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  1. Article: Artificial Intelligence Research: The Utility and Design of a Relational Database System.

    Dilling, Thomas J

    Advances in radiation oncology

    2020  Volume 5, Issue 6, Page(s) 1280–1285

    Abstract: Although many researchers talk about a "patient database," they typically are not referring to a database at all, but instead to a spreadsheet of curated facts about a cohort of patients. This article describes relational database systems and how they ... ...

    Abstract Although many researchers talk about a "patient database," they typically are not referring to a database at all, but instead to a spreadsheet of curated facts about a cohort of patients. This article describes relational database systems and how they differ from spreadsheets. At their core, spreadsheets are only capable of describing one-to-one (1:1) relationships. However, this article demonstrates that clinical medical data encapsulate numerous one-to-many relationships. Consequently, spreadsheets are very inefficient relative to relational database systems, which gracefully manage such data. Databases provide other advantages, in that the data fields are "typed" (that is, they contain specific kinds of data). This prevents users from entering spurious data during data import. Because each record contains a "key," it becomes impossible to add duplicate information (ie, add the same patient twice). Databases store data in very efficient ways, minimizing space and memory requirements on the host system. Likewise, databases can be queried or manipulated using a highly complex language called SQL. Consequently, it becomes trivial to cull large amounts of data from a vast number of data fields on very precise subsets of patients. Databases can be quite large (terabytes or more in size), yet still are highly efficient to query. Consequently, with the explosion of data available in electronic health records and other data sources, databases become increasingly important to contain or order these data. Ultimately, this will enable the clinical researcher to perform artificial intelligence analyses across vast amounts of clinical data in a way heretofore impossible. This article provides initial guidance in terms of creating a relational database system.
    Language English
    Publishing date 2020-07-13
    Publishing country United States
    Document type Journal Article
    ISSN 2452-1094
    ISSN 2452-1094
    DOI 10.1016/j.adro.2020.06.027
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Radiation dose in non-small cell lung cancer: too much of a good thing?

    Dilling, Thomas J

    International journal of radiation oncology, biology, physics

    2014  Volume 90, Issue 5, Page(s) 979–982

    MeSH term(s) Antibodies, Monoclonal, Humanized/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Carboplatin/administration & dosage ; Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/mortality ; Carcinoma, Non-Small-Cell Lung/radiotherapy ; Cetuximab ; Clinical Trials, Phase I as Topic ; Clinical Trials, Phase III as Topic ; Dose Fractionation ; Hospitals, High-Volume ; Humans ; Incidence ; Lung Neoplasms/drug therapy ; Lung Neoplasms/mortality ; Lung Neoplasms/radiotherapy ; Paclitaxel/administration & dosage ; Quality of Life ; Radiation Injuries/epidemiology ; Radiotherapy Dosage ; Retreatment/adverse effects ; Retrospective Studies ; Treatment Outcome
    Chemical Substances Antibodies, Monoclonal, Humanized ; Carboplatin (BG3F62OND5) ; Paclitaxel (P88XT4IS4D) ; Cetuximab (PQX0D8J21J)
    Language English
    Publishing date 2014-12-01
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2014.08.333
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Deep Learning-Guided Dosimetry for Mitigating Local Failure of Patients With Non-Small Cell Lung Cancer Receiving Stereotactic Body Radiation Therapy.

    Dudas, Denis / Saghand, Paymen Ghasemi / Dilling, Thomas J / Perez, Bradford A / Rosenberg, Stephen A / El Naqa, Issam

    International journal of radiation oncology, biology, physics

    2023  

    Abstract: Purpose: Non-small cell lung cancer (NSCLC) stereotactic body radiation therapy with 50 Gy/5 fractions is sometimes considered controversial, as the nominal biologically effective dose (BED) of 100 Gy is felt by some to be insufficient for long-term ... ...

