Follow-Up Imaging Guidelines for Patients with Stage III Unresectable NSCLC: Recommendations Based on the PACIFIC Trial.
Jenny J KoShantanu O BanerjiNormand BlaisAnthony BradeCathy ClellandDevin SchellenbergStephanie SnowPaul Wheatley-PriceRen YuanBarbara L MeloskyPublished in: Current oncology (Toronto, Ont.) (2023)
The PACIFIC trial showed a survival benefit with durvalumab through five years in stage III unresectable non-small cell lung cancer (NSCLC). However, optimal use of imaging to detect disease progression remains unclearly defined for this population. An expert working group convened to consider available evidence and clinical experience and develop recommendations for follow-up imaging after concurrent chemotherapy and radiation therapy (CRT). Voting on agreement was conducted anonymously via online survey. Follow-up imaging was recommended for all suitable patients after CRT completion regardless of whether durvalumab is received. Imaging should occur every 3 months in Year 1, at least every 6 months in Year 2, and at least every 12 months in Years 3-5. Contrast computed tomography was preferred; routine brain imaging was not recommended for asymptomatic patients. The medical oncologist should follow-up during Year 1 of durvalumab therapy, with radiation oncologist involvement if pneumonitis is suspected; medical and radiation oncologists can subsequently alternate follow-up. Some patients can transition to the family physician/community primary care team at the end of Year 2. In Years 1-5, patients should receive information regarding smoking cessation, comorbidity management, vaccinations, and general follow-up care. These recommendations provide guidance on follow-up imaging for patients with stage III unresectable NSCLC whether or not they receive durvalumab consolidation therapy.
Keyphrases
- end stage renal disease
- high resolution
- primary care
- computed tomography
- chronic kidney disease
- ejection fraction
- newly diagnosed
- healthcare
- radiation therapy
- small cell lung cancer
- smoking cessation
- squamous cell carcinoma
- peritoneal dialysis
- locally advanced
- clinical trial
- rheumatoid arthritis
- magnetic resonance
- multiple sclerosis
- photodynamic therapy
- clinical practice
- mental health
- emergency department
- prognostic factors
- mesenchymal stem cells
- patient reported outcomes
- study protocol
- health information
- resting state
- patient reported
- phase ii
- blood brain barrier
- functional connectivity
- bone marrow
- white matter
- advanced cancer