Thoracic Cancer最新文献

{"title":"The Efficacy and Safety of Brain Radiotherapy Combined With Immune Checkpoint Inhibitors (ICIs) for Small-Cell Lung Cancer (SCLC) Patients With Brain Metastases (BMs).","authors":"Jie Xu, Yanling Yang, Tingting Chen, Dongmin Liu, Yajing Yuan, Liming Xu","doi":"10.1111/1759-7714.70112","DOIUrl":"10.1111/1759-7714.70112","url":null,"abstract":"<p><strong>Objective: </strong>This study was designed to evaluate the efficacy and safety of brain radiotherapy combined with immune checkpoint inhibitors (ICIs) retrospectively in small-cell lung cancer (SCLC) patients with brain metastases (BMs).</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 42 SCLC patients with BMs, who received brain radiotherapy combined with ICIs at our Hospital from 2020 to 2024. They received chemotherapy plus ICIs regimens and brain radiotherapy, and received concurrent/sequential thoracic radiotherapy. This study investigated the forms of WBRT vs. WBRT+ simultaneous integrated boost (SIB, different doses of radiation being delivered simultaneously to different parts of the tumor) combined with ICIs on overall survival (OS), intracranial local control (iLC), and radiotherapy adverse reactions (side effection). The Kaplan-Meier method was used for survival rate analysis. The log-rank test was used to compare the survival curves between different groups, and the chi-square (χ²) test was used to compare categorical data.</p><p><strong>Results: </strong>In all the patients, the median follow-up time was 19.2 (range: 9.79-36.8) months. The 2-year OS rate and iLC rate were 42.3% and 68.8%, respectively. A total of 26 patients died of disease progression; 2 patients developed radiation-induced brain necrosis. The results showed that there was no significant difference in radiation-induced brain necrosis between the two groups. The WBRT patients suffered high rates of headache, dizziness, nausea, and radiodermatitis. The 2-year OS and iLC were brilliant.</p><p><strong>Conclusions: </strong>When brain radiotherapy combined with ICIs, even WBRT or WBRT + SIB had well OS and iLC with tolerable side reactions. Its indications needed to be considered from multiple perspectives. Further evaluation of brain radiotherapy combined with ICIs in SCLC BMs is required. Further prospective studies should be conducted to verify the conclusions.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70112"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12197861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144498107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"S- and R-Carvedilol Prevent Benzo(a)pyrene-Induced Lung Carcinogenesis.","authors":"Ayaz Shahid, Steven Yeung, Bradley T Andresen, Ying Huang","doi":"10.1111/1759-7714.70109","DOIUrl":"10.1111/1759-7714.70109","url":null,"abstract":"<p><p>Lung cancer is the most common and deadly type of cancer. Our previous study showed that carvedilol, a β-blocker, can prevent lung cancer induced by benzo(a)pyrene [B(a)P]. Carvedilol is a 1:1 racemic mixture of S- and R-carvedilol, with S-carvedilol acting as a β-adrenergic blocker, while R-carvedilol lacks β-blocking activity. Despite this, a previous study showed that R-carvedilol effectively prevents UV-induced skin cancer. This study aimed to determine whether carvedilol's lung cancer prevention relies on its β-blocking activity. We compared the effectiveness of S- and R-carvedilol in preventing lung cancer induced by B(a)P and its metabolite, benzo(a)pyrene diol epoxide (BPDE), both in vivo and in vitro. Our results showed that S- and R-carvedilol equally prevent malignant transformation of the human bronchial epithelial cell line (BEAS-2B) induced by BPDE. Furthermore, both S- and R-carvedilol significantly inhibit the B(a)P-induced activation of the aryl hydrocarbon receptor (AhR)/xenobiotic responsive element (XRE) and mRNA expression of CYP1A1 in BEAS-2B cells. In mice, daily administering S- or R-carvedilol for 7 days before exposing them to B(a)P resulted in a significant decrease in the levels of lactate dehydrogenase and malondialdehyde and prevented inflammatory cell infiltration and histopathologic abnormalities in mouse lungs. Exposure to B(a)P caused the development of lung tumors, but treating the mice with S- or R-carvedilol for 23 weeks significantly reduced the number and size of these tumors. The results were confirmed by H&E-stained images of the mouse lungs. These findings support the hypothesis that carvedilol prevents B(a)P-induced lung inflammation and carcinogenesis independently of β-blockade.