Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
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The optimal approach to patients with malignant airway obstruction who require intubation and mechanical ventilation but are ineligible for bronchoscopic interventions is uncertain. Radiotherapy (RT) may be delivered but requires substantial resources in this patient population. In the absence of evidence, it is unknown whether RT facilitates extubation or delays an appropriate transition to end-of-life care. ⋯ A significant minority of patients receiving RT were successfully extubated. Higher radiation doses were predictive of improved OS and showed a trend for increased ES. Survival beyond 6 months was uncommon, however, the majority of patients with ES were able to be discharged home.
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Practice Guideline
Screening high-risk populations for lung cancer: guideline recommendations.
The aim of this practice guideline was to develop evidence-based recommendations for screening high-risk populations for lung cancer. ⋯ The benefits of screening high-risk populations for lung cancer with LDCT outweigh the harms if screening is implemented in a strictly controlled manner.
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This study aimed to evaluate the long-term efficacy of multimodality therapy for patients with type B3 thymoma. ⋯ The type B3 thymoma often presented with the later stages at the diagnosis. The Masaoka stage was closely associated with OS, FFR, and TTP. Resection margin after surgery was related to TTP. Adjuvant radiotherapy may be beneficial to stage III and IV patients in this clinical setting.
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Transformation into small-cell lung carcinoma (SCLC) has been reported as an evolution of lung adenocarcinoma acquiring resistance to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI). However, spontaneous association of SCLC and adenocarcinoma also exists. We sought to compare patients' clinical features and mutation status of EGFR in each tumor component in these conditions. ⋯ SCLC developing in association with adenocarcinoma, either synchronously or metachronously, seem linked to EGFR mutation, regardless of TKI use. Our findings suggest that such associated cases should be tested for EGFR mutations.
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The aim of this study was to radiologically identify early lung adenocarcinoma in clinical T1bN0M0 lung cancer, based on pathological findings and long-term prognosis. ⋯ In patients with clinical T1bN0M0 disease, the C/T ratio of 0.5 or less identified early lung adenocarcinoma. In patients with the identified early disease, a feasibility study of limited surgery may be warranted.