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BACKGROUND@#Anlotinib is a newly developed small molecule multiple receptor tyrosine kinase (RTK) inhibitor that was approved for the treatment of patients with lung cancer in China. We aim to report 3 cases of rare complication of anlotinib-bronchial fistula (BF) during the treatment of lung cancer patients and summarize the possible causes.@*METHODS@#We collected three patients who developed BF due to anlotinib treatment, and conducted a search of Medline and PubMed for medical literature published between 2018 and 2020 using the following search terms: "anlotinib," "lung cancer," and "fistula."@*RESULTS@#Our literature search produced two case reports (three patients) which, in addition to our three patients. We collated the patients' clinical characteristics including demographic information, cancer type, imaging features, treatment received, risk factors for anlotinib related BF, and treatment-related outcomes. The six patients shared some common characteristics: advanced age, male, concurrent infection symptoms, diabetes mellitus (DM), advanced squamous cell and small cell lung cancers, centrally located tumors, tumor measuring ≥5 cm in longest diameter, and newly formed tumor cavitation after multi-line treatment especially after receiving radiotherapy. Fistula types included broncho-pericardial fistula, broncho-pleural fistula, and esophago-tracheobronchial fistula. Six patients all died within 6 months.@*CONCLUSIONS@#Although anlotinib is relatively safe, it is still necessary to pay attention to the occurrence of BF, a rare treatment side effect that threatens the quality of life and overall survival of patients. Anlotinib, therefore, requires selective use and close observation of high-risk patients.
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<p><b>OBJECTIVE</b>To explore the clinicopathological and bronchoscopic characteristics of CT-occult lung cancer.</p><p><b>METHODS</b>Clinical data of 11 patients who were diagnosed with CT-occult lung cancer by bronchoscopy were analyzed retrospectively.</p><p><b>RESULTS</b>Seven out of eleven patients had bloody sputum. The median disease course was 3 months. Nine patients were in stage I or II, among them 5 cases underwent surgery, with a 5-year survival rate of 80.0%. The upper lobes were predilection areas, and all of the 11 patients had direct sign by bronchoscopy. The most common histopathology was squamous cell carcinoma, which had proliferative changes.</p><p><b>CONCLUSIONS</b>Patients with symptoms of persistent bloody sputum should undergo a bronchoscopy to make sure whether there is an occult lung cancer or not, even if the chest CT scan is negative at first visit.</p>
Subject(s)
Humans , Bronchoscopy , Carcinoma, Squamous Cell , Diagnosis , Lung Neoplasms , Diagnosis , Retrospective Studies , Survival Rate , Tomography, X-Ray ComputedABSTRACT
Patients with advanced lung cancer should be given proper hospice care .Doctors should not only practice protective medicine on the foundation of laws and regulations , informing the patients about their conditions tactfully , but also try their best to provide the patients with optimal therapeutic strategies , taking the patient's physi-cal tolerance, economy, etc.into account and achieving the goal of humanized and individualized therapy .Mean-while, the construction of professional medical -nursing institution is in urgent need .Only providing general nurs-ing in multiple aspects of illness , mental health , social functions , can we relieve the pain both physically and men-tally, and improve the patient's quality of their terminal times .
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Objective To observe the safety and efficiency of two different ways of intravenous anesthesia combined with oropharyngeal airway ventilation in hysteroscope operation.Methods 40 ASA Ⅰ ～ Ⅱ patients undergoing hysteroscopy were randomly assigned into two groups,20 cases in each group.Patients in the group A,B,were administered respectively with sufentanil 0.1 μg/kg or dexmedetomidine 0.5μg/kg by micro-pump in at least 10 minutes before operation.The perioperative hemodynamic index was recorded.The different outcomes including total dose of propofol,hemodynamic changes,recovery time,postoperative uterine contraction pain and episodes of adverse actions were observed and compared.Results Compared with group A,heart rate (HR) and systolic blood pressure (SBP) were higher in group B (P ＜ 0.05).The recovery time in group A was longer than that in group B (P ＜0.05).But there were no statistical differences of the total dosage of propofol,the incidence of respiratory depression,and the incidence rate of drowsiness after operation betwween group A and group B (P ＞ 0.05).Conclusion There was safe and effective of two different ways of intravenous anesthesia combined with oropharyngeal airway ventilation in hysteroscope operation,but the dynamic index was more stable,and the recovery time was shorter in patients with lowdose dexmedetomidine.
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Objective To evaluate the effect of bronchoscopic argon plasma coagulation thera-py on bronchial carcinoma. Methods Thirty-one bronchial carcinoma patients were diagnosed by bronchoscope and pathological tests, with or without atelectasis or obstructive pneumonia on chest X-ray or chest CT. Argon plasma coagulation therapy was performed through bronchoscope. The location of the airway lesions, the degree of obstruction, dyspnea index, and complications were evaluated. Results The patients with bronchial carcinoma were treated 1～4 times by bronchoscopic argon plas-ma coagulation therapy. Full effectiveness was achieved in 15 patients (48.4 %), partial in 12 (38.7%), and mild in the other 4 ( 12.9 % ). The overall effective rate was 100 %. Conclu-sion Bronchoscopic argon plasma coagulation therapy for bronchial carcinoma can remarkably reduce the tumor size, relieve clinical symptoms, and alleviate the obstruction caused by bronchial neoplasm. Brouchoscopic argon plasma coagulation therapy is an effective and safe method for patients with bron-chial carcinoma.
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<p><b>BACKGROUND</b>The excision repair cross-complementing gene 1 (ERCC1), which is important in the repair of cisplatin-DNA adducts, is reported to be related to cisplatin resistance in tumor cells. The aim of this study is to investigate the influence of low-dose cisplatin on expression of ERCC1 gene and to confirm the correlation between ERCC1 and cisplatin resistance in human lung adenocarcinoma cell lines.</p><p><b>METHODS</b>A549 and A549/DDP cell lines were treated with 10 μmol/L cisplatin for 12, 24, 48 and 72 h, or treated with 5, 10, 20, 40 μmol/L cisplatin for 24 h respectively. Then the expression of ERCC1 mRNA and protein was measured by RT-PCR and immunocytohistology SABC assay respectively. The resistance of A549/DDP cells was measured by MTT assay.</p><p><b>RESULTS</b>After treating with 10 μmol/L cisplatin for 12 h, up-regulation of ERCC1 mRNA and protein was observed in A549 cells, then reached the peak levels in 72 h group. After treating with 5 μmol/L cisplatin for 24 h, up-regulation of ERCC1 mRNA and protein was observed in A549 cells, and when treated with 20 μmol/L cisplatin for 24 h, the ERCC1 mRNA and protein reached the peak levels. Comparing with the parental cells, ERCC1 expression increased obviously in A549/DDP cells, which were established by continuous low-dose cisplatin treatment.</p><p><b>CONCLUSIONS</b>Up-regulation of ERCC1 expression can be induced by low-dose cisplatin in human lung adenocarcinoma cell line A549, and ECRR1 may play roles in cisplatin resistance.</p>