    Abstract Purpose: Non-small cell lung cancer (NSCLC) stereotactic body radiation therapy with 50 Gy/5 fractions is sometimes considered controversial, as the nominal biologically effective dose (BED) of 100 Gy is felt by some to be insufficient for long-term local control of some lesions. In this study, we analyzed such patients using explainable deep learning techniques and consequently proposed appropriate treatment planning criteria. These novel criteria could help planners achieve optimized treatment plans for maximal local control.
    Methods and materials: A total of 535 patients treated with 50 Gy/5 fractions were used to develop a novel deep learning local response model. A multimodality approach, incorporating computed tomography images, 3-dimensional dose distribution, and patient demographics, combined with a discrete-time survival model, was applied to predict time to failure and the probability of local control. Subsequently, an integrated gradient-weighted class activation mapping method was used to identify the most significant dose-volume metrics predictive of local failure and their optimal cut-points.
    Results: The model was cross-validated, showing an acceptable performance (c-index: 0.72, 95% CI, 0.68-0.75); the testing c-index was 0.69. The model's spatial attention was concentrated mostly in the tumors' periphery (planning target volume [PTV] - internal gross target volume [IGTV]) region. Statistically significant dose-volume metrics in improved local control were BED D
    Conclusions: Deep learning-identified dose-volume metrics have shown significant prognostic power (log-rank, P = .003) and could be used as additional actionable criteria for treatment planning in NSCLC stereotactic body radiation therapy patients receiving 50 Gy in 5 fractions. Although our data do not confirm or refute that a significantly higher BED for the prescription dose is necessary for tumor control in NSCLC, it might be clinically effective to escalate the nominal prescribed dose from BED 100 to 105 Gy.
    Language English
    Publishing date 2023-12-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2023.11.059
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Pulmonary vein isolation by visually guided laser balloon ablation: single-center 5-year follow-up results.

    Koopman, Pieter / Bekelaar, Thalia / Schurmans, Joris / Phlips, Thomas / Dilling-Boer, Dagmara / Vijgen, Johan

    Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing

    2023  Volume 66, Issue 9, Page(s) 2081–2089

    Abstract: Background: Visually guided laser balloon (VGLB) ablation is a balloon-based treatment for atrial fibrillation (AF) that uses a titratable laser energy source to perform pulmonary vein isolation (PVI), allowing for real-time visualization of target ... ...

    Abstract Background: Visually guided laser balloon (VGLB) ablation is a balloon-based treatment for atrial fibrillation (AF) that uses a titratable laser energy source to perform pulmonary vein isolation (PVI), allowing for real-time visualization of target tissue and ablation lesions through an endoscopic camera. Few long-term data on this technique are currently available. This report presents acute efficacy, procedural data, complication rates, and long-term AF-free survival up to 5 years post-ablation.
    Methods: In this single-center, retrospective, observational report, 152 patients (72.4% male, mean age 60.6 ± 9.7 years, 62.5% paroxysmal AF, 598 pulmonary veins in total) treated with the first-generation VGLB system between 2014 and 2016 were included for analysis. AF ablation consisted of PVI only.
    Results: Acute PVI was achieved in 98.2% of veins, with first-pass isolation in 92.5%. Procedure duration of 129 min [IQR 113-150], fluoroscopy time of 15 min [IQR 11-20], and dose area product of 5016 mGy·cm
    Conclusions: First-generation VGLB ablation demonstrated high acute isolation rates, reasonable procedure times and low complication rates. Long-term freedom from AF was 78.8% for paroxysmal AF and 65.3% for persistent AF, performing PVI only.
    MeSH term(s) Humans ; Male ; Middle Aged ; Aged ; Female ; Pulmonary Veins/surgery ; Follow-Up Studies ; Retrospective Studies ; Treatment Outcome ; Atrial Fibrillation/surgery ; Catheter Ablation/methods ; Recurrence
    Language English
    Publishing date 2023-04-15
    Publishing country Netherlands
    Document type Observational Study ; Journal Article
    ZDB-ID 1329179-8
    ISSN 1572-8595 ; 1383-875X
    ISSN (online) 1572-8595
    ISSN 1383-875X
    DOI 10.1007/s10840-023-01544-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Artificial Intelligence for Outcome Modeling in Radiotherapy.

    Cui, Sunan / Hope, Andrew / Dilling, Thomas J / Dawson, Laura A / Ten Haken, Randall / El Naqa, Issam

    Seminars in radiation oncology

    2022  Volume 32, Issue 4, Page(s) 351–364

    Abstract: Outcome modeling plays an important role in personalizing radiotherapy and finds applications in specialized areas such as adaptive radiotherapy. Conventional outcome models that are based on a simplified understanding of radiobiological effects or ... ...

