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Objective To evaluate the efficacy and safety of radiation combined with targeted therapy of EGFR-TKI in the patients with stage IV non-small cell lung cancer ( NSCLC). Methods There were 17 female and 9 male patients with NSCLC enrolled into this study, which included 19 adenocarcinoma, 4 alveolar carcinoma and 3 uncertain carcinoma according to the iconography findings. Sixteen patients suffered from single or multiple bone metastasis,and 10 cases with brain metastasis. Gefitinib 250 mg or Erlotinib ISO mg per day were administrated during and after the process of radiation until the disease progressed. Results All patients had complete combined therapy, 12 of them suffered from diarrhea, 8 from emesia and 12 from erythra. The average score of ECOG improved from 3 to 2 after combined therapy. The bone metastasis control rate was 93.8% ,brain metastasis control rate was 70.0% , and the 6-month local lung lumps control rate was 84. 6%. Conclusion Palliative radiation combined with targeted therapy of EGFR-TKI is an effect and safe therapy for the patients with the stage IV of NSCLC, but the influence on survival shall be observed in further study.
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Objective: This study was designed to identify the influence of age and comorbidity on the treatment strategies and survival time of the elderly patients(≥70 years) with advanced (stage III B or IV) non-small cell lung cancer (NSCLC). Methods: The clinical characteristics, treatment strategies and survival features of 127 elderly patients with a good performance status (PS≤1) were retrospectively analyzed. They were diagnosed as NSCLC and received chemotherapy in our oncological department between January 2005 and December 2005. These patients were stratified by age into two groups: 70-74 years group and ≥75 years group; and divided into three groups based on the degree of comorbidity: no comorbidity (0), mild comorbidity (1-2) and severe comorbidity (≥3) groups. Their relationship with clinical features, treatment strategies, and survival time was analyzed. Results: More than 50% patients in 70-74 years group (51.2%) were treated with cisplatin-based combination therapy, while only 20.6% patients in ≥75 years group received cisplatin-based combination therapy (P=0.003). There were 37.0% patients in the severe comorbidity group received palliative radiotherapy, which was significantly higher than that of the no or moderate comorbidity groups (21.7% and 11.7%, P=0.014). In 70-74 years group and ≥75 years group, the 1-year survival rate was 41.4% and 35.3% (log-rank, P=0.319). In no, mild and severe comorbidity group, the 1-year survival rate was 53.5%, 41.3%, and 20.8%, respectively (log-rank, P=0.071). In univariate and multivariate COX model analyses, age and mild comorbidity did not increase the risk of survival, but severe comorbidity was an independent risk factor for the survival of elderly patients with NSCLC; the relative risk ratio (95% confidence interval) was 2.09 (1.06-4.15) and 2.56 (1.18-5.76) (P=0.034 and 0.023). Conclusions: Different treatment strategies should be given to elderly patients with advanced NSCLC according to the age or the degree of comorbidity. Severe comorbidity is an independent risk factor for survival of elderly patients with advanced NSCLC.
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Objectives To explore the expression of HER4 and VEGF in NSCLC and elucidate the relationship between their expression and the characteristic of clinical pathology. Methods 82 cases of paraffin-embedded tissues from informative NSCLC were used to detect the expression of HER4 and VEGF by means of immunohistochemical assay. Results HER4 is overexpressed in 65;9%of NSCLC cases. The overexpression of HER4 is correlated with the lymph node metastasis and TNM staging. VEGF is expressed in 53.7%of NSCLC cases. The expression of VEGF is also correlated with the lymph node metastasis and TNM staging, and the expression of VEGF is correlated with the overexpression of HER4.Conclusions HER4 and VEGF are the protein to regulate the growth of NSCLC and it might be a good way for the treatment of NSCLC by suppressing the overexpression of HER4 and VEGF.
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Bone scintigraphy is a very sensitive and cost-effective diagnostic method for detecting bony metastases of malignant neoplasm. However it has been reported that bone scan is less sensitive for early bony metastases, especially vertebral metastases. PET is a non-invasive clinical imaging methodology that can be used to assess such biochemical disturbance in tissue in vivo quantitatively with high resolution.We experienced two cases of small cell lung cancer with multiple bony metastases which were detected on PET imaging but not on planar bone scan. This case report suggests that FDG-PET will be a very effective diagnostic tool for bony metastases especially in clinically suspected case despite a normal planar bone scan.