ABSTRACT
BACKGROUND@#Among malignant tumors, lung cancer has the highest mortality rate. Small cell lung cancer (SCLC) is a kind of malignant lung cancer. Its doubling time is very fast. Patients are prone to drug resistance during treatment, and their condition often deteriorates rapidly after recurrence. Except for topotecan, there is a lack of effective second-line single-agent chemotherapy. This study aims to analysis the efficacy and safety of irinotecan (CPT-11) in the second-line treatment of refractory and relapsed SCLC.@*METHODS@#A total of 107 SCLC patients were collected from the Department of Oncology, Jilin Guowen Hospital, who were diagnosed from April 2012 to March 2020, relapsed within 6 months after first-line treatment, and received second-line chemotherapy with single-agent CPT-11. Follow-up until November 2020, calculate the patient's progression free survival (PFS) and overall survival (OS), and summarize the effects and adverse reactions of CPT-11 chemotherapy.@*RESULTS@#The patient's median PFS was 3.8 (3.4-4.4) months, median OS was 8.1 (6.5-10.9) months, objective response rate (ORR) was 16.82% (18/107), and DCR was 55.14% (59/107). The incidence of grade 3-4 adverse reactions in patients was relatively low. Among them, neutropenia was 13.08%, delayed diarrhea was 7.48%, nausea and vomiting was 17.76%, and liver function impairment was 6.54%. The influencing factors of PFS in single-agent CPT-11 second-line chemotherapy were gender (P=0.001), NSE (P=0.029), and effusion (P=0.040). While the influencing factors of OS were NSE level only (P=0.033).@*CONCLUSIONS@#For patients with refractory relapsed SCLC, CPT-11 single-agent second-line chemotherapy has a certain effect, is well tolerated, and is worthy of promotion. .
ABSTRACT
Objective To investigate the related factors affecting the efficacy of microvascular decompression (MVD) in the treatment of primary trigeminal neuralgia (TN). Methods MVD was performed in 120 patients with primary TN and single factor χ2 test and Logistic regression analysis were performed on the clinical data to evaluate the independent risk factors influencing the efficacy of MVD in the treatment of primary TN. Results The pain completely disappeared in 101 cases, the pain was relieved in 16 cases and the unhealed in 3 cases. Sixty cases had pure arterial compression,57 cases had venous compression, and 3 cases had no obvious responsibility vessel. Complete elimination of pain in the patients with venous compressionwaslower than that in patients with pure arterial oppression: 73.7% (42/57) vs. 86.7% (52/60), and the difference was statistically significant (P<0.05). The complete pain relief rate in patients with V2 bronchial pain was lower than that in other pain distribution areas: 13/19 vs. 87.1%(88/101), With significant difference (P<0.05). In patients with V2 bronchitis, the responsible vessels were mostly compressed from the ventral surface of the trigeminal nerve, and the difference was statistically significant (P<0.05). Logistic regression analysis showed , Venous compression and V2 pain were the independent risk factors influencing the clinical efficacy of MVD in the treatment of primary TN. Conclusions Patients with venous compression and V2 pain are less likely to havegood postoperative outcomes, and venous compression and V2 painare independent risk factors. In patients with V2 pain, the responsible vasculature tends to ventrally massage the trigeminal nerve, which is a new study direction of refractory V2 pain.