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70109"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144326980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response Letter to \"Management of Chylothorax Following Thoracic Surgery\" by Busetto et al.","authors":"Lionel Arrivé","doi":"10.1111/1759-7714.70103","DOIUrl":"10.1111/1759-7714.70103","url":null,"abstract":"","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70103"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chinese Expert Consensus on Leptomeningeal Metastases of Lung Cancer.","authors":"Gen Lin, Yongsheng Wang, Tao Xin, Ding Zhang, Qiuyu Zhang, Yangsi Li, Yudan Chi, Yun Fan, Anwen Liu, Haipeng Xu, Liang Shi, Longfeng Zhang, Qian Miao, Xiaobin Zheng, Lijun Li, Kaijia Zhou, Qiwei Yao, Zihua Zou, Kang Miao, Yaping Hong","doi":"10.1111/1759-7714.70088","DOIUrl":"10.1111/1759-7714.70088","url":null,"abstract":"<p><p>Lung cancer patients with leptomeningeal metastases (LMs) suffer from severe clinical symptoms, poor quality of life, narrow diagnostic and therapeutic time windows, low response to standard treatments, short survival periods, and poor prognoses. At present, there is a lack of precise diagnosis and treatment pathways and relevant consensus for LMs of lung cancer. In order to better guide the clinical diagnosis and treatment of LMs of lung cancer in an early, reasonable, and safe way, the experts of the Neurological Tumor Specialist Committee of the Chinese Society of Clinical Oncology (CSCO) have formulated this consensus based on the actual diagnosis and treatment of LMs of lung cancer in China, with reference to the latest research data, relevant guidelines and consensus, and the experts' clinical experience, as well as the results of experts' polling on the pre-set issues of LMs. The consensus focuses on diagnosing LMs, stratified management, efficacy evaluation systems, treatment strategies, common complications, and palliative care. It gives recommendations in each of the five aspects to provide clinicians with suggestions and references for diagnosing and treating LMs in lung cancer.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70088"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12145986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Pre-Operative Clinical Staging in Resectable Non-Small Cell Lung Cancer (NSCLC): A Retrospective Cohort Study.","authors":"E Samuel, C Thomas, C Thompson, E Paul, M Cherk, S Ellis, M Siemienowicz, S Tissera, U Samankula, S Scholz, L Zhang, J Grewal, J Cox, C Yu, G Adabi, D Keating, J Taverner, J Gooi, S Wayne, J Zalcberg, R G Stirling","doi":"10.1111/1759-7714.70108","DOIUrl":"10.1111/1759-7714.70108","url":null,"abstract":"<p><strong>Background: </strong>Accurate pre-operative clinical staging is essential for guiding treatment in resectable non-small cell lung cancer (NSCLC). Discrepancies between clinical and pathological staging raise concerns about treatment appropriateness. This study aimed to assess staging accuracy, identify predictors of discordance, and evaluate survival implications.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of Stage I-IIIA NSCLC patients who underwent surgical resection in Melbourne, Australia, between 2011 and 2020. Clinical staging was based on CT, PET, and nodal evaluation; pathological staging was based on surgical histology. The primary outcome was concordance between clinical (cTN) and pathological (pTN) stage. Multivariable logistic and Cox regression models evaluated predictors of discordance and survival.</p><p><strong>Results: </strong>Among 221 patients, 58% had concordant clinical and pathological staging. Discordance occurred in 42% of cases-23.9% were upstaged and 17.2% downstaged. N-stage concordance was associated with female sex, tumor histology, SUV max, and CT-to-surgery interval. Nodal discordance independently predicted worse survival (HR 0.43, 95% CI: 0.24-0.77; p = 0.01).</p><p><strong>Conclusions: </strong>Substantial discrepancies exist between clinical and pathological staging in resectable NSCLC. Nodal stage discordance is an independent predictor of mortality and highlights the need for improved pre-operative staging strategies to ensure guideline-concordant care.