    Abstract Outcome modeling plays an important role in personalizing radiotherapy and finds applications in specialized areas such as adaptive radiotherapy. Conventional outcome models that are based on a simplified understanding of radiobiological effects or empirical fitting often only consider dosimetric information. However, it is recognized that response to radiotherapy is multi-factorial and involves a complex interaction of radiation therapy, patient and treatment factors, and the tumor microenvironment. Recently, large pools of patient-specific biological and imaging data have become available with the development of advanced biotechnology and multi-modality imaging techniques. Given this complexity, artificial intelligence (AI) and machine learning (ML) are valuable to make sense of such a plethora of heterogeneous data and to aid clinicians in their decision-making process. The role of AI/ML has been demonstrated in many retrospective studies and more recently prospective evidence has been emerging as well to support AI/ML for personalized and precision radiotherapy.
    MeSH term(s) Artificial Intelligence ; Humans ; Machine Learning ; Prospective Studies ; Radiation Oncology/methods ; Retrospective Studies
    Language English
    Publishing date 2022-10-06
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1146999-7
    ISSN 1532-9461 ; 1053-4296
    ISSN (online) 1532-9461
    ISSN 1053-4296
    DOI 10.1016/j.semradonc.2022.06.005
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Magnetic Resonance-Guided Stereotactic Body Radiation Therapy/Hypofractionated Radiation therapy for Metastatic and Primary Central and Ultracentral Lung Lesions.

    Sandoval, Maria L / Sim, Austin J / Bryant, John M / Bhandari, Menal / Wuthrick, Evan J / Perez, Bradford A / Dilling, Thomas J / Redler, Gage / Andreozzi, Jacqueline / Nardella, Louis / Feygelman, Vladimir / Latifi, Kujtim / Rosenberg, Stephen A

    JTO clinical and research reports

    2023  Volume 4, Issue 5, Page(s) 100488

    Abstract: Introduction: The recent results from the Nordic-HILUS study indicate stereotactic body radiation therapy (SBRT) is associated with high-grade toxicity for ultracentral (UC) tumors. We hypothesized that magnetic resonance-guided SBRT (MRgSBRT) or ... ...

    Abstract Introduction: The recent results from the Nordic-HILUS study indicate stereotactic body radiation therapy (SBRT) is associated with high-grade toxicity for ultracentral (UC) tumors. We hypothesized that magnetic resonance-guided SBRT (MRgSBRT) or hypofractionated radiation therapy (MRgHRT) enables the safe delivery of high-dose radiation to central and UC lung lesions.
    Methods: Patients with UC or central lesions were treated with MRgSBRT/MRgHRT with real-time gating or adaptation. Central lesions were defined as per the Radiation Therapy Oncology Group and UC as per the HILUS study definitions: (1) group A or tumors less than 1 cm from the trachea and/or mainstem bronchi; or (2) group B or tumors less than 1 cm from the lobar bronchi. The Kaplan-Meier estimate and log-rank test were used to estimate survival. Associations between toxicities and other patient factors were tested using the Mann-Whitney
    Results: A total of 47 patients were included with a median follow-up of 22.9 months (95% confidence interval: 16.4-29.4). Most (53%) had metastatic disease. All patients had central lesions and 55.3% (n = 26) had UC group A. The median distance from the proximal bronchial tree was 6.0 mm (range: 0.0-19.0 mm). The median biologically equivalent dose (α/β = 10) was 105 Gy (range: 75-151.2). The most common radiation schedule was 60 Gy in eight fractions (40.4%). Most (55%) had previous systemic therapy, 32% had immunotherapy and 23.4% had previous thoracic radiation therapy. There were 16 patients who underwent daily adaptation. The 1-year overall survival was 82% (median = not reached), local control 87% (median = not reached), and progression-free survival 54% (median = 15.1 mo, 95% confidence interval: 5.1-25.1). Acute toxicity included grade 1 (26%) and grade 2 (21%) with only two patients experiencing grade 3 (4.3%) in the long term. No grade 4 or 5 toxicities were seen.
    Conclusions: Previous studies noted high rates of toxicity after SBRT to central and UC lung lesions, with reports of grade 5 toxicities. In our cohort, the use of MRgSBRT/MRgHRT with high biologically effective doses was well tolerated, with two grade 3 toxicities and no grade 4/5.
    Language English
    Publishing date 2023-02-25
    Publishing country United States
    Document type Journal Article
    ISSN 2666-3643
    ISSN (online) 2666-3643
    DOI 10.1016/j.jtocrr.2023.100488
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article: Novel MR-Guided Radiotherapy Elective Rotation for Radiation Oncology Trainees.

