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.
Management of locally advanced non-small cell lung cancer in the modern era: A national Italian survey on diagnosis, treatment and multidisciplinary approach / Bruni, A.; Giaj-Levra, N.; Ciammella, P.; Maragna, V.; Ferrari, K.; Bonti, V.; Grossi, F.; Greco, S.; Greco, C.; Borghetti, P.; Franceschini, D.; Capelletto, E.; Perna, M.; Banna, G.; Vagge, S.; Baldini, E.; Bria, E.; Botti, A.; Tiseo, M.; Paci, M.; Taraborrelli, M.; Poletti, V.; Granone, P.; Ricardi, U.; Novello, S.; Scotti, V.. - In: PLOS ONE. - ISSN 1932-6203. - 14:11(2019), p. e0224027. [10.1371/journal.pone.0224027]
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