Adjuvant chemotherapy and adjuvant radiation recommended for R1 resected cancer patients -
A survey by the Committee oncologists ESMO Young
A historical survey over 700 specialists provides an overview of critical real-world treatment most oncologists choose for lung cancer patients whose tumor was not completely resected, an expert from the European Society for medical oncology (ESMO) said.
Jean Yves Douillard, ICO Cancer Institute West Ren- Gauducheau, France, Chairman of the ESMO Educational Committee, commenting on an article published in the journal Lung cancer . In the study, researchers led by Raffaele Califano The Christie NHS Foundation Trust, Manchester, UK, the survey of 768 oncologists 41 European countries on the salaries they offered patients who had "R1 resected" cancer non-small lung cells.
R1 resection is a term used by oncologists to indicate that it is possible to find microscopic evidence of remaining cancer cells after cancer was surgically removed.
"We know that the incomplete resection, or R1 resection is associated with a higher risk of relapse, but there are no recommendations based on solid evidence on how to treat these patients after surgery, "said Douillard.
" This study is important because it gives a good overview of how the issue is addressed in clinical practice across Europe by practitioners who treat lung cancer ".
overall, 83% of experts surveyed were --specialists trained medical oncologists to treat cancer with chemotherapy, targeted therapies, immunotherapy and other drugs.
Of the respondents, 91.4% prescribed chemotherapy, mostly cisplatin / vinorelbine or cisplatin / gemcitabine. The survey showed that the majority of physicians (85%) discussed with the patient the fact that there was little clinical evidence to guide treatment options. Nearly 50% of participants prescribed radiotherapy, with oncologists are most likely to offer this radiation treatment approach.
"The doctors clearly believe in what they do, and try to provide the best for their patients," says Douillard. "According to the investigation, however, the practice is heterogeneous and varies depending on the specialty of the treating physician, if radiation oncologists and medical oncologists. That is why treatment decisions are best made by multidisciplinary teams. "
data collected in this survey is supported by the recommendations of the 2nd ESMO Conference Consensus on lung cancer occurred in 2013, Douillard note. This group of experts recognized internationally recommended adjuvant chemotherapy and adjuvant radiation R1 resected patients.
the authors of the last call for paper for any tests to be undertaken to provide better evidence to guide postoperative treatment in this situation. Douillard agrees that these tests would be instructive.
"However, the adjuvant treatment trials in R1 resected lung cancer would be very difficult to design and implement, as is fortunately little frequent. R1 resection would also need to be clearly defined in these studies because it actually represents a rather heterogeneous group. "
" based on data from clinical trials in resected patients with all tumor cells were completely removed, there is a rationale for using both chemotherapy and radiotherapy lung cancer non-small cell R1-resected, "said Douillard.
" as the authors of this state of the investigation, definitive evidence comes from a randomized clinical trial, although these studies would difficult to perform. "
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