    Sim, Austin J / Frakes, Jessica M / Hoffe, Sarah E / Wuthrick, Evan / Dilling, Thomas J / Rosenberg, Stephen

    Cureus

    2020  Volume 12, Issue 9, Page(s) e10706

    Abstract: MR-guided adaptive radiation therapy (RT) is emerging as an integral treatment modality for certain applications and is poised to become an exciting opportunity for greater treatment precision and personalization. However, this is still a relatively ... ...

    Abstract MR-guided adaptive radiation therapy (RT) is emerging as an integral treatment modality for certain applications and is poised to become an exciting opportunity for greater treatment precision and personalization. However, this is still a relatively nascent technology and only a few institutions and programs have access to this technology for clinical use and trainee education. To increase the diversity of elective offerings and improve the understanding of an MR-guided radiotherapy program, we initiated a unique MR-guided radiotherapy elective rotation for radiation oncology residents. During a representative four-week rotation, 21 simulations were completed by the resident on service. A plurality of simulations were for pancreas stereotactic body radiation therapy (SBRT; 48%) and a majority (71%) of simulations were for adaptive treatments. Additionally, 74 adaptive fractions were completed during this month, of which a significant majority (74%) were for pancreas SBRT. Of the non-adaptive fractions, the majority were for prostate SBRT and intensity-modulated radiation therapy (IMRT). Although many programs may offer training in some aspects of MR-guided radiotherapy as trainees rotate through certain disease sites, we hope this may serve as a blueprint to encourage programs with this technology to fully embrace training in essential competencies related to MR-guided radiotherapy. MR-guided radiotherapy has unique challenges that trainees need to understand to deliver treatment safely: geometric uncertainty, MRI to RT isocenter, and uncertainties with voxel size/tracking.
    Language English
    Publishing date 2020-09-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.10706
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Book: Praxishandbuch Psychotherapie-Richtlinie und Psychotherapie-Vereinbarung - Abrechnung

    Bender, Carmen / Berner, Barbara / Best, Dieter / Dilling, Julian / Schaff, Christa / Uhlemann, Thomas

    2022  

    Abstract: Mit der Reform der Psychotherapie-Richtlinie von 2017 und den seitherigen weiteren Reformschritten haben sich die Rahmenbedingungen für die ambulante psychotherapeutische Versorgung als Leistung der Gesetzlichen Krankenversicherung grundlegend geändert. ... ...

