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. 2019 Nov 13;14(11):e0224027.
doi: 10.1371/journal.pone.0224027. eCollection 2019.

Management of locally advanced non-small cell lung cancer in the modern era: A national Italian survey on diagnosis, treatment and multidisciplinary approach

Alessio Bruni  1 , Niccolò Giaj-Levra  2 , Patrizia Ciammella  3 , Virginia Maragna  4 , Katia Ferrari  5 , Viola Bonti  5 , Francesco Grossi  6 , Stefania Greco  7 , Carlo Greco  8 , Paolo Borghetti  9 , Davide Franceschini  10 , Enrica Capelletto  11 , Marco Perna  4 , Giuseppe Banna  12 , Stefano Vagge  13 , Editta Baldini  14 , Emilio Bria  15 , Andrea Botti  16 , Marcello Tiseo  17 , Massimiliano Paci  18 , Maria Taraborrelli  19 , Venerino Poletti  20   21 , Pierluigi Granone  22 , Umberto Ricardi  23 , Silvia Novello  11 , Vieri Scotti  4
Affiliations

Management of locally advanced non-small cell lung cancer in the modern era: A national Italian survey on diagnosis, treatment and multidisciplinary approach

Alessio Bruni et al. PLoS One. .

Abstract

Concurrent chemotherapy and radiotherapy (cCRT) is considered the standard treatment of locally advanced non-small cell lung cancer (LA-NSCLC). Unfortunately, management is still heterogeneous across different specialists. A multidisciplinary approach is needed in this setting due to recent, promising results obtained by consolidative immunotherapy. The aim of this survey is to assess current LA-NSCLC management in Italy. From January to April 2018, a 15-question survey focusing on diagnostic/therapeutic LA-NSCLC management was sent to 1,478 e-mail addresses that belonged to pneumologists, thoracic surgeons, and radiation and medical oncologists. 421 answers were analyzed: 176 radiation oncologists, 86 medical oncologists, 92 pneumologists, 64 thoracic surgeons and 3 other specialists. More than a half of the respondents had been practicing for >10 years after completing residency training. Some discrepancies were observed in clinical LA-NSCLC management: the lack of a regularly planned multidisciplinary tumor board, the use of upfront surgery in multistation stage IIIA, and territorial diffusion of cCRT in unresectable LA-NSCLC. Our analysis demonstrated good compliance with international guidelines in the diagnostic workup of LA-NSCLC. We observed a relationship between high clinical experience and good clinical practice. A multidisciplinary approach is mandatory for managing LA-NSCLC.

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Conflict of interest statement

A pharma company (Astra Zeneca Italy, principal site in Basiglio, Milano, Italy) gave the unconditional support to develop a web platform for data entry. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No patents or products needs to be declared related to the study. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. LA-NSCLC lymph nodal mediastinal PET positivity–question 9.
Fig 2
Fig 2. LA-NSCLC diagnosis with lymph nodal negativity–question 10.
Fig 3
Fig 3. LA-NSCLC clinical stage cT1b cN2, single station, fit for surgery—question number 12.
Fig 4
Fig 4. LA-NSCLC clinical stage cT2cN2, multiple stations, IIIB—question number 13.
Fig 5
Fig 5. LA-NSCLC inoperable in partial response/stability (ycN2) after neoadjuvant chemotherapy—question number 14.
See this image and copyright information in PMC

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