Aaron M. Allen1,2, Damien Urban3, Julia Dudnik4, Mira Wollner5, Abed Agbarya6, Shoshana Keren Rosenberg7, Mor Moskovitz7 and Jair Bar1,3*
1Department of Oncology, Tel Aviv University, Israel
2Department of Oncology, Davidoff Cancer Center, Rabin Medical Center, Israel
3Department of Oncology, Sheba Medical Center, Israel
4Department of Oncology, Soroka Medical Center, Affiliated with Ben-Gurion University of the Negev, Israel
5Department of Oncology, Rambam Health Care Campus, Israel
6Department of Oncology, Clalit Health Services, Israel 7Department of Oncology, Lin Medical Center, Affiliated to Carmel Hospital Medical Center, Israel
Background: Stage III Non-Small Cell Lung Cancer (NSCLC) is a highly heterogeneous condition, with many treatment options. We evaluated treatment practices among lung cancer specialists, reasoning that these practices reflect their accumulated real life experience. Patients and
Methods: An internet-based survey was conducted among members of the Israeli Society for Clinical Oncology and Radiotherapy involved in the treatment of lung cancer patients. Responses from specialists who have treated at least 100 patients with stage III NSCLC were analyzed.
Results: Significant heterogeneity was found. Most participants chose Concomitant Chemoradiotherapy (CCRT) even for poor PS, patients with weight loss and patients with comorbidities. Mediastinal staging prior to CCRT was not deemed required by 46% of the participants. Most responders agreed that following CCRT, surgery may be considered, even for right pneumonectomy, but not if no radiological response is seen.
Conclusion: The views expressed by a group of experienced lung cancer specialists differ in some cases from the conclusions of clinical trials. Future prospective studies in stage III NSCLC should attempt to include more defined and homogenous groups of patients, as well as patients with comorbid conditions in order to arrive at widely accepted conclusions.
Chemoradiotherapy; Internet-based survey; Neoadjuvant; Tri-modality; Singlestation N2
Allen AM, Urban D, Dudnik J, Wollner M, Agbarya A, Rosenberg SK, et al. Real-World Practice Patterns in the Treatment of Stage III Non-Small Cell Lung Cancer; the Israeli Experience. Ann Thorac Oncol Res. 2017; 1(2): 1006.