ABSTRACT
Objective To explore the clinical effect of epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKIs) gefitinib combined with platinum-containing chemotherapy and whole brain radiotherapy in the treatment of non-small cell lung cancer (NSCLC) with brain metastasis. Methods One hundred and fifty-six patients of NSCLC with brain metastasis were divided into observation group (82 cases) and control group (74 cases) according to the therapeutic regimens. On basis of whole brain radiotherapy, the patients in control group received platinum-containing chemotherapy (paclitaxel+cis-platinum+pemetrexed), while the patients in observation group received gefitinib. The serum levels of carcino-embryonic antigen (CEA), cytokeratin 19 fragment antigen (CYFRA21-1) and EGFR, short-term effects, progression-free survival (PFS) and incidences of adverse reactions between two groups were evaluated. A subgroup analysis was carried on the 41 cases of patients with EGFR mutant type. The short-term effects and PFS between two groups were compared. Results The levels of CYFRA21-1 and EGFR in observation group were obviously lower than those in control group (P<0.01). The ORR and DCR in observation group was obviously higher than that in control group (81.71％ vs. 36.49％, 93.90％ vs. 82.43％) (P < 0.05 or < 0.01). The median PFS in observation group and control group was 12 months and 6months. There were statistic differences between two groups (P < 0.05). Subgroup analysis showed that the ORR and DCR in observation group was obviously higher than that in control group (72.0％vs. 25.0％, 96.0％vs. 31.25％)(P<0.01). The median PFS in observation group and control group was 13 months and 5 months. There were statistic differences between two groups (P<0.05). There was no statistic difference in incidences of adverse reactions between two groups (P>0.05). Conclusions For patients with NSCLC with brain metastasis, compared with the therapeutic regimen of whole brain radiotherapy + platinum-containing chemotherapy, whole brain radiotherapy + platinum-containing chemotherapy+EGFR-TKIs (gefitinib) could more effectively reduce the levels of EGFR and CYFRA21-1, improve short-term effects, prolong PFS and do not increase the incidence of adverse reactions.
ABSTRACT
Objective To study the application value and safety of sentinel lymph node biopsy ( SLNB) replacing axillary lymph node dissection ( ALND) for patients with early breast cancer .Methods Data was col-lected for patients undergoing SLNB or ALND in the Second Hospital of Dalian Medical University from June 2011 to June 2014.The complication of upper extremity , axillary local recurrence and distant metastasis were retro-spectively analyzed.The patients were followed up to Nov .2014, with the median follow-up of 41 ( 18-52 ) months.Results Patients undergoing SLNB had less postoperative complications of upper extremity ( numb and painχ2 =18.174, P =0.000;Restricted movement χ2 =20.413, P =0.000; Strength loss χ2 =23.785, P =0.000;P0.05).Conclusion In early breast cancer without SLN, SLNB can achieve the equivalent effect to ALND with less damage and complications .