Detection and prognostic significance of micrometastasis in peripheral blood of patients with non-small cell lung cancer treated by chemo-radiation therapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the prognostic significance of micrometastasis (MM) in peripheral blood of patients with non-small cell lung cancer (NSCLC) treated by chemo-radiation therapy.</p><p><b>METHODS</b>Peripheral blood was taken from 67 NSCLC patients before and after definitive chemo-radiation therapy. CK19 mRNA of the peripheral blood was measured by nested RT-PCR and both their relationship with clinicopathological features and prognostic significance were further investigated.</p><p><b>RESULTS</b>The micrometastasis-positive rates were 65.7% (44/67) and 32.8% (22/67), respectively, before and after the treatment. The micrometastasis-positive rate before treatment was closely in correlation with N-stage (P = 0.014). In contrast, it turned out to be more closely related with histological types (P = 0.019), weight loss (P = 0.01), KPS status (P = 0.027) as well as N-stage (P = 0.032) after chemo-radiation therapy. 4-yr distant metastasis rates (DMR) for micrometastasis-positive and -negative patients were 78.3% and 70.4%, respectively, before the treatment (P = 0.544) while they were 100% and 62.9%, respectively, after the chemoradiation (P < 0.001). The median survival time (MST) and 4-yr overall survival rate (OSR) for pretreatment micrometastasis-positive and -negative patients were 13.8 months and 17.6 months, and 18.2% and 17.4%, respectively (P = 0.619), while for post-treatment micrometastasis-positive and -negative patients they were 7.8 months and 27.6 months and 0 and 26.4%, respectively (P < 0.001). Multivariate analysis showed that the post-treatment positive micrometastasis was an independent unfavorable prognostic factor (P = 0.000).</p><p><b>CONCLUSION</b>Detection of micrometastasis in peripheral blood may possess a prognostic significance after definitive chemo-radiation therapy. Micrometastasis-negative patients have better prognosis compared to those with positive micrometastasis.</p>

Comparative study on prognostic factors in young and old lung cancer patients under chemo-radiotherapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the differences in prognostic factors between the young and old lung cancer patients treated by chemo-radiotherapy.</p><p><b>METHODS</b>The clinical data were collected from 70 young patients (< 40 years old, the study group) and 82 randomly selected old patients (> or = 40 years old, the control group) treated by chemo-radiotherapy. Survival analysis was done by the Kaplan-Meier method, univariate analysis by Log rank test and multivariate analysis by Cox proportional hazard model, respectively.</p><p><b>RESULTS</b>Median survival time was 10 months in the study group and 12 months in the control group. The 2-year survival rate was 11.1% versus 23.1% and the 5-year survival was 3.1% versus 5.4%, respectively. Univariate analyses demonstrated that symptom duration time, mis-diagnosis duration time, clinical stage, chemo-radiation regimen, radiation dose, DDP dose, weight loss and Karnofsky performance status were associated with the prognosis of the study group, and symptom duration time, clinical stage, radiation dose, DDP dose, weight loss and Karnofsky performance status were associated with that of the control group. Multivariate analyses showed that clinical stage, weight loss and Karnofsky performance status were independent prognostic factors for both groups, but DDP dose only for the study group.</p><p><b>CONCLUSION</b>The overall survival was similar in young and old patient groups; There was some difference in prognostic factors between the two groups; DDP dose was an independent prognostic factor for young lung cancer patients which might bear dose-response relationship.</p>

Clinico-pathologic and prognostic studies on lung adenocarcinoma patients under 40 years of age / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study whether the clinico-pathologic characteristics and survival of young lung cancer patients < 40 years of age differ from those of lung cancer patients >or= 40 years of age.</p><p><b>METHODS</b>Retrospective analysis was carried out to compare the clinico-pathologic features and survival of 129 young patients (young group) with those of 140 randomly selected older ones (elderly group).</p><p><b>RESULTS</b>The young group, when compared with the older group, had more female (P = 0.037), longer mean duration of symptoms (4.7 m vs 2.5 m, P < 0.001), higher misdiagnostic rate (65.1% vs 24.3%, P < 0.001) with longer mean duration of misdiagnosis for the misdiagnosed patients (5.6 m vs 2.5 m, P < 0.001), more adenocarcinoma (54.3% vs 42.1%, P < 0.001), higher pathologic grade (69.5% vs 36.0%, P < 0.001), more advanced-stage diseases at diagnosis (74.4% vs 45.7%, P < 0.001), more patients receiving combined-modality treatment (94.6% vs 62.1%, P < 0.001) and more distant failures as initial relapse (64.7% vs 50.6%, P = 0.02). The median survivals and 5-year survival rates were better in patients with stage I-II disease in the young group than the older group (54 m vs 33 m and 46.2% vs 25.0%, P = 0.0495), even though the overall median survivals and 5-year survival rates were similar in either group (11 m vs 14 m and 8.3% vs 11.9%, P = 0.2889). There was no difference in family or smoking history (P = 0.227 and 0.171).</p><p><b>CONCLUSION</b>Younger patients with lung cancer present difference in clinico-pathologic features from the older ones, but the survivals of the two groups are similar. To define younger lung cancer as "the younger type of lung cancer" may have a practical clinical significance.</p>

Clinical study of standardized three stages rehabilitation program in promoting comprehensive function in stroke patients / 中华物理医学与康复杂志

0.05).However,in the end of the treatment,the patients in the treatment group scored significantly better with all the scales than the control group(P