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BACKGROUND@#Chronic obstructive pulmonary diseases (COPD) affects 45%-63% of lung cancer patients worldwide. Lung cancer patients complicated with COPD have decreased cardiopulmonary function and increased perioperative risk, and their postoperative exercise endurance and lung function are significantly lower than those with conventional lung cancer. Previous studies have shown that postoperative exercise training can improve the exercise endurance of unselected lung cancer patients, but it is unclear whether lung cancer patients with COPD can also benefit from postoperative exercise training. This study intends to explore the effects of postoperative exercise training on exercise endurance, daily activity and lung function of lung cancer patients with COPD.@*METHODS@#Seventy-four patients with non-small cell lung cancer (NSCLC) complicated with COPD who underwent pneumonectomy in the lung cancer center of West China Hospital of Sichuan University from August 5, 2020 to August 25, 2021 were prospectively analyzed. They were randomly divided into exercise group and control group; The patients in the two groups received routine postoperative rehabilitation in the first week after operation, and the control group was given routine nursing from the second week. On this basis, the exercise group received postoperative exercise rehabilitation training for two weeks. Baseline evaluation was performed 3 days before operation and endpoint evaluation was performed 3 weeks after operation.@*RESULTS@#The exercise endurance, daily activity and pulmonary function test results of the two groups decreased from baseline to the end point. However, after the operation and intervention program, the maximum oxygen consumption of Cardiopulmonary Exercise Test and the walking distance of 6-Minute Walking Test in the exercise group were significantly better than those in the control group [(13.09±1.46) mL/kg/min vs (11.89±1.38) mL/kg/min, P=0.033; (297±46) m vs (243±43) m, P=0.041]. The average number of we-chat steps in the exercise group was also significantly better than that in the control group (4,381±397 vs 3,478±342, P=0.035). Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) in the exercise group were better than those in the control group, but the difference did not reach a statistically significant level [(1.76±0.19) L vs (1.60±0.28) L, P=0.084; (1.01±0.17) L vs (0.96±0.21) L, P=0.467].@*CONCLUSIONS@#Postoperative exercise rehabilitation training can improve exercise endurance and daily activity ability of patients with lung cancer complicated with COPD and promote postoperative rehabilitation.
Subject(s)
Humans , Carcinoma, Non-Small-Cell Lung/surgery , Exercise , Forced Expiratory Volume , Lung Neoplasms/surgery , Pulmonary Disease, Chronic Obstructive/complicationsABSTRACT
Hypothyroidism is a common complication in patients with nasopharyngeal carcinoma after radiotherapy, and its incidence is mainly associated with clinical factors, such as radiotherapy, chemotherapy, sex, age and clinical stage, etc. The normal tissue complication probability models of radiation-induced hypothyroidism can be established by using related factors, which can be employed to screen the high-risk patients. In this article, clinical factors related to radiation-induced hypothyroidism were summarized, aiming to prevent the early radiation-induced hypothyroidism, reduce the incidence of hypothyroidism and improve the quality of life of patients.
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Objective:To explore the main factors of hypothyroidism after radiotherapy and to identify the optimal thyroid dosimetric parameters by analyzing the dosimetric parameters of the thyroid.Methods:The general clinical characteristics and dosimetric parameters of 206 patients with nasopharyngeal carcinoma treated in Cancer Hospital of University of Chinese Academy of Sciences were collected, and the correlation between them and the incidence of hypothyroidism was analyzed.Results:The incidence of hypothyroidism in patients with nasopharyngeal carcinoma after radiotherapy was 50.49%(104/206). Univariate analysis showed that gender, N-stage, volume, mean dose, V 20Gy, V 25Gy, V 30Gy, V 35Gy, V 40Gy, V 45Gy of thyroid were associated with the incidence of hypothyroidism. Multivariate analysis demonstrated that volume (≤12.82 cm 3) and mean dose of thyroid were the independent risk factors of hypothyroidism. Mean dose of thyroid combined with volume could significantly predict the incidence of hypothyroidism after radiotherapy. Conclusion:Mean dose of thyroid ≤ 47.21 Gy is the optimal dosimetric parameter for radiation-induced hypothyroidism, especially the patients with thyroid volume ≤ 12.82 cm 3 should pay more attention to the protection of thyroid gland during radiotherapy.
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Radiation-induced cognitive dysfunction is a common complication in patients with nasopharyngeal carcinoma after undergoing radiotherapy, which has been proven to be associated with neurogenesis dysfunction, oligodendrocyte loss, vascular damage and abnormal cytokine expression. With the development of medicine, functional magnetic resonance image (fMRI) can detect the early lesions of cognitive dysfunction. Hippocampus-sparing technology and drug therapy (memantine, donepezil and bevacizumab) can mitigate radiation-induced cognitive dysfunction. In this article, the pathogenesis, neuroimaging, radiodosimetry and therapies of radiotherapy-induced cognitive dysfunction in nasopharynal carcinoma patients were reviewed.
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Objective:To analyze the relationship between hematological examination combined with clinical factors and radiation-induced hypothyroidism (HT) in patients with nasopharyngeal carcinoma (NPC).Methods:Clinical data of 206 patients with NPC who received radiotherapy in Cancer Hospital of University of Chinese Academy of Sciences between January 2015 to August 2018 were retrospectively analyzed. The correlation between general clinical data, hematological examination and HT was analyzed to establish a hematological prediction model.Results:Univariate analysis showed that sex, N-stage, thyroid volume, average dose, V 20Gy, V 25Gy, V 30Gy, V 35Gy, V 40Gy, V 45Gy, fibrinogen content, cholinesterase and neutrophil count were closely associated with the incidence of HT. Multivariate analysis showed that thyroid volume, fibrinogen content and cholinesterase were the independent predictors of HT. Conclusion:The combination of sex, N-stage, thyroid volume, dose parameters, fibrinogen content, cholinesterase, neutrophil percentage and neutrophil count can predict the incidence of HT (AUC=0.777).
