Περίληψη:
Background: Currently there is major lack of agreement on the diagnostic
and therapeutic management of patients with idiopathic pulmonary
fibrosis (IPF) and lung cancer. Our aim was to identify variations in
diagnostic and management strategies across different institutions and
provide rationale for a consensus statement on this issue.
Methods: This was a joint-survey by European Respiratory Society (ERS)
Assemblies 8, 11 and 12. The survey consisted of 25 questions.
Results: Four hundred and ninety-four (n=494) physicians from 68
different countries and five continents responded to the survey.
Ninety-four per cent of participants were pulmonologists, 1.8% thoracic
surgeons and 1.9% oncologists; 97.7% were involved in
multidisciplinary team approaches on diagnosis and management. Regular
low-dose high-resolution computed tomography (HRCT) scan was used by
49.5% of the respondents to screen for lung cancer in IPF. Positron
emission tomography (PET) scan and endobronchial ultrasound (EBUS) is
performed by 60% and 88% to diagnose nodular lesions with mediastinal
lymphadenopathy in patients with advanced and mild IPF, respectively.
Eighty-three per cent of respondents continue anti-fibrotics following
lung cancer diagnosis; safety precautions during surgical interventions
including low tidal volume are applied by 67%. Stereotactic
radiotherapy is used to treat patients with advanced IPF (diffusing
capacity of the lung for carbon monoxide (DLCO) <35%) and otherwise
operable nonsmall cell lung cancer (NSCLC) by 54% of respondents and
doublet platinum regimens and immunotherapy for metastatic disease by
25% and 31.9%, respectively. Almost all participants (93%) replied
that a consensus statement for the management of these patients is
highly warranted.
Conclusion: The diagnosis and management of IPF-lung cancer (LC) is
heterogeneous with most respondents calling for a consensus statement.
Συγγραφείς:
Tzouvelekis, Argyris
Antoniou, Katerina
Kreuter, Michael and
Evison, Matthew
Blum, Torsten G.
Poletti, Venerino
Grigoriu,
Bogdan
Vancheri, Carlo
Spagnolo, Paolo
Karampitsakos,
Theodoros
Bonella, Francesco
Wells, Athol
Raghu, Ganesh and
Molina-Molina, Maria
Culver, Daniel A.
Bendstrup, Elisabeth and
Mogulkoc, Nesrin
Elia, Stefano
Cadranel, Jacques
Bouros,
Demosthenes