    Title translation Practice handbook of psychotherapy guideline and psychotherapy agreement
    Abstract Mit der Reform der Psychotherapie-Richtlinie von 2017 und den seitherigen weiteren Reformschritten haben sich die Rahmenbedingungen für die ambulante psychotherapeutische Versorgung als Leistung der Gesetzlichen Krankenversicherung grundlegend geändert. So wurde das Versorgungsangebot erheblich erweitert und die Abläufe wurden entbürokratisiert. Mit mehreren Maßnahmen wird die Gruppenpsychotherapie besonders gefördert, etwa durch die Einführung einer "Gruppenpsychotherapeutischen Grundversorgung". Als neues Richtlinienverfahren hinzugekommen ist die Systemische Therapie. Im vorliegenden Praxishandbuch werden sämtliche Regelungen der Psychotherapie-Richtlinie und der Psychotherapie-Vereinbarung erläutert. Neu in der dritten Auflage ist ein Kapitel zur Abrechnung der Leistungen, die im Rahmen der Psychotherapie-Richtlinie erbracht werden können. Dem Anspruch, den behandelnden Therapeutinnen und Therapeuten ebenso wie den Mitarbeiterinnen und Mitarbeitern der Krankenkassen fundierte Handlungsanweisungen für die praktische Arbeit an die Hand zu geben, werden auch die ergänzenden Abrechnungshinweise und die Erläuterungen zu den erweiterten Verordnungsmöglichkeiten für die Psychologischen Psychotherapeuten und Kinder- und Jugendlichenpsychotherapeuten gerecht. Neu hinzugekommen sind die Verordnung von Ergotherapie und von psychiatrischer häuslicher Krankenpflege. Ebenfalls neu ist für alle Ärzte und Psychotherapeuten die Möglichkeit der Verordnung digitaler Gesundheitsanwendungen. - Inhalt: (1) Die psychotherapeutischen Versorgungsangebote (Telefonische persönliche Erreichbarkeit zur Terminkoordination; Psychotherapeutische Sprechstunde; Gruppenpsychotherapeutische Grundversorgung; Psychotherapeutische Akutbehandlung; Probatorische Sitzungen; Richtlinientherapie; Rezidivprophylaxe; Gruppentherapie; Einbeziehung des sozialen Umfelds bei Erwachsenen; Digitale Gesundheitsanwendungen). (2) Psychotherapeutische Leistungen bei Kindern und Jugendlichen. (3) Formale Voraussetzungen einer Durchführung einer Psychotherapie. (4) Definitionen und rechtliche Fragen. (5) Psychosomatische Grundversorgung. (6) Abrechnung der Leistungen nach der Psychotherapie-Richtlinie. (7) Zahlen zur Psychotherapie in der Gesetzlichen Krankenversicherung. - Anhänge (Überblick über die Kontingentschritte in der Langzeittherapie nach Verfahren und Patientengruppen; Richtlinie des Gemeinsamen Bundesausschusses über die Durchführung der Psychotherapie (Psychotherapie-Richtlinie); Vereinbarung über die Anwendung von Psychotherapie in der vertragsärztlichen Versorgung (Psychotherapie-Vereinbarung); Formblätter; Ausfüllhilfen für Formblätter).
    Keywords Adolescent Psychotherapy ; Ambulante Behandlung ; Child Psychotherapy ; Gesetze ; Gesundheitspolitik ; Gesundheitsversorgungssystem ; Health Care Delivery ; Health Care Policy ; Health Insurance ; Jugendlichenpsychotherapie ; Kinderpsychotherapie ; Krankenversicherung ; Laws ; Outpatient Treatment ; Psychosomatic Medicine ; Psychosomatische Medizin ; Psychotherapie ; Psychotherapy
    Language German
    Size 398 S., 111 S. Anhang
    Publisher medhochzwei (3., neu bearb. u. erw. Aufl.)
    Publishing place Heidelberg
    Document type Book
    ISBN 978-3-86216-838-5 ; 3-86216-838-7
    Database PSYNDEX

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  9. Article ; Online: Damage to the left descending coronary artery due to radiofrequency ablation in the right ventricular outflow tract: Clinical case series and anatomical considerations.

    Dilling-Boer, Dagmara / Nof, Eyal / Beinaert, Roy / Wakili, Reza / Heidbuchel, Hein / Koopman, Pieter / Schurmans, Joris / Phlips, Thomas / Didenko, Maxim / Vijgen, Johan

    Journal of cardiovascular electrophysiology

    2023  Volume 34, Issue 2, Page(s) 468–477

    Abstract: The purpose of this paper was to highlight the importance of the anatomy of the right ventricular outflow tract (RVOT) and the proximity of the mid segment of the left anterior descending coronary artery (LAD) to the RVOT in the setting of ablation of ... ...

