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

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

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Carcinoma, Non-Small-Cell Lung / diagnosis*
  • Carcinoma, Non-Small-Cell Lung / therapy*
  • Combined Modality Therapy
  • Diagnosis, Differential
  • Humans
  • Interdisciplinary Communication
  • Italy
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / therapy*
  • Neoplasm Staging
  • Oncologists
  • Pulmonologists
  • Surveys and Questionnaires

Grants and funding

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 funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.