A case of superior vena cava syndrome

Superior Vena Cava Syndrome is the clinical manifestation of the Superior Vena Cava obstruction, with severe reduction in venous return from the head, neck and upper extremities. More than 80% cases of SVCS is nearly attributable to advanced malignancy, most commonly lung cancer. SVC syndrome is characterized by congestion and swelling of the face and upper thorax, with distended superficial chest veins. The most severe complications of SVC syndrome include Glottic edema and venous thrombosis in the central nervous system. We represent a case SVC syndrome due to Small Cell