ABSTRACT
Objective To investigate the analgesic efficacy,quality of life,and the incidence of adverse reactions of palliative radiotherapy combined with the principle of three-step analgesic ladder in treatment of metastatic bone pain in non-small cell lung cancer (NSCLC).Methods A total of 88 NSCLC patients with metastatic bone pain at Fujian Provincial Hospital from April 2015 to April 2018 were retrospectively analyzed.According to the treatment,the patients were divided into the combined group and the control group,and 44 cases in each group.The combined group was given palliative radiotherapy combined with the principle of three-step analgesic ladder,and the control group received the principle of three-step analgesic ladder.The analgesic efficacy,changes of quality of life,and the incidence of adverse reactions were compared between the two groups.Results The total analgesic effective rate in the combined group was higher than that in the control group [84.1％ (37/44) vs.54.5 ％ (24/44)],and the difference between the two groups was statistically significant (Z =-3.227,P =0.001).For mild and moderate pain,the effective rate in the combined group and control group were 84.6 ％ (11/13) vs.57.1％ (8/14),80.0 ％ (12/15) vs.42.9 ％ (6/14) respectively,and the differences were not statistically significant (Z =-1.473,P =0.141;Z =-1.793,P =0.073).For severe pain,the effective rates in the combined group and control group were 87.5 ％ (14/16) and 62.5 ％ (10/16),and the difference was statistically significant (Z =-2.327,P =0.020).The quality of life in the combined group was better than that in the control group,and the difference between the two groups was statistically significant (Z =-2.254,P =0.024).The overall incidence rate of adverse reactions in the combined group was 36.4 ％ (16/44),which was significantly lower than that in the control group [59.1％ (26/44)],and the difference between the two groups was statistically significant (x2 =4.55,P =0.033).Conclusion Palliative radiotherapy combined with the principle of three-step analgesic ladder in treatment of metastatic bone pain of NSCLC can significantly improve the efficacy,especially for severe pain,and improve the quality of life,and reduce the incidence of adverse reactions.
ABSTRACT
<p><b>OBJECTIVE</b>A prospective, multicenter and non-interventional prospective study was conducted to evaluate the clinical features of rituximab combined with chemotherapy (R-Chemo) as first-line treatment on newly diagnosed Chinese patients with diffuse large B-cell lymphoma (DLBCL).</p><p><b>METHODS</b>This was a single arm, prospective, observational multicenter and phase IV clinical trial for 279 patients, who were newly diagnosed as CD20-positive DLBCL from 24 medical centers in China 2011 and 2012, no special exclusion criteria were used. All patients received rituximab based R-Chemo regimes, such as R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisolone) and other regimes as the first-line treatment. The treatment strategies were determined by physicians and patients without detailed description for treatment course, dose, interval time and examination. Clinical response and safety of all patients were investigated in 120 days after completion of last dose of rituximab.</p><p><b>RESULTS</b>Of 279 patients, 258 with stage I-IV who received at least 1 cycle of rituximab treatment and completed at least one time of tumor assessment were enrolled into intention-to-treat analysis, including 148 male and 110 female. The median age of all patients was 57.2(12.8-88.4) years. ECOG performance statuses of 0 or 1 were observed in 91.1% of patients, international prognostic index levels in the low-risk and low-middle-risk groups in 76.4% of patients, the tumor diameters smaller than 7.5 cm in 69.0% of patients. All patients received 6 median cycles of R-Chemo treatment every 24.4 days. R-CHOP treatment was shown to improve the clinical response with overall response rates of 94.2%. Common adverse events included anemia, marrow failure, leukopenia, thrombocytopenia, digestive diseases, infection and liver toxicity. All adverse events are manageable.</p><p><b>CONCLUSION</b>Non-interventional clinical trial of R-Chemo remains the standard first-line treatment for newly diagnosed patients with DLBCL in real clinical practice, which is consistent with international treatment recommendations for DLBCL patients. R-Chemo can provide the clinical evidence and benefit as the first-line standard treatment for Chinese patients with DLBCL.</p>