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Objective:To evaluate the efficacy and safety of thoracic radiotherapy in the treatment of patients with extensive-stage small cell lung cancer (ES-SCLC) with different metastatic sites.Methods:A retrospective analysis was performed among 830 ES-SCLC patients who were admitted to our hospital from 2010 to 2019. They all received the first-line chemotherapy and had no progression after chemotherapy. 341 patients of them received thoracic radiotherapy after chemotherapy. The main endpoint was overall survival. The Chi-square test was used to compare the categorical data including gender and age, etc. Univariate survival analysis was estimated by Kaplan-Meier method and the log-rank test was used to compare the survival curves between two groups. A multivariate prognostic analysis was made by the Cox proportional hazard model.Results:In all the patients, the overall survival (OS) was 12.4 months. The patients with thoracic radiotherapy had significantly higher OS than the patients without thoracic radiotherapy (15.2 months vs.10.8 months, P<0.001). Thoracic radiotherapy significantly improved the OS in patients without liver metastasis (16.0 months vs.11.4 months, P<0.001) in the oligometastatic patients. But for the oligometastatic patients with liver metastasis, the OS benefit was not significant (14.2 months vs. 10.6 months, P=0.072). For polymetastatic patients without liver metastasis, thoracic radiotherapy offered significant OS benefits (14.5 months vs.10.9 months, P<0.001), but for the polymetastatic patients with liver metastasis, the OS was not improved with thoracic radiotherapy (10.2 months vs.9.2 months, P=0.715). Conclusions:In ES-SCLC patients, thoracic radiotherapy provides significant OS benefits in patients with oligometastases ES-SCLC without liver metastasis and for the liver metastatic patients may also benefit from thoracic radiotherapy based on the effectiveness of chemotherapy. In patients with multiple metastases, thoracic radiotherapy only improves the OS in patients without liver metastasis, but does not improve the prognosis in patients with liver metastasis.
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Objective:To evaluate whether whole brain radiation therapy(WBRT) could benefit small cell lung cancer (SCLC) patients with brain metastases.Methods:Clinical data of 245 patients who were diagnosed with extensive stage SCLC with brain metastases admitted to our hospital from 2010 to 2020 were retrospectively analyzed. Among them, 168 patients received WRBT (WBRT group, radiation dose: 30Gy in 10 fractions), and 77 patients did not receive WBRT (non-WBRT group). All patients received 4-6 cycles of chemotherapy, and the chemotherapy regimen included cisplatin (or carboplatin) plus etoposide. One hundred and fifteen patients received thoracic radiotherapy. The endpoint was overall survival after brain metastases(BM-OS). Chi-square test was used to compare categorical data, and stabilized inverse probability of treatment weighting(sIPTW) was used to match the factors between WBRT and no-WBRT groups. Survival analysis was estimated by Kaplan-Meier method, and the log-rank test was used to compare survival curves between two groups. Results:The median BM-OS for the whole group of patients was 9.1 months, and 10.6 months and 6.7 months in the WBRT and non-WBRT groups, respectively( P=0.003). After balanced influencing factors with stabilized sIPTW, significant difference still existed in BM-OS between two groups( P=0.02). In 118 patients with synchronous brain metastases, the median BM-OS in two groups were 13.0 months and 9.6 months( P=0.007); and in 127 patients with metachronous brain metastases, the median BM-OS were 8.0 months and 4.1 months( P=0.003). In 50 patients without extracranial metastases, the median BM-OS were 13.3 months and 10.9 months( P=0.259)in two groups; while in 195 patients with extracranial metastases, the median BM-OS were 9.5 months and 5.9 months( P=0.009)in two groups. Conclusions:WBRT could prolong the OS in extensive stage SCLC patients with brain metastases.
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Objective:To compare the incidence of radiation pneumonitis (RP) between lung cancer patients from the European, American and Asian regions.Methods:The studies related to lung cancer and RP were searched from PubMed, Embase, and Cochrane library. According to the different places where the studies were conducted, the searched studies were divided into two types: Asian studies and European, American and Australian studies. The incidence of RP between two regions was summarized. Studies related to dosimetry parameters were searched from PubMed database.Results:A total of 3, 190 patients from 14studies were included. Meta-analysis results showed that the incidence of ≥ grade 3 RP was similar in patients from Asia and Europe, America and Australia (4.9% vs. 4.6%, P=0.895), whereas the incidence of grade 5 RP in Asia was significantly higher than that in Europe, America and Australia (1.5% vs. 0.2%, P=0.002). Moreover, the lung irradiation dose received by the patients in the Asian group was relatively low. Lung V 20Gy dose limitation standard was reported in 21studies. Further analysis found no statistical significance in lung V 20Gy dose limitation standard between two regions ( P=0.440), and the standard in Asian studies is likely to be even stricter. Conclusions:The incidence of RP after chemoradiotherapy in lung cancer patients in Asia is relatively higher compared with those in Europe, America and Australia. The differences in dose limitation standard should be noted when the thoracic radiation regimen based solely on the data from foreign studies is applied to the patients in Asia.
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Objective To analyze the effect of compound Minwei on serum interleukin-4(IL-4),interferon-γ(IFN-γ)value in children with acute urticaria.Methods in our hospital from March 2015 to October 2016 received 148 cases of children with acute urticaria eczema,were randomly divided into study group and control group,74 cases in each group,study the application of compound chlorphenamine maleate and vitamin syrup for treatment,the control group were applied paeonol ointment treatment,curative effect,evaluation of children with symptoms before and after treatment respectively,and detection serum IL-4 and IFN-levels.Results before treatment,the two groups had no statistical significance with symptom score,serum IL-4,IFN-levels difference(P>0.05);after treatment,the clinical efficacy of the study group,serum IFN-γ levels higher than the control group,the serum level of IL-4 score,symptoms than the control group,the difference has statistical significance(P<0.05).Conclusion acute eczema urticaria children with compound Minwei syrup treatment,can significantly relieve the symptoms of children,improve the body immunity,promote children rehabilitation,has good treatment effect.
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Objective To study the effect of compound Minwei syrup on serum interleukin-4 (IL-4) and interferon-γ(IFN-γ) in patients with chronic urticaria.Methods 189 patients with chronic urticaria were enrolled as the observation group,60 cases of non-allergic diseases were selected as the control group.The observation group was treated by compound Minwei syrup for average 7 days.Serum levels of IL-4 and IFN-γbefore and after treatment were detected.Results After treatment,in the observation group 123 cases recovered,34 cases had marked effect,effective in 23 cases,9 cases without effect,the total effective rate was 95.2％.Serum IL-4 in the observation group before treament was significantly higher than the control group(t =3.729,P ＜ 0.01),IFN-γwas significantly lower than the control group(t =3.064,P ＜ 0.01).After treatment,serum IL-4 in the observation group was significantly lower than before treatment (t =2.778,P ＜ 0.05),1FN-γwas significantly higher than the control group (t =2.467,P ＜ 0.05).Mild drowsiness and sleepiness appeared in 2 patients in the observation group,symptoms disappeared after drug withdrawal.Conclusion Minwei syrup can significantly improve IL-4 and IFN-γ balance in patients with chronic urticaria.