Controversies in the Treatment of Lung Cancer

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Under the auspices of the 12th International Symposium on Special Aspects in Radiotherapy 2008 in Berlin, acknowledged experts presented their perspectives on small and non-small cell lung cancer, reflecting the latest standards and engaging in controversies in the diagnosis and treatment of this disease.

Cover 2
Contents 7
Prognostic Factors in Histopathology ofLung Cancer 9
- Abstract 9
- Tumor Size: An Essential Prognostic Factor in Lung Cancer 11
- Small Cell Lung Cancer 11
- Prognosis and Predictive Factors in Small Cell Lung Cancer 12
- Histological Subtype: A Prognostic Factor in NSCLC 13
- Squamous Cell Carcinoma Histological Subtypes Associated with Poor Prognosis 13
- Bronchioloalveolar Cell Carcinoma Growth Pattern: A Favorable Prognostic Factor 14
- Adenocarcinoma Histological Subtypes Associated with Poor Prognosis 14
- Large Cell Carcinomas 15
- Prognostic Implication of Molecular Markers 16
- Conclusion 20
- References 21

Cover 2
Contents 7
Prognostic Factors in Histopathology ofLung Cancer 9
- Abstract 9
- Tumor Size: An Essential Prognostic Factor in Lung Cancer 11
- Small Cell Lung Cancer 11
- Prognosis and Predictive Factors in Small Cell Lung Cancer 12
- Histological Subtype: A Prognostic Factor in NSCLC 13
- Squamous Cell Carcinoma Histological Subtypes Associated with Poor Prognosis 13
- Bronchioloalveolar Cell Carcinoma Growth Pattern: A Favorable Prognostic Factor 14
- Adenocarcinoma Histological Subtypes Associated with Poor Prognosis 14
- Large Cell Carcinomas 15
- Prognostic Implication of Molecular Markers 16
- Conclusion 20
- References 21
FDG-PET/CT in Lung Cancer: An Update 23
- Abstract 23
- Non-Small Cell Lung Cancer 24
- Staging of Lung Cancer – Distant Metastases 33
- Prediction and Monitoring Response to Therapy 41
- Pleural Metastases 43
- Cost-Effectiveness 44
- References 45
- Small Cell Lung Cancer 45
Whole-Body Magnetic Resonance Imaging for Staging of Lung Cancer 54
- Abstract 54
- Technical Aspects of Whole-Body MRI 55
- Staging of Lung Cancer Using Whole-Body MRI 55
- Conclusions 61
- References 61
Bronchoscopy/Endobronchial Ultrasound 63
- Abstract 63
- EBUS-TBNA: Technique 64
- Clinical Results 66
- Complications 68
- Conclusion 68
- References 69
New Developments in Videomediastinoscopy: Video-Assisted Mediastinoscopic Lymphadenectomy and Mediastinoscopic Ultrasound 71
- Abstract 71
- Methods 72
- Results 72
- Comments 75
- Implications for Clinical Practice and Further Research 77
- References 78
Resection in Stage I/II Non-Small Cell Lung Cancer 79
- Abstract 79
- Surgery in Stages I and II 80
- Conclusion 83
- References 83
Role of Mediastinal Lymph Node Dissection in Non-Small Cell Lung Cancer 86
- Abstract 86
- Surgical Technique of Systematic Lymph Node Dissection 87
- Role of Nodal Involvement on Survival 89
- Impact of Mediastinal Lymph Node Dissection on Operative Morbidity, Mortality and Quality of Life 89
- Diagnostic Role of Mediastinal Lymph Node Dissection 90
- Therapeutic Role of Mediastinal Lymph Node Dissection 91
- Conclusion 92
- References 92
Radiation Therapy for Early Stage (I/II) Non-Small Cell Lung Cancer 95
- Abstract 95
- Radiation Therapy alone in Early Non-Small Cell Lung Cancer 96
- Avenues for an Improvement of RT Alone in Early NSCLC 99
- References 100
