Recommendation for supportive care in patients receiving concurrent chemotherapy and radiotherapy for lung cancer

D. De Ruysscher; C. Faivre-Finn; K. Nackaerts; K. Jordan; J. Arends; J. Y. Douillard; U. Ricardi; S. Peters

doi:10.1016/j.annonc.2019.10.003

Recommendation for supportive care in patients receiving concurrent chemotherapy and radiotherapy for lung cancer

D. De Ruysscher^*, C. Faivre-Finn, K. Nackaerts, K. Jordan, J. Arends, J. Y. Douillard, U. Ricardi, S. Peters

^*Corresponding author for this work

Research output: Contribution to journal › (Systematic) Review article › peer-review

Abstract

Concurrent chemotherapy and radiotherapy (CCRT) followed by durvalumab immune therapy in appropriate patients is considered to be the standard of care in most fit stage III non-small-cell lung cancer (NSCLC) patients. However, CCRT is a toxic treatment that affects all organ systems and may cause acute and permanent side effects, some of which may be lethal. Supportive care is therefore of utmost importance in this clinical setting. A group of experts from the European Society for Therapeutic Radiology and Oncology (ESTRO) and the European Society of Medical Oncology (ESMO) identified the following items of importance for further improvement of supportive care: smoking cessation; nutrition before and during CCRT (including treatment and prevention of anorexia); physical exercise before and during CCRT; prevention and treatment of acute esophagitis and dysphagia; treatment of cough and dyspnea; treatment of skin reactions; treatment of fatigue; prophylaxis of nausea and emesis; prevention, diagnosis, and treatment of cardiac disease and damage; and optimization of radiotherapy techniques and chemotherapy adjustments to reduce toxicity in the era of immune therapy. The resulting recommendations are summarized in this manuscript and knowledge gaps identified, in which future investments are needed to improve supportive care and hence quality of life and survival for our stage III NSCLC patients.

Original language	English
Pages (from-to)	41-49
Number of pages	9
Journal	Annals of Oncology
Volume	31
Issue number	1
DOIs	https://doi.org/10.1016/j.annonc.2019.10.003
Publication status	Published - Jan 2020

Keywords

ESMO
ESTRO
guidelines
lung cancer
recommendations
supportive care
PLACEBO-CONTROLLED TRIAL
RANDOMIZED CONTROLLED-TRIAL
DOUBLE-BLIND TRIAL
SMOKING-CESSATION
RADIATION-THERAPY
NUTRITIONAL MANAGEMENT
INDUCED ESOPHAGITIS
AMERICAN SOCIETY
POSITION PAPER
FATIGUE

Access to Document

10.1016/j.annonc.2019.10.003Licence: Free access - publisher

Cite this

@article{c11ace67220a486a867cad509c603776,

title = "Recommendation for supportive care in patients receiving concurrent chemotherapy and radiotherapy for lung cancer",

abstract = "Concurrent chemotherapy and radiotherapy (CCRT) followed by durvalumab immune therapy in appropriate patients is considered to be the standard of care in most fit stage III non-small-cell lung cancer (NSCLC) patients. However, CCRT is a toxic treatment that affects all organ systems and may cause acute and permanent side effects, some of which may be lethal. Supportive care is therefore of utmost importance in this clinical setting. A group of experts from the European Society for Therapeutic Radiology and Oncology (ESTRO) and the European Society of Medical Oncology (ESMO) identified the following items of importance for further improvement of supportive care: smoking cessation; nutrition before and during CCRT (including treatment and prevention of anorexia); physical exercise before and during CCRT; prevention and treatment of acute esophagitis and dysphagia; treatment of cough and dyspnea; treatment of skin reactions; treatment of fatigue; prophylaxis of nausea and emesis; prevention, diagnosis, and treatment of cardiac disease and damage; and optimization of radiotherapy techniques and chemotherapy adjustments to reduce toxicity in the era of immune therapy. The resulting recommendations are summarized in this manuscript and knowledge gaps identified, in which future investments are needed to improve supportive care and hence quality of life and survival for our stage III NSCLC patients.",

keywords = "ESMO, ESTRO, guidelines, lung cancer, recommendations, supportive care, PLACEBO-CONTROLLED TRIAL, RANDOMIZED CONTROLLED-TRIAL, DOUBLE-BLIND TRIAL, SMOKING-CESSATION, RADIATION-THERAPY, NUTRITIONAL MANAGEMENT, INDUCED ESOPHAGITIS, AMERICAN SOCIETY, POSITION PAPER, FATIGUE",

author = "{De Ruysscher}, D. and C. Faivre-Finn and K. Nackaerts and K. Jordan and J. Arends and Douillard, {J. Y.} and U. Ricardi and S. Peters",

note = "Funding Information: None declared. KN: advisory board of AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Pfizer, Roche. DdeR: advisory board of Astra Zeneca, Bristol-Myers-Squibb, Roche/Genentech, Merck/Pfizer, Celgene. Investigator-initiated grants from Bristol-Myers-Squibb, Astra Zeneca, Philips, Olink. CF-F: advisory board of Astra Zeneca. Investigator-initiated grants from Elekta, Astra Zeneca, and MSD. KJ: Advisory board and/or honoraria for presentations for MSD, Merck, Amgen, Hexal, Riemser, Helsinn, Tesaro, Kreussler, Voluntis, Pfizer, Pomme-med, Pharma Mar, Prime Oncology, OnkoUpdate. JA: advisory board of Baxter, Nutricia; honoraria from Fresenius Kabi. J-YD: No conflict of interest to declare. UR: advisory board of Astra Zeneca. SP has received education grants, provided consultation, attended advisory boards, and/or provided lectures for Abbvie, Amgen, AstraZeneca, Bayer, Biocartis, Boehringer-Ingelheim, Bristol-Myers Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, F. Hoffmann-La Roche, Foundation Medicine, Illumina, Janssen, Merck Sharp and Dohme, Merck Serono, Merrimack, Novartis, Pharma Mar, Pfizer, Regeneron, Sanofi, Seattle Genetics, and Takeda, from whom she has received honoraria. Publisher Copyright: {\textcopyright} 2019 European Society for Medical Oncology",

year = "2020",

month = jan,

doi = "10.1016/j.annonc.2019.10.003",

language = "English",

volume = "31",

pages = "41--49",

journal = "Annals of Oncology",

issn = "0923-7534",

publisher = "Oxford University Press",

number = "1",

}

TY - JOUR

T1 - Recommendation for supportive care in patients receiving concurrent chemotherapy and radiotherapy for lung cancer

AU - De Ruysscher, D.

AU - Faivre-Finn, C.

AU - Nackaerts, K.

AU - Jordan, K.

AU - Arends, J.

AU - Douillard, J. Y.

AU - Ricardi, U.

AU - Peters, S.

N1 - Funding Information: None declared. KN: advisory board of AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Pfizer, Roche. DdeR: advisory board of Astra Zeneca, Bristol-Myers-Squibb, Roche/Genentech, Merck/Pfizer, Celgene. Investigator-initiated grants from Bristol-Myers-Squibb, Astra Zeneca, Philips, Olink. CF-F: advisory board of Astra Zeneca. Investigator-initiated grants from Elekta, Astra Zeneca, and MSD. KJ: Advisory board and/or honoraria for presentations for MSD, Merck, Amgen, Hexal, Riemser, Helsinn, Tesaro, Kreussler, Voluntis, Pfizer, Pomme-med, Pharma Mar, Prime Oncology, OnkoUpdate. JA: advisory board of Baxter, Nutricia; honoraria from Fresenius Kabi. J-YD: No conflict of interest to declare. UR: advisory board of Astra Zeneca. SP has received education grants, provided consultation, attended advisory boards, and/or provided lectures for Abbvie, Amgen, AstraZeneca, Bayer, Biocartis, Boehringer-Ingelheim, Bristol-Myers Squibb, Clovis, Daiichi Sankyo, Debiopharm, Eli Lilly, F. Hoffmann-La Roche, Foundation Medicine, Illumina, Janssen, Merck Sharp and Dohme, Merck Serono, Merrimack, Novartis, Pharma Mar, Pfizer, Regeneron, Sanofi, Seattle Genetics, and Takeda, from whom she has received honoraria. Publisher Copyright: © 2019 European Society for Medical Oncology

PY - 2020/1

Y1 - 2020/1

N2 - Concurrent chemotherapy and radiotherapy (CCRT) followed by durvalumab immune therapy in appropriate patients is considered to be the standard of care in most fit stage III non-small-cell lung cancer (NSCLC) patients. However, CCRT is a toxic treatment that affects all organ systems and may cause acute and permanent side effects, some of which may be lethal. Supportive care is therefore of utmost importance in this clinical setting. A group of experts from the European Society for Therapeutic Radiology and Oncology (ESTRO) and the European Society of Medical Oncology (ESMO) identified the following items of importance for further improvement of supportive care: smoking cessation; nutrition before and during CCRT (including treatment and prevention of anorexia); physical exercise before and during CCRT; prevention and treatment of acute esophagitis and dysphagia; treatment of cough and dyspnea; treatment of skin reactions; treatment of fatigue; prophylaxis of nausea and emesis; prevention, diagnosis, and treatment of cardiac disease and damage; and optimization of radiotherapy techniques and chemotherapy adjustments to reduce toxicity in the era of immune therapy. The resulting recommendations are summarized in this manuscript and knowledge gaps identified, in which future investments are needed to improve supportive care and hence quality of life and survival for our stage III NSCLC patients.

AB - Concurrent chemotherapy and radiotherapy (CCRT) followed by durvalumab immune therapy in appropriate patients is considered to be the standard of care in most fit stage III non-small-cell lung cancer (NSCLC) patients. However, CCRT is a toxic treatment that affects all organ systems and may cause acute and permanent side effects, some of which may be lethal. Supportive care is therefore of utmost importance in this clinical setting. A group of experts from the European Society for Therapeutic Radiology and Oncology (ESTRO) and the European Society of Medical Oncology (ESMO) identified the following items of importance for further improvement of supportive care: smoking cessation; nutrition before and during CCRT (including treatment and prevention of anorexia); physical exercise before and during CCRT; prevention and treatment of acute esophagitis and dysphagia; treatment of cough and dyspnea; treatment of skin reactions; treatment of fatigue; prophylaxis of nausea and emesis; prevention, diagnosis, and treatment of cardiac disease and damage; and optimization of radiotherapy techniques and chemotherapy adjustments to reduce toxicity in the era of immune therapy. The resulting recommendations are summarized in this manuscript and knowledge gaps identified, in which future investments are needed to improve supportive care and hence quality of life and survival for our stage III NSCLC patients.

KW - ESMO

KW - ESTRO

KW - guidelines

KW - lung cancer

KW - recommendations

KW - supportive care

KW - PLACEBO-CONTROLLED TRIAL

KW - RANDOMIZED CONTROLLED-TRIAL

KW - DOUBLE-BLIND TRIAL

KW - SMOKING-CESSATION

KW - RADIATION-THERAPY

KW - NUTRITIONAL MANAGEMENT

KW - INDUCED ESOPHAGITIS

KW - AMERICAN SOCIETY

KW - POSITION PAPER

KW - FATIGUE

U2 - 10.1016/j.annonc.2019.10.003

DO - 10.1016/j.annonc.2019.10.003

M3 - (Systematic) Review article

C2 - 31912794

SN - 0923-7534

VL - 31

SP - 41

EP - 49

JO - Annals of Oncology

JF - Annals of Oncology

IS - 1

ER -