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Is multidisciplinary management possible in the treatment of lung cancer? A report from three Italian meetings

  • Davide FranceschiniEmail author
  • Alessio Bruni
  • Paolo Borghetti
  • Niccolò Giaj-Levra
  • Sara Ramella
  • Lucio Buffoni
  • Serena Badellino
  • Maria Andolina
  • Camilla Comin
  • Emanuela Vattemi
  • Michela Bezzi
  • Marco Trovò
  • Antonio Passaro
  • Alessandra Bearz
  • Rita Chiari
  • Franchina Tindara
  • Katia Ferrari
  • Gaia Piperno
  • Andrea Riccardo Filippi
  • Domenico Genovesi
  • Vieri Scotti
RADIOTHERAPY
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Abstract

Purpose

To report criticisms and barriers to the “real-life” application of international guidelines and recent developments in the management of locally advanced non-small cell lung cancer (NSCLC) in Italy.

Methods

Three 2-day courses were organized. During the first day, experts in different fields of thoracic oncology gave their lecture on diagnosis and therapy for locally advanced NSCLC. During the second day, all participants were divided into four groups to discuss on a clinical case as a multidisciplinary team (MDT). The aim was to stimulate the discussion on practical issues in the management of NSCLC patients in the real-life practice.

Results

A total of 196 physicians were involved in the courses as learners. Invasive diagnosis of nodal disease for staging purposes, a priori definition of “surgical resectability” and a regular MDT with all crucial participants available were the three main key points identified for a good management of these patients. The main barriers to the clinical application of a good diagnostic and therapeutic approach to the patient were the absence of a regular and complete MDT in the South and Centre of Italy, while in the North of Italy, time for discussion of clinical cases in the MDT and waiting lists for staging and therapeutic interventions were deemed as the major concerns.

Conclusion

The meetings showed that diagnosis and treatment of locally advanced NSCLC are still extremely variable between different Italian regions. Logistic issues, waiting lists, paucity of well-trained staff and expertise seem to be the main barriers to international guidelines application.

Keywords

Non small cell lung cancer Stage III Multidisciplinary evaluation 

Notes

Compliance with ethical standards

Conflict of interest

Dr Alessio Bruni-Astra Zeneca: Support for Conference participation, Advisory board. All other authors declare no conflict of interest.

Research involving human participants and/or animals

Not applicable.

Informed consent

Not applicable.

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Copyright information

© Italian Society of Medical Radiology 2019

Authors and Affiliations

  • Davide Franceschini
    • 1
    Email author
  • Alessio Bruni
    • 2
  • Paolo Borghetti
    • 3
  • Niccolò Giaj-Levra
    • 4
  • Sara Ramella
    • 5
  • Lucio Buffoni
    • 6
  • Serena Badellino
    • 7
  • Maria Andolina
    • 2
  • Camilla Comin
    • 8
  • Emanuela Vattemi
    • 9
  • Michela Bezzi
    • 10
  • Marco Trovò
    • 11
  • Antonio Passaro
    • 12
  • Alessandra Bearz
    • 13
  • Rita Chiari
    • 14
  • Franchina Tindara
    • 15
  • Katia Ferrari
    • 16
  • Gaia Piperno
    • 17
  • Andrea Riccardo Filippi
    • 18
  • Domenico Genovesi
    • 19
  • Vieri Scotti
    • 20
  1. 1.Radiation Oncology DepartmentHumanitas Research Hospital and Cancer CenterRozzanoItaly
  2. 2.Radiotherapy UnitUniversity Hospital of ModenaModenaItaly
  3. 3.Radiation Oncology DepartmentASST Spedali Civili and University of BresciaBresciaItaly
  4. 4.Advanced Radiation Oncology DepartmentIRCCS Sacro Cuore Don Calabria HospitalNegrarItaly
  5. 5.Radiation Oncology DepartmentCampus Bio-MedicoRomeItaly
  6. 6.Oncology DepartmentSan Luigi Hospital University of TurinOrbassanoItaly
  7. 7.Radiation Oncology DepartmentA.O.U. Città della Salute e della ScienzaTurinItaly
  8. 8.Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
  9. 9.Oncology UnitCentral HospitalBolzanoItaly
  10. 10.Endoscopic Pneumology UnitASST Spedali Civili BresciaBresciaItaly
  11. 11.Radiation Oncology DepartmentAzienda Sanitaria Universitaria Integrata UdineUdineItaly
  12. 12.Division of Thoracic OncologyIEO, European Institute of Oncology IRCCSMilanItaly
  13. 13.Medical Oncology UnitCentro di Riferimento Oncologico-IRCCSAvianoItaly
  14. 14.Medical Oncology UnitOspedale Madre Teresa di Calcutta, “AULSS6 Euganea-Padova”PaduaItaly
  15. 15.Department of Human Pathology of the Adult and Evolutive Age “G. Barresi”MessinaItaly
  16. 16.Section of Respiratory MedicineCareggi University HospitalFlorenceItaly
  17. 17.Division of RadiotherapyEuropean Institute of Oncology, IRCCSMilanItaly
  18. 18.Department of Medical Sciences and Infectious Diseases, Unit of Radiation TherapyFondazione IRCCS Policlinico San MatteoPaviaItaly
  19. 19.Radiation Oncology Department, SS. Annunziata Hospital“G. D’Annunzio” University of ChietiChietiItaly
  20. 20.Department of Oncology, Radiation Therapy UnitCareggi University HospitalFlorenceItaly

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