical resection for stage I non small cell lung cancer
Stereotactic body radiation therapy versus surgical resection for stage I non small cell lung cancer Traves D. Crabtree, MD, a Chadrick E. Denlinger, MD, a Bryan F. Meyers, MD, a Issam El Naqa, PhD, b
Radiotherapy in NSCLC: What are the ESMO Guidelines?
- The role of radiation in early stage - RT/CT for unresectable NSCLC - Brain metastasis - Oligometastatic disease Radiotherapy in NSCLC: What are the ESMO Guidelines? Jean-Yves DOUILLARD MD PhD Chief
Stereotactic Ablative Radiotherapy for Centrally Located Early Stage Non Small-Cell Lung Cancer. What We Have Learned
State of the Art: Concise Review Stereotactic Ablative Radiotherapy for Centrally Located Early Stage Non Small-Cell Lung Cancer What We Have Learned Joe Y. Chang, MD, PhD*, Andrea Bezjak, MD, and Françoise
The 1995 publication from the Lung Cancer Study. Sublobar Resection. A Movement from the Lung Cancer Study Group REVIEW ARTICLE
REVIEW ARTICLE A Movement from the Lung Cancer Study Group Justin D. Blasberg, MD,* Harvey I. Pass, MD, and Jessica S. Donington, MD Abstract: The 1995 Lung Cancer Study Group consensus recommending lobectomy
Badiyan et al. Radiation Oncology 2013, 8:4
Badiyan et al. Radiation Oncology 2013, 8:4 RESEARCH Open Access Stereotactic body radiation therapy for the treatment of early-stage minimally invasive adenocarcinoma or adenocarcnioma in situ (formerly
VATS Metastasectomy. Inderpal (Netu) S. Sarkaria, MD, FACS
VATS Metastasectomy Inderpal (Netu) S. Sarkaria, MD, FACS Vice Chairman, Clinical Affairs Director, Robotic Thoracic Surgery Co-Director, Esophageal and Lung Surgery Institute Disclosures Speaking & Education:
The Evolution of SBRT and Hypofractionation in Thoracic Radiation Oncology
The Evolution of SBRT and Hypofractionation in Thoracic Radiation Oncology (specifically, lung cancer) 2/10/18 Jeffrey Kittel, MD Radiation Oncology, Aurora St. Luke s Medical Center Outline The history
肺癌放射治療新進展 Recent Advance in Radiation Oncology in Lung Cancer 許峰銘成佳憲國立台灣大學醫學院附設醫院腫瘤醫學部
肺癌放射治療新進展 Recent Advance in Radiation Oncology in Lung Cancer 許峰銘成佳憲國立台灣大學醫學院附設醫院腫瘤醫學部 Outline Current status of radiation oncology in lung cancer Focused on stage III non-small cell lung cancer Radiation
Stereotactic Body Radiation Therapy for Lung Cancer: Achievements and Perspectives
Stereotactic Body Radiation Therapy for Lung Cancer: Achievements and Perspectives Masahiro Hiraoka *, Yukinori Matsuo and Kenji Takayama Department of Radiation Oncology and Image-applied Therapy, Kyoto
Gastroesophag Gastroesopha eal Junction Adenocarcinoma: What is the best adjuvant regimen? Michael G. G. H addock Haddock M.D.
Gastroesophageal Junction Adenocarcinoma: What is the best adjuvant regimen? Michael G. Haddock M.D. Mayo Clinic Rochester, MN Locally Advanced GE Junction ACA CT S CT or CT S CT/RT Proposition Chemoradiation
Doctor, How Am I Doing? Conditional Survival Analyses
Doctor, How Am I Doing? Conditional Survival Analyses Background Survival rates usually reported from time of diagnosis only Doesn't reflect changing hazard rates over time: early: higher hazard rate late:
Radiological changes following stereotactic radiotherapy for stage I lung cancer. M. Dahele, D. Palma, F. Lagerwaard, B. Slotman, S.
Chapter 9 Radiological changes following stereotactic radiotherapy for stage I lung cancer M. Dahele, D. Palma, F. Lagerwaard, B. Slotman, S. Senan Department of Radiation Oncology, VU University Medical
The 7th Edition of TNM in Lung Cancer.
