• 2018-07
  • 2020-07
  • 2020-08
  • br We provide what to our knowledge is the first


    We provide what to our knowledge is the first evidence to sup-port the recently changed NCCN guidelines recommending post-surveillance imaging and examination at 3 to 6 months after definitive treatment. Of note, however, our findings suggest that somewhat more frequent follow-up than this is probably preferable, because patients with asymptomatic recurrences detected on imag-ing fared better in our cohort. These findings also raise the question of whether periodic repeat Mocetinostat (MGCD0103, MG0103) imaging might be of benefit in the asymptomatic patient. Optimally, our findings should be validated in a prospective randomized controlled trial or (more realistically) a larger retrospective analysis of pooled patients from multiple in-stitutions to better define an optimal posttreatment surveillance interval after curative-intent CRT.
    Clinical Practice Points
    The optimal surveillance frequency after definitive CRT for stage III NSCLC patients is unknown.
    Most relapses after definitive CRT for stage III NSCLC happen within 1 year of completing treatment.
    Symptomatic relapses result in worse OS compared to asymp-tomatic relapses identified by surveillance imaging.
    More aggressive surveillance imaging may improve outcomes by identifying asymptomatic relapses that are amenable to earlier salvage therapy.
    The authors have stated that they have no conflict of interest.
    3. Didkowska J, Wojciechowska U, Manczuk M, Lobaszewski J. Lung cancer epidemiology: contemporary and future challenges worldwide. Ann Transl Med 2016; 4:150.
    4. Yoon SM, Shaikh T, Hallman M. Therapeutic management options for stage III nonesmall cell lung cancer. World J Clin Oncol 2017; 8:1-20.
    5. Baker S, Dahele M, Lagerwaard FJ, Senan S. A critical review of recent developments in radiotherapy for nonesmall cell lung cancer. Radiat Oncol 2016; 11:115.
    6. Bradley JD, Paulus R, Komaki R, et al. Standard-dose versus high-dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage IIIA or IIIB nonesmall-cell lung cancer (RTOG 0617): a randomised, two-by-two factorial phase 3 study. Lancet Oncol 2015; 16:187-99.
    7. Demicheli R, Fornili M, Ambrogi F, et al. Recurrence dynamics for nonesmall-cell lung cancer: effect of surgery on the development of metastases. J Thorac Oncol 2012; 7:723-30.
    8. Lou F, Sima CS, Rusch VW, Jones DR, Huang J. Differences in patterns of recurrence in early-stage versus locally advanced nonesmall cell lung cancer. Ann Thorac Surg 2014; 98:1755-60.
    9. Nakamura R, Kurishima K, Kobayashi N, et al. Postoperative follow-up for patients with nonesmall cell lung cancer. Onkologie 2010; 33:14-8.
    10. Colt HG, Murgu SD, Korst RJ, Slatore CG, Unger M, Quadrelli S. Follow-up and surveillance of the patient with lung cancer after curative-intent therapy: diagnosis and management of lung cancer, 3rd ed.: American College of Chest Physicians evidence-based clinical practice guidelines. Chest 2013; 143:e437S-54S.
    11. Postmus PE, Kerr KM, Oudkerk M, et al. Early and locally advanced nonesmall-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2017; 28:iv1-21.
    12. National Comprehensive Cancer Network. NCCN clinical practice guidelines: nonesmall cell lung cancer, version 5.2017, Available at: professionals/physician_gls/default.aspx. Accessed: September 6, 2018.  G. Daniel Grass et al
    14. Larici AR, del Ciello A, Maggi F, et al. Lung abnormalities at multimodality imaging after radiation therapy for nonesmall cell lung cancer. Radiographics 2011; 31:771-89.
    17. Westeel V, Choma D, Clement F, et al. Relevance of an intensive postoperative follow-up after surgery for nonesmall cell lung cancer. Ann Thorac Surg 2000; 70: 1185-90.
    18. Jimenez-Bonilla JF, Quirce R, Martinez-Rodriguez I, De Arcocha-Torres M, Carril JM, Banzo I. The role of PET/CT molecular imaging in the diagnosis of recurrence and surveillance of patients treated for nonesmall cell lung cancer. Diagnostics (Basel) 2016; 6. 19. van Loon J, Grutters J, Wanders R, et al. Follow-up with 18FDG-PET-CT after radical radiotherapy with or without chemotherapy allows the detection of potentially curable progressive Mocetinostat (MGCD0103, MG0103) disease in nonesmall cell lung cancer patients: a prospective study. Eur J Cancer 2009; 45:588-95.
    20. Reddy JP, Tang C, Shih T, et al. Influence of surveillance PET/CT on detection of early recurrence after definitive radiation in stage III nonesmall-cell lung cancer. Clin Lung Cancer 2017; 18:141-8.