    Abstract The purpose of this paper was to highlight the importance of the anatomy of the right ventricular outflow tract (RVOT) and the proximity of the mid segment of the left anterior descending coronary artery (LAD) to the RVOT in the setting of ablation of ventricular arrhythmias in the RVOT. During the period from 2014 till 2017, five patients with injury to the LAD during ablation within RVOT were identified in three centers, in Belgium, Germany and Israel. The clinical characteristics, procedural data and follow up data, where available, are reported. The literature review over coronary artery damage during radiofrequency ablation procedures is provided and the anatomy of the RVOT and the neighboring vascular structures is discussed. We present five patients who underwent radiofrequency ablation of ventricular arrhythmias mapped to the inferior and anterior part of the RVOT, at the insertion of the right ventricular wall to the septum, whereby ablation resulted in occlusion in four and severe stenosis in one, of the mid segment of the LAD coronary artery. All patients underwent percutaneous coronary intervention and stenting, four of them immediately during the same procedure and one 3 days later because of lack of signs and symptoms of acute coronary occlusion. In conclusion, the mid segment of the LAD at the level of the second septal perforator/second diagonal branch runs in very close proximity to the endocardial aspect of the lower part of the RVOT and care should be taken during ablation of ventricular arrhythmias in this region. Additional imaging such as intracardiac echocardiography and coronary angiography may be helpful in avoiding complications.
    MeSH term(s) Humans ; Arrhythmias, Cardiac/surgery ; Catheter Ablation/adverse effects ; Catheter Ablation/methods ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/surgery ; Electrocardiography ; Radiofrequency Ablation ; Tachycardia, Ventricular/diagnostic imaging ; Tachycardia, Ventricular/surgery
    Language English
    Publishing date 2023-01-19
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1025989-2
    ISSN 1540-8167 ; 1045-3873
    ISSN (online) 1540-8167
    ISSN 1045-3873
    DOI 10.1111/jce.15816
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Analysis of Relapse Events After Definitive Chemoradiotherapy in Locally Advanced Non-Small-Cell Lung Cancer Patients.

    Grass, G Daniel / Naghavi, Arash O / Abuodeh, Yazan A / Perez, Bradford A / Dilling, Thomas J

    Clinical lung cancer

    2018  Volume 20, Issue 1, Page(s) e1–e7

    Abstract: Background: The appropriate follow-up frequency after definitive chemoradiotherapy (CRT) for locally advanced non-small-cell lung cancer patients is unknown. Although surveillance guidelines have been proposed, very few data support current ... ...

    Abstract Background: The appropriate follow-up frequency after definitive chemoradiotherapy (CRT) for locally advanced non-small-cell lung cancer patients is unknown. Although surveillance guidelines have been proposed, very few data support current recommendations. Here we analyze relapse events after CRT and investigate whether symptomatic relapses versus those detected by surveillance imaging influences outcomes.
    Patients and methods: Stage III non-small-cell lung cancer patients treated with CRT at our institution between 2005 and 2014 were retrospectively analyzed. Relapse events were grouped into posttreatment intervals and analyzed with cumulative tables. Time to relapse and overall survival (OS) were compared between patients with relapse detection via symptomatic presentation versus surveillance imaging.
    Results: A total of 211 patients were identified for analysis. The median follow-up was 43 months for patients alive at the time of analysis. The median age was 63 years, and equal proportions had IIIA or IIIB disease. A total of 135 patients (64%) experienced disease relapse, and of these, 74% did so within 12 months. In those who did not experience relapse at ≤ 12 months, 16%, 6%, and < 5% experienced relapse during 12 to 24, 24 to 36, and > 36 months of follow-up, respectively. In patients with relapse, 56% presented symptomatically, which led to inferior median OS compared to those identified by surveillance imaging (23 vs. 36 months; P = .013).
    Conclusion: This study identified that most relapses occur within 1 year of completing CRT, and approximately half of these occur within 6 months. A symptomatic relapse led to inferior OS. More aggressive surveillance imaging may therefore identify asymptomatic relapses that are amenable to earlier salvage therapy.
    MeSH term(s) Carcinoma, Non-Small-Cell Lung/drug therapy ; Carcinoma, Non-Small-Cell Lung/epidemiology ; Carcinoma, Non-Small-Cell Lung/mortality ; Chemoradiotherapy ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms/drug therapy ; Lung Neoplasms/epidemiology ; Lung Neoplasms/mortality ; Male ; Middle Aged ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm Staging ; Platinum/therapeutic use ; Retrospective Studies ; Survival Analysis ; United States/epidemiology
    Chemical Substances Platinum (49DFR088MY)
    Language English
    Publishing date 2018-08-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2145146-1
    ISSN 1938-0690 ; 1525-7304
    ISSN (online) 1938-0690
    ISSN 1525-7304
    DOI 10.1016/j.cllc.2018.08.009
    Database MEDical Literature Analysis and Retrieval System OnLINE

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