10th European Conference Perspectives in Lung Cancer. Brussels, March 2009. The 7th Edition of TNM in Lung Cancer. Peter Goldstraw, Consultant Thoracic Surgeon, Royal Brompton Hospital, Professor of Thoracic
stereotactic body radiation therapy Citation Journal of radiation research (2013 original work is properly cited
Differences in the dose-volume metr Titlecorrection status and its influence stereotactic body radiation therapy Ueki, Nami; Matsuo, Yukinori; Shibu Author(s) Mitsuhiro; Narabayashi, Masaru; Sak Norihisa,
Stereotactic body radiotherapy (SBRT) has been increasingly
original article Central versus Peripheral Tumor Location Influence on Survival, Local Control, and Toxicity Following Stereotactic Body Radiotherapy for Primary Non Small-Cell Lung Cancer Henry S. Park,
Clinical Aspects of SBRT in Abdominal Regions Brian D. Kavanagh, MD, MPH University of Colorado Department of Radiation Oncology
Clinical Aspects of SBRT in Abdominal Regions Brian D. Kavanagh, MD, MPH University of Colorado Department of Radiation Oncology Abdominal SBRT: Clinical Aspects Rationales for liver and pancreas SBRT
Digital Washington University School of Medicine. Shahed N. Badiyan Washington University School of Medicine in St.
Washington University School of Medicine Digital Commons@Becker Open Access Publications 2013 Stereotactic body radiation therapy for the treatment of early-stage minimally invasive adenocarcinoma or adenocarcnioma
Updates in Thoracic Oncology
Updates in Thoracic Oncology Dr. Sameena Uddin MD FRCSC Thoracic Surgical Oncologist Division Head, Thoracic Surgery Trillium Health Partners 1 Faculty/Presenter Disclosure Faculty: Dr. Sameena Uddin MD,
History of Surgery for Lung Cancer
Welcome to Master Class for Oncologists Session 1: 7:30 AM - 8:15 AM San Francisco, CA October 23, 2009 Innovations in The Surgical Treatment of Lung Cancer Speaker: Scott J. Swanson, MD 2 Presenter Disclosure
Results of Stereotactic radiotherapy for Stage I and II NSCLC Is There a Need for Image Guidance?
Results of Stereotactic radiotherapy for Stage I and II NSCLC Is There a Need for Image Guidance? Frank Zimmermann Institute of Radiation Oncolgy University Clinic Basel Petersgraben 4 CH 4031 Basel radioonkologiebasel.ch
National Institute for Health and Care Excellence
National Institute for Health and Care Excellence Final Lung cancer update [D] Evidence reviews for the clinical and cost effectiveness of different radiotherapy regimens with curative intent for NSCLC
Post-Induction PET Does Not Correlate with Persistent Nodal Disease or Overall Survival in Surgically Treated Stage IIIA Non-Small Cell Lung Cancer
Post-Induction PET Does Not Correlate with Persistent Nodal Disease or Overall Survival in Surgically Treated Stage IIIA Non-Small Cell Lung Cancer R. Taylor Ripley, Kei Suzuki, Kay See Tan, Manjit Bains,
Cooperative Group Update - Japan; JCOG & WJOG - Masahiro Tsuboi, M.D., Ph.D.
Cooperative Group Update - Japan; JCOG & WJOG - Masahiro Tsuboi, M.D., Ph.D. Group Chair, Lung Cancer Surgical Study Group in Japan Clinical Oncology Group (JCOG) Chief, Division of Thoracic Surgery, Kanagawa
Stereotactic ablative radiotherapy (SABR) for early-stage lung cancer. Professor Suresh Senan VU University Medical Center Amsterdam, The Netherlands
Stereotactic ablative radiotherapy (SABR) for early-stage lung cancer Professor Suresh Senan VU University Medical Center Amsterdam, The Netherlands Disclosures Research support: Varian Medical Systems
NEJ, Sendai North East Japan. TCOG, Tokyo Tokyo Clinical Oncology G.
Slide 1 Cooperative Group Update - Japan; JCOG & WJOG - Masahiro Tsuboi, M.D., Ph.D. Group Chair, Lung Cancer Surgical Study Group in Japan Clinical Oncology Group (JCOG) Chief, Division of Thoracic Surgery,
The role of chemoradiotherapy in GE junction and gastric cancer. Karin Haustermans
The role of chemoradiotherapy in GE junction and gastric cancer Karin Haustermans Overview Postoperative chemoradiotherapy Preoperative chemoradiotherapy Palliative radiation Technical aspects Overview
Cheng-Yang Song, Takehiro Sakai, Daisuke Kimura, Takao Tsushima, Ikuo Fukuda
Original Article Comparison of perioperative and oncological outcomes between video-assisted segmentectomy and lobectomy for patients with clinical stage IA non-small cell lung cancer: a propensity score
Role of Prophylactic Cranial Irradiation in Small Cell Lung Cancer
Role of Prophylactic Cranial Irradiation in Small Cell Lung Cancer Kazi S. Manir MD,DNB,ECMO,PDCR Clinical Tutor Department of Radiotherapy R. G. Kar Medical College and Hospital, Kolkata SCLC 15% of lung