Analysis of the First Diagnosis Symptom and Its Influencing Factors in 500 Patients with Lung Cancer / 中国肺癌杂志

BACKGROUND@#As the morbidity and mortality in lung cancer keep raising, we are here to discuss the effect of clinical features especially the initial symptomon on diagnosis and follow-up treatment of newly diagnosed lung cancer patients.@*METHODS@#The clinical features of the 500 patients with lung cancer in our hospital from March, 2017 to May, 2017 were analyzed retrospectively, including the initial symptom, stage, biomarkers, pathology, etc. RESULTS: There were 266 famle (53.3%), 372 adenocarcinoma (74.4%), 285 smokers (58%), status score of most patients (98.2%) was 0-1. 58.2% (n=291) of all the patients got biomarkers test, of which epidermal growth factor receptor (EGFR) mutations was 61.2%(178/291), anaplasticlymphoma kinase (ALK) fusion gene positive was 4.1% (12/291). Smoking status, initial symptom, pathological typing, TNM staging and EGFR mutation were the main factors affecting follow-up treatment.@*CONCLUSIONS@#Patients with typical symptoms have shorter diagnosis time. Smoking status, lung cancer-related symptoms, pathology, TNM staging and EGFR mutation status are the main factors that affect the follow-up treatment.

Prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The prognosis of R1-resection at the bronchial stump in patients with non-small cell lung cancer (NSCLC) remains unclear. This study intends to identify the prognostic factors and to optimize treatments for these patients under update conditions.</p><p><b>METHODS</b>The data of 124 NSCLC patients who underwent R1-resection at the bronchial stump was reviewed. There were 41 patients in the surgery group (S), 21 in the postoperative radiotherapy (PORT) group (S+R), 30 in the postoperative chemotherapy (POCT) group (S+C), and 32 in the PORT plus POCT group (S+R+C). The constitute proportion in different groups was tested using the χ(2) method, univariate analysis was performed using the Kaplan-Meier and log-rank method, and multivariate analysis was done using the Cox hazard regression with entry factors including age, sex, pathological type and stage, classification of the residual disease, and treatment procedure. The process was performed stepwise backward with a maximum iteration of 20 and an entry possibility of 0.05 as well as an excluded possibility of 0.10 at each step.</p><p><b>RESULTS</b>In univariate analysis, survival was more favorable for patients with squamous cell carcinoma, early pathological T or N stage, and chemotherapy or radiotherapy. There was no significant difference in the survival for patients with different types of the residual disease, except for the difference between patients with carcinoma in situ and lymphangiosis carcinomatosa (P = 0.030). The survival for patients receiving chemoradiotherapy was superior to that for those undergoing surgery alone (P = 0.016). In multivariate analysis, the pathological type (HR 2.51, 95% CI 1.59 to 3.96, P = 0.000), pathological T (HR 1.29, 95% CI 1.04 to 1.60, P = 0.021) or N stage (HR 2.04, 95% CI 1.40 to 2.98, P = 0.000), and chemotherapy (HR 0.24, 95% CI 0.13 to 0.43, P = 0.000) were independent prognostic factors.</p><p><b>CONCLUSION</b>Patients with squamous cell carcinoma, early pathological T or N stage, or receiving chemotherapy had a more favorable prognosis.</p>

Clinical report of combined chemotherapy with gemcitabine plus cisplatin as first-line treatment to 79 cases of advanced non-small cell lung cancer / 中国肺癌杂志

<p><b>BACKGROUND</b>Chemotherapy is the main treatment measure of advanced non-small cell lung cancer(NSCLC).The aim of this study is to explore the efficacy,toxicity,time to disease progression(TTP) and overall survival under the combined chemotherapy with gemcitabine(GEM) plus cisplatin(DDP) in the treatment of advanced NSCLC.</p><p><b>METHODS</b>Retrospective review was conducted on 79 chemotherapy-naive cases of advanced NSCLC treated with GEM and DDP from October 1999 to November 2005.Among 79 patients,51 were male and 28 female;the median age was 53 years old(ranged from 21 to 74);there were 17 cases of squamous cell carcinoma,53 cases of adenocarcinoma,3 cases of large cell carcinoma,1 case of adeno-sqamous cell carcinoma,5 unidentified cases;there were 26 cases in IIIB stage and 53 cases in IV stage according to AJCC 1997 standard.All patients received GEM 800-1250 mg/m² on days 1 and 8 and DDP 75-80 mg/m² on day 1 or 30 mg/m² for three days by intravenous administration,with 21 days as one cycle.Each patient received 2-4 cycles chemotherapy.</p><p><b>RESULTS</b>The total clinical reponse rate(complete and partial response) was 31.6%,and clinical benefit rate(complete and partial response and stable disease) was 73.4%.1-year survival rate was 64.9%,2-year survival rate was 32%.After median follow-up of 2.33 years,median TTP was 5.06 months.The main toxicities were nausea,vomitting and hematological toxicities.The rates of grade III to IV leukopenia and thrombocytopenia were 25.4% and 31.6% respectively.Other toxicities were slight and tolerable.</p><p><b>CONCLUSIONS</b>Combined chemotherapy with GEM plus DDP as first-line treatment to advanced NSCLC is an effective and feasible regimen,which is one of the standard regimens.For old patients,this regimen is a good choice.The fit dosage of GEM for Chinese is 1000 mg/m².</p>

A randomized, prospective, multi-centre clinical trial of NP regimen (vinorelbine+cisplatin) plus Gensing Rg3 in the treatment of advanced non-small cell lung cancer patients / 中国肺癌杂志

<p><b>BACKGROUND</b>Gensing Rg3 is an active component from ginseng. The aim of this study is to observe the clinical anticancer effect of Rg3 in combination with chemotherapy regimen NP (vinorelbine+cisplatin) in advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Stage III-IV NSCLC patients confirmed by pathology or cytology all received vinorelbine plus cisplatin for at least two cycles, and were randomized into two groups: patients in arm A also received placebo twice a day, while patients in arm B received two tablets of Rg3 twice a day for at least two months. The endpoints of the study were the efficacy, survival and tolerance of patients.</p><p><b>RESULTS</b>From July 2000 to May 2002, 115 patients were enrolled into the trial. The patients' characteristics were well balanced in the two groups. Sex of patients: male, 79; female 36. Types of pathology: adenocarcinoma, 71; squamous cell carcinoma, 29; adenosquamous carcinoma, 8; others, 7. TNM stage: stage III, 45; stage IV, 70. Prior chemotherapy: with, 17; without, 98. Prior radiotherapy: with, 15; without, 100. Prior surgical treatment: with, 23; without, 92. Nine patients discontinued from the trial due to severe adverse effects (5) and other reasons (4), so there were 106 patients evaluable for clinical efficacy. The response rate was 14.5% (8/55) in arm A, and 33.3% (17/51) in arm B (P=0.011). The survival time in arm A was 9.7 months (mean) and 8.0 months (median), and 15.3 months (mean) and 10.0 months (median) in arm B (P=0.0088).</p><p><b>CONCLUSIONS</b>Preliminary results show improvements in response rate and survival time (median and mean) in Rg3 arm compared with placebo arm. It is worthy to confirm the results in further clinical trials.</p>