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70108"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Impact of Tumor Solid Components in Stereotactic Body Radiotherapy for Clinical Stage Tis-1N0M0 Lung Cancer.","authors":"Junki Fukuda, Hiroshi Doi, Atsushi Kono, Takaya Inagaki, Naoko Ishida Hamazawa, Saori Tatsuno Imamura, Takuya Uehara, Masahiro Inada, Kiyoshi Nakamatsu, Makoto Hosono, Kazunari Ishii, Yukinori Matsuo","doi":"10.1111/1759-7714.70110","DOIUrl":"10.1111/1759-7714.70110","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to assess the potential of prognostic factors including consolidation tumor ratio (CTR) on treatment outcomes in patients with clinical stage 0-IA non-small cell lung cancer (NSCLC) undergoing stereotactic body radiotherapy (SBRT).</p><p><strong>Methods: </strong>The analysis included data of 63 patients with 67 lesions of clinical stage 0-IA NSCLC treated with SBRT. According to the Union for International Cancer Control 8th edition, the following tumor stages were observed: Tis, 3; T1mi, 2; T1a, 11; T1b, 29; and T1c, 22. The prescribed dose was 48 (range, 42-52) Gy in four fractions.</p><p><strong>Results: </strong>The median follow-up was 29.3 (range: 2.4-120.5) months. The five-year local control (LC), overall survival, and progression-free survival (PFS) rates were 89.4%, 60.3%, and 40.5%, respectively. Squamous cell carcinoma (Sq) and D_max < 125 Gy_BED10 for planning target volume (PTV) were associated with a worse LC (p = 0.001 and 0.017, respectively). Patients with Sq, T1b-c, CTR > 0.25, PTV ≥ 30 cm³ tumors were associated with worse PFS than those with non-Sq, ≤ cT1a, CTR ≤ 0.25, PTV < 30 cm³ tumors (p = 0.049, 0.004, 0.038, and 0.004, respectively). No recurrences, metastases, or deaths were found in patients with CTR ≤ 0.25 (n = 5).</p><p><strong>Conclusion: </strong>In patients with stage 0-IA lung cancer treated with SBRT, tumors classified as ≤ T1a showed a better PFS than T1b-c. NSCLC with a low CTR of ≤ 0.25 seemed to have a low risk of recurrence after SBRT.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70110"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12168223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolution of Uniportal Robotic-Assisted Thoracic Surgery: A Retrospective Study on the Original and Modified Techniques for Lung Anatomic Resections.","authors":"Ching Yang Wu, Ming Ju Hsieh, Yu Fu Wu, Diego Gonzalez-Rivas, Chun Ting Kuo, Ching Feng Wu","doi":"10.1111/1759-7714.70085","DOIUrl":"10.1111/1759-7714.70085","url":null,"abstract":"<p><strong>Background: </strong>Uniportal robotic-assisted thoracic surgery (uRATS) has emerged as an innovative minimally invasive approach for lung anatomic resections. This study evaluates the safety, feasibility, and outcomes of uRATS, comparing the original technique with a modified approach utilizing a novel trocar configuration to minimize incision size.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 40 patients who underwent uRATS for lung cancer between August 2023 and August 2024 at a tertiary medical center. The first 20 cases employed a 4 cm incision with three 8 mm trocars, while the subsequent 20 cases utilized a modified technique incorporating two flared trocars and a central 8 mm trocar, reducing the incision to 3.5 cm. Perioperative outcomes, postoperative pain, and complications were analyzed.</p><p><strong>Results: </strong>The mean docking, console, and operative times showed no significant differences between the original and modified techniques. The mean postoperative pain scores and analgesic requirements were comparable. No conversions to multiport RATS, VATS, or open surgery were required. The most common complication was mild subcutaneous emphysema (5%). Learning curve analysis indicated that approximately 20 cases were needed to achieve technical proficiency.</p><p><strong>Conclusion: </strong>uRATS is a safe and feasible approach for lung anatomic resections. The modified technique with flared trocars enables a smaller incision without compromising outcomes. Further studies are warranted to assess long-term oncologic efficacy and cost-effectiveness.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 12","pages":"e70085"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful Treatment of HER2 V659E Mutation-Positive Lung Adenocarcinoma With Trastuzumab Deruxtecan: A Case Report.","authors":"Mariko Nishihara, Yuki Shinno, Yoshihiro Masui, Ken Masuda, Yuji Matsumoto, Yusuke Okuma, Tatsuya Yoshida, Yasushi Goto, Hidehito Horinouchi, Noboru Yamamoto, Yuichiro Ohe","doi":"10.1111/1759-7714.70100","DOIUrl":"10.1111/1759-7714.70100","url":null,"abstract":"<p><p>A 67-year-old patient with metastatic lung adenocarcinoma harboring a HER2 V659E mutation received trastuzumab deruxtecan (T-DXd) as second-line treatment. The V659E mutation is a rare alteration located in the transmembrane domain of HER2. The antitumor effect observed in this patient was comparable to that reported in a previous phase 2 trial, in which most patients had mutations in the kinase domain. Here, we present the detailed clinical course and discuss the findings from a molecular biological perspective.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70100"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12138039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144226867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Duodenal Metastasis From Malignant Pleural Mesothelioma Diagnosed by Gastrointestinal Endoscopy Following Progressive Anemia During Salvage Chemotherapy.","authors":"Naruhiko Ichiyama, Hiromichi Yamane, Takako Saitou, Masafumi Miura, Ayaka Mimura, Yoko Kosaka, Tatsuyuki Kawahara, Yasunari Nagasaki, Nobuaki Ochi, Hidekazu Nakanishi, Hideyo Fujiwara, Nagio Takigawa","doi":"10.1111/1759-7714.70098","DOIUrl":"10.1111/1759-7714.70098","url":null,"abstract":"<p><p>Malignant pleural mesothelioma (MPM) primarily progresses through direct invasion into the lung and pleura and is a refractory tumor in which asbestos exposure is a major underlying factor in most cases. Hematogenous metastasis of MPM is not uncommon in advanced stages, and reports suggest that metastatic sites may impact prognosis. Gastrointestinal metastases, ranging from the stomach to the colon, have been sporadically observed, but metastases to the small intestine and duodenum are exceedingly rare. Here, we report a case in which duodenal metastasis of MPM was endoscopically identified during the patient's lifetime while undergoing salvage chemotherapy following treatment with an immune checkpoint inhibitor and cytotoxic chemotherapy. Given the rarity and clinical significance of such cases, we present this report with a review of the relevant literature.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70098"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suitability of Frozen Pleural Fluid Pellets for Next-Generation Sequencing-Based Driver Gene Testing in Non-Small Cell Lung Cancer.","authors":"Kazuki Nakashima, Kohei Otsubo, Yuko Tsuchiya-Kawano, Hironori Mikumo, Eiji Iwama, Eiji Harada, Isamu Okamoto","doi":"10.1111/1759-7714.70107","DOIUrl":"10.1111/1759-7714.70107","url":null,"abstract":"<p><strong>Background: </strong>Driver gene alterations are increasingly being identified, and multiplex genetic tests have become essential for determining the optimal treatment method for advanced non-small cell lung cancer (NSCLC). Next-generation sequencing (NGS) enables the simultaneous detection of multiple driver gene alterations using nucleic acids extracted from tumor tissue samples. However, obtaining sufficient tumor tissue volume is challenging, and inadequate formalin fixation can lead to the failure of NGS analysis. Malignant pleural effusions can be collected using a simple, minimally invasive technique; however, it remains uncertain whether pleural fluid is a suitable source for detecting driver gene alterations using NGS. This retrospective observational study examined the suitability of fresh-frozen pleural fluid pellets for NGS in clinical practice.</p><p><strong>Methods: </strong>Patients with NSCLC whose frozen pleural fluid pellets were analyzed using the Oncomine Dx Target Test Multi-CDx System between June 2019 and February 2024 were included in the study. The primary endpoint was the success rate of driver gene analysis.</p><p><strong>Results: </strong>In total, 26 patients were enrolled. The success rate for testing alterations in driver genes was 92.3% (24/26), and the detection rate of targetable driver gene alterations was 53.8% (14/26). The median turnaround time from sample submission to result confirmation was 10 days (range 7-19 days).</p><p><strong>Conclusion: </strong>Our findings indicate that frozen pleural fluid pellets are suitable for NGS-based driver gene testing in patients with advanced NSCLC. This approach provides a practical alternative for multigene testing when sufficient tissue is not available.</p>","PeriodicalId":23338,"journal":{"name":"Thoracic Cancer","volume":"16 11","pages":"e70107"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12150351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}