BreathePub Date : 2024-08-27eCollection Date: 2024-06-01DOI: 10.1183/20734735.0219-2023
Georgia Hardavella, Dimitrios E Magouliotis, Roberto Chalela, Adam Januszewski, Fabio Dennstaedt, Paul Martin Putora, Alfred So, Angshu Bhowmik
{"title":"Stage I and II nonsmall cell lung cancer treatment options.","authors":"Georgia Hardavella, Dimitrios E Magouliotis, Roberto Chalela, Adam Januszewski, Fabio Dennstaedt, Paul Martin Putora, Alfred So, Angshu Bhowmik","doi":"10.1183/20734735.0219-2023","DOIUrl":"10.1183/20734735.0219-2023","url":null,"abstract":"<p><p>Chest radiography, computed tomography (CT) and positron emission tomography (PET)-CT are required for staging nonsmall cell lung cancers. Stage I cancers may be up to 4 cm in maximal diameter, with stage IA tumours being up to 3 cm and stage IB up to 4 cm. A lung cancer becomes stage II if the tumour is between 4 and ≤5 cm (stage IIA), or it spreads to ipsilateral peribronchial or hilar lymph nodes (stage IIB). Stage IA tumours should be surgically resected, ideally using minimally invasive methods. Lobectomy is usually performed, although some studies have shown good outcomes for sublobar resections. If surgery is not possible, stereotactic body radiotherapy is a good alternative. This involves delivering a few high-dose radiation treatments at very high precision. For stage IB to IIB disease, combinations of surgery, chemotherapy or immunotherapy and radiotherapy are used. There is evidence that neoadjuvant treatment (immunotherapy with nivolumab and chemotherapy for stage IB and II) optimises outcomes. Adjuvant chemotherapy with a platinum-based doublet (typically cisplatin+vinorelbine) should be offered for resected stage IIB tumours and considered for resected IIA tumours. Adjuvant pembrolizumab is used for stage IB-IIIA following resection and adjuvant platinum-based chemotherapy. Osimertinib may be used for resected stage IB to IIIA cancers which have relevant mutations (epidermal growth factor receptor exon 19 deletions or exon 21 (L858R) substitution). There are no fixed guidelines for follow-up, but most centres recommend 6-monthly CT scanning for the first 2-3 years after definitive treatment, followed by annual scans.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"230219"},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BreathePub Date : 2024-08-27eCollection Date: 2024-06-01DOI: 10.1183/20734735.0002-2024
Nadia Castaldo, Alberto Fantin, Michelangelo Palou-Schwartzbaum, Giovanni Viterale, Ernesto Crisafulli, Giulia Sartori, Avinash Aujayeb, Filippo Patrucco, Vincenzo Patruno
{"title":"Exploring the efficacy and advancements of medical pleurodesis: a comprehensive review of current research.","authors":"Nadia Castaldo, Alberto Fantin, Michelangelo Palou-Schwartzbaum, Giovanni Viterale, Ernesto Crisafulli, Giulia Sartori, Avinash Aujayeb, Filippo Patrucco, Vincenzo Patruno","doi":"10.1183/20734735.0002-2024","DOIUrl":"10.1183/20734735.0002-2024","url":null,"abstract":"<p><p>This narrative review aims to provide an overview of medical pleurodesis techniques, and their indications and potential adverse effects. Pleurodesis is a procedure performed with the aim of obliterating the pleural space. It has indications in the management of both malignant and benign pleural effusions and pneumothorax. Various nonsurgical techniques exist to perform pleurodesis. The scope of this work is to review the different nonsurgical techniques and their indications. This narrative review was performed checking scientific databases for medical literature, focusing especially on the data derived from randomised controlled trials. Pleurodesis is an effective method to manage pleural effusions and pneumothorax, and minimally invasive techniques are now frequently used with good results. Further research is needed to assess the efficacy of new treatments and the possibility of using different techniques in association.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"240002"},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BreathePub Date : 2024-08-27eCollection Date: 2024-06-01DOI: 10.1183/20734735.0201-2023
Ales Rozman, Elzbieta Magdalena Grabczak, Vineeth George, Mateja Marc Malovrh, Helder Novais Bastos, Anna Trojnar, Simon Graffen, Eric Daniel Tenda, Georgia Hardavella