Stereotactic Body Radiation Therapy for Early Non-Small Cell Lung Cancer 102
- Abstract 102
- Definitions of Stereotactic Body Radiation Therapy 103
- Staging Procedures before SBRT 105
- Implementation of Techniques in Clinical Routine 106
- Biological Basis of Hypofractionated SBRT 109
- Historical Aspects and Early Clinical Experience in SBRT of Lung Cancer 110
- Clinical Experience 110
- Follow-Up Recommendations 117
- Future 118
- References 118
Extended Surgical Resection in Stage III Non-Small Cell Lung Cancer 123
- Abstract 123
- Discussion of Stage-Related Treatment 124
- Conclusions 128
- References 128
Stage III: Definitive Chemoradiotherapy 130
- Abstract 130
- Optimization of Combined Radiotherapy and Chemotherapy 131
- Which Chemotherapy and Radiotherapy Regimens Are Optimal for Concurrent Chemoradiotherapy? 134
- How Do Comorbidities Influence the Performance of Concurrent Chemoradiotherapy? 138
- References 140
Adjuvant Therapy in Early-Stage Non-Small Cell Lung Cancer 143
- Abstract 143
- Landmark Studies Concerning Adjuvant Platinum-Based Chemotherapy 144
- Negative Studies 145
- The LACE (Lung Adjuvant Cisplatin Evaluation) Meta-Analysis (table 2) 145
- Adjuvant Chemotherapy and Stage (table 3) 146
- Adjuvant Radiotherapy 148
- Patient Selection and Predictive or Prognostic Factors 148
- Which Chemotherapy Combination? 148
- Conclusion 150
- Neoadjuvant Chemotherapy 150
- References 151
Postoperative Irradiation in Non-Small Cell Lung Cancer 153
- Abstract 153
- References 156
Altered Fractionation Schemes in Radiotherapy 158
- Abstract 158
- Hypofractionated Stereotactic Body Radiotherapy for NSCLC (Stage I) 159
- Hyperfractionated Accelerated Radiotherapy for Stage III NSCLC 162
- References 163
Chemotherapy of Advanced Non-Small Cell Lung Cancer 165
- Abstract 165
- Cisplatin- vs. Carboplatin-Based Chemotherapy 166
- Pemetrexed 166
- Elderly Patients and Patients with Reduced Performance Status 167
- Customized Chemotherapy 167
- Targeted Therapies 168
- Maintenance Therapy 168
- Assessment of Efficacy 169
- Systemic Chemotherapy in Patients Progressing after First-Line Chemotherapy 169
- References 170
Radiotherapy 172
- Abstract 172
- Clinical Manifestations of Advanced Lung Carcinoma 172
- Palliative Potential of Radiotherapy 173
- Treatment Strategies 175
- References 179
Treatment of Limited Disease Small Cell Lung Cancer 181
- Abstract 181
- Thoracic Radiotherapy 182
- Patient Selection 185
- References 186
- Future Perspectives 186
Radiochemotherapy in Extensive Disease Small Cell Lung Cancer ED-SCLC 188
- Abstract 188
- RT in ED-SCLC Trial 189
- Future Approaches 192
- Conclusions 193
- References 193
Radiotherapy for Extensive Stage Small Cell Lung Cancer 195
- Abstract 195
- Introduction 195
- Prophylactic Cranial Irradiation 196
- Brain Metastases 196
- Thoracic Radiotherapy 198
- References 199
Controversies in the Treatment of Advanced Stages of Small Cell Lung Cancer 201
- First-Line Chemotherapy 201
- Abstract 201
- Prophylactic Cranial Irradiation after First-Line Chemotherapy 203
- Second-Line Chemotherapy 203
- References 204
Complementary and Alternative Medicinein Lung Cancer Patients: A Neglected Phenomenon? 206
- Abstract 206
- Methods 208
- Results 209
- Discussion 210
- Conclusions 211
- References 212
Author Index 214
Subject Index 215
Back cover 220

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