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It is found that gambogic acid can play anti-tumor effects through different mechanisms in a variety of tumor cells,including induce apoptosis,inhibit telomerase and topoisomerase activity,inhibit the expression of heat shock protein and channel protein,inhibit tumor angiogenesis and metastasis and reverse multidrug resistance.Gambogic acid is expected to become a new anti-tumor drug,still need to be further explored its value in the field of anti-tumor.
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Objective To investigate the expression of p73 gene and its protein and their relation with clinicopathologic features in nasopharyngeal carcinoma (NPC) tissues.Methods Expression of p73 mRNA and protein in 52 NPC and 25 normal nasopharyngeal tissues was detected by real-time fluorescent quantitative PCR and immunohistochemistry.Results Expression of p73 mRNA and protein was significantly higher in NPC than that in normal nasopharyngeal tissues (mRNA:73.1％ vs 24.0 ％,protein:71.2 ％ vs 36.0 ％),there were significant statistical differences between the two groups (P ＜ 0.05),and their expression was closely related to tumor invasion depth,degree of differentiation and clinical stage (P ＜ 0.05).Expression of p73 gene and protein was not closely related to age and gender (P ＞ 0.05).Conclusion Detection expression of p73 mRNA and its protein can be helpful in the diagnosis and prognostic evaluation in NPC.
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Objective To evaluate the clinical efficacy,overall survival and toxicities in the patients with advanced non-small cell lung cancer treated by liposome paclitaxel combined with nedaplatin as first-line treating.Methods 34 cases with advanced NSCLC were treated with liposome paclitaxel 150 mg/m2 on day 1 and nedaplatin 80 mg/m2 on day 1 by intravenous infusion,with 21 days as one cycle.The patients were treated with chemotherapy more than 2 cycles.Efficacy evaluation and adverse events were evaluated every 2 cycles.Results 34 patients were available for evaluation of efficacy and adverse events.The patients recieved 174 cycles of chemotherapy,and the median was 5.3 cycles.The objective response rate of liposome paclitaxel combined with nedaplatin was 32.3 ％,the disease control rate was 67.6 ％,the median overall survival was 9.5 months (95 ％ CI 6.2-10.7),1 years survival rate was 40.6 ％.The main adverse events were hematological and gastrointestinal toxicities.Frequent grade Ⅲ-Ⅳ toxicities included neutropenia (41.7 ％),anemia (17.6 ％),thrombocytopenia (8.8 ％),nausea and vomiting (8.8 ％),diarrhea (5.8 ％).Conclusions The regimen of liposome paclitaxel combined with nedaplatin is against advanced non-small cell lung cancer with high efficacy and acceptable toxicities,and it may be used as a new choice for treatment of advanced non-small cell lung cancer.
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Objective To evaluatc the efficacy and safcty of recombinant endostatin (Endostar)combined with concurrent radio-chemotherapy (CRCT) in patients with unresectable stage Ⅲ non-small cell lung cancer (NSCLC).Methods From March 2009 to November 2011,47 patients received threedimensional conformal radiotherapy of 60-66 Gy in 30-33 fractions over 6-7 weeks And concurrent chemotherapy of docetaxel 65 mg/m2 and cisplatin 65 mg/m2.Endostar was administered once a week before and on week 2,4,6 during CRCT at a dose level of 7.5 mg/m2/d.Tumor response was evaluated with thoracic CT scans performed 4 weeks after completion of treatment in accordance with RECIST 1.1 criteria.Acute toxicities were evaluated in accordance with CTCAE 3.0.Results Forty-four patients completed treatment and toxicity evaluation,42 patients completed evaluation of efficacy.Five patients achieved complete response,29 partial response,3 stable disease,and 5 progressive disease,2 were net assessed.Overall response rate was 77％.One-year overall survival rate was 81％,and one-year progression-free survival rate was 51％.Twelve patients died,2 died of treatment related toxicities,8 of cancer,and 2 of unknown causes.Nineteen patients developed grade 3/4 neutrocytopenia,grade 3 acute esophagitis and pneumonitis were observed in 4 and 4 patients,respectively,and 1 patient died of pneumonitis.No patient developed cardiovascular toxicities and hemorrhage.Conclusions Endostar combined with CRCT for unresectable stage Ⅲ NSCLC was safe and the short term outcomes were promising.Further investigations are warranted.
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Objective To study the relationship between the expression of nm23- H1 gene product and early distant metastases in nasopharyngeal carcinoma (NPC). Methods The S- P immunohistochemical method was used to detect the expression of nm23- H1 in 95 cases of NPC. Results The positive rate of nm23- H1 was 47.4 % (45/95). The positive rate of nm23- H1 in early distant metastases group (26.7 %) was much lower than those without distant metastases group (60.0 %) (P
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The management is a science,which can generalize as the manmgement to people and to things,as well as manager and person managed;the essence of any management is the management to people.Ldeological and political work is always the differentiated point of Chinese Communist Party from other parties,also is an important advantage of our party.Health care units,under the condition of Socialist market economy,must insist on and strdngthen the importance of ldeological and political work in the management of hospital,if they want to achieve the success of Reform and opening-up.Countless histories and realitids tell us that one dynamic socialistic hospital must have a powerful ldeological and political working group and atmosphere.Ldeological and political work can remedy the insufficient of prordssional level,and create the scientific,democratic and upward health care colleatives.