{"title":"Interventional bronchoscopy in lung cancer treatment.","authors":"Ales Rozman, Elzbieta Magdalena Grabczak, Vineeth George, Mateja Marc Malovrh, Helder Novais Bastos, Anna Trojnar, Simon Graffen, Eric Daniel Tenda, Georgia Hardavella","doi":"10.1183/20734735.0201-2023","DOIUrl":"10.1183/20734735.0201-2023","url":null,"abstract":"<p><p>Interventional bronchoscopy has seen significant advancements in recent decades, particularly in the context of lung cancer. This method has expanded not only diagnostic capabilities but also therapeutic options. In this article, we will outline various therapeutic approaches employed through either a rigid or flexible bronchoscope in multimodal lung cancer treatment. A pivotal focus lies in addressing central airway obstruction resulting from cancer. We will delve into the treatment of initial malignant changes in central airways and explore the rapidly evolving domain of early peripheral malignant lesions, increasingly discovered incidentally or through lung cancer screening programmes. A successful interventional bronchoscopic procedure not only alleviates severe symptoms but also enhances the patient's functional status, paving the way for subsequent multimodal treatments and thereby extending the possibilities for survival. Interventional bronchoscopy proves effective in treating initial cancerous changes in patients unsuitable for surgical or other aggressive treatments due to accompanying diseases. The key advantage of interventional bronchoscopy lies in its minimal invasiveness, effectiveness and favourable safety profile.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"230201"},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BreathePub Date : 2024-08-27eCollection Date: 2024-06-01DOI: 10.1183/20734735.0190-2023
Georgia Hardavella, Armin Frille, Katherina Bernadette Sreter, Florence Atrafi, Uraujh Yousaf-Khan, Ferhat Beyaz, Fotis Kyriakou, Elena Bellou, Monica L Mullin, Sam M Janes
{"title":"Lung cancer screening: where do we stand?","authors":"Georgia Hardavella, Armin Frille, Katherina Bernadette Sreter, Florence Atrafi, Uraujh Yousaf-Khan, Ferhat Beyaz, Fotis Kyriakou, Elena Bellou, Monica L Mullin, Sam M Janes","doi":"10.1183/20734735.0190-2023","DOIUrl":"10.1183/20734735.0190-2023","url":null,"abstract":"<p><p>Lung cancer screening (LCS) programmes have emerged over recent years around the world. LCS programmes present differences in delivery, inclusion criteria and resource allocation. On a national scale, only a few LCS programmes have been fully established, but more are anticipated to follow. Evidence has shown that, in combination with a low-dose chest computed tomography scan, smoking cessation should be offered as part of a LCS programme for improved patient outcomes. Promising tools in LCS include further refined risk prediction models, the use of biomarkers, artificial intelligence and radiomics. However, these tools require further study and clinical validation is required prior to routine implementation.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"230190"},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BreathePub Date : 2024-08-27eCollection Date: 2024-06-01DOI: 10.1183/20734735.0046-2024
Georgia Hardavella, Federica Carlea, Ioannis Karampinis, Alexandro Patirelis, Kalliopi Athanasiadi, Dimitrios Lioumpas, Joana Rei, Lucas Hoyos, Georgios Benakis, Edward Caruana, Eugenio Pompeo, Stefano Elia
{"title":"A scoping review of lung cancer surgery with curative intent: workup, fitness assessment, clinical outcomes.","authors":"Georgia Hardavella, Federica Carlea, Ioannis Karampinis, Alexandro Patirelis, Kalliopi Athanasiadi, Dimitrios Lioumpas, Joana Rei, Lucas Hoyos, Georgios Benakis, Edward Caruana, Eugenio Pompeo, Stefano Elia","doi":"10.1183/20734735.0046-2024","DOIUrl":"10.1183/20734735.0046-2024","url":null,"abstract":"<p><p>Lung cancer surgery with curative intent has significantly developed over recent years, mainly focusing on minimally invasive approaches that do not compromise medical efficiency and ensure a decreased burden on the patient. It is directly linked with an efficient multidisciplinary team that will perform appropriate pre-operative assessment. Caution is required in complex patients with several comorbidities to ensure a meaningful and informed thoracic surgery referral leading to optimal patient outcomes.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"240046"},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Adjuvant immunotherapy and targeted therapy in early and locally advanced resectable lung cancer: expanding treatment tentacles?","authors":"Evaggelos Fergadis, Amadea Heitmann, Theodore Tsaras, Georgia Hardavella","doi":"10.1183/20734735.0035-2024","DOIUrl":"10.1183/20734735.0035-2024","url":null,"abstract":"<p><p>Adjuvant platinum-based chemotherapy has been the main treatment following surgical resection with curative intent in early and locally advanced nonsmall cell lung cancer (NSCLC) albeit with a 5% improvement in 5-year survival rates. Recent advances in biomarkers pave the way for targeted treatments and immunotherapy in a broader spectrum of patients with subsequently improved clinical outcomes. Targeted treatments and immunotherapy have established their place in the adjuvant setting of resected NSCLC.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"240035"},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Lung cancer: an update on the multidisciplinary approach from screening to palliative care.","authors":"Georgia Hardavella, Joanna Chorostowska-Wynimko, Torsten Gerriet Blum","doi":"10.1183/20734735.0117-2024","DOIUrl":"10.1183/20734735.0117-2024","url":null,"abstract":"<p><p><b>This issue of <i>Breathe</i> aims to provide a succinct overview of the current state of play in various aspects in thoracic oncology</b> https://bit.ly/3XQexmp.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"240117"},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11348915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Two women with unexplained dyspnoea: removing the blame game from the lungs.","authors":"Eirini Vasarmidi, Irini Lambiri, Eirini Foteinaki, Vaia Stamatopoulou, Ioanna Mitrouska, Georgios Pitsidianakis, Alexandros Patrianakos, Anthoula Plevritaki, Stylianos Michelakis, Vasilis Amargianitakis, Georgios Prinianakis, Sophia Schiza, Nikolaos Tzanakis","doi":"10.1183/20734735.0029-2024","DOIUrl":"https://doi.org/10.1183/20734735.0029-2024","url":null,"abstract":"<p><p><b>Hypoxaemia due to right-to-left atrial shunt with normal pressures in the right heart cavities represents an underdiagnosed condition. A systematic approach to hypoxaemic respiratory failure based on pathophysiology can lead to an accurate diagnosis.</b> https://bit.ly/4bTP8fJ.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"240029"},"PeriodicalIF":2.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11356787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BreathePub Date : 2024-07-16eCollection Date: 2024-06-01DOI: 10.1183/20734735.0033-2024
Joshua Aigbirior, Amer Almaghrabi, Monder Lafi, Adel H Mansur
{"title":"The role of radiological imaging in the management of severe and difficult-to-treat asthma.","authors":"Joshua Aigbirior, Amer Almaghrabi, Monder Lafi, Adel H Mansur","doi":"10.1183/20734735.0033-2024","DOIUrl":"10.1183/20734735.0033-2024","url":null,"abstract":"<p><p>Radiological imaging has proven to be a useful tool in the assessment of asthma, its comorbidities and potential complications. Characteristic chest radiograph and computed tomography scan findings can be seen in asthma and in other conditions that can coexist with or be misdiagnosed as asthma, including chronic rhinosinusitis, inducible laryngeal obstruction, excessive dynamic airway collapse, tracheobronchomalacia, concomitant COPD, bronchiectasis, allergic bronchopulmonary aspergillosis, eosinophilic granulomatosis with polyangiitis, and eosinophilic pneumonia. The identification of the characteristic radiological findings of these conditions is often essential in making the correct diagnosis and provision of appropriate management and treatment. Furthermore, radiological imaging modalities can be used to monitor response to therapy.</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"240033"},"PeriodicalIF":2.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11249838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141626040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BreathePub Date : 2024-07-16eCollection Date: 2024-06-01DOI: 10.1183/20734735.5084-2023
{"title":"Erratum: \"Rolling out new anti-tuberculosis drugs without diagnostic capacity\". T. Ness, L.H. Van, I. Petermane, R. Duarte, C. Lange, D. Menzies and D.M. Cirillo on behalf of the UNITE4TB Consortium. <i>Breathe</i> 2023; 19: 230084.","authors":"","doi":"10.1183/20734735.5084-2023","DOIUrl":"https://doi.org/10.1183/20734735.5084-2023","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1183/20734735.0084-2023.].</p>","PeriodicalId":9292,"journal":{"name":"Breathe","volume":"20 2","pages":"1"},"PeriodicalIF":2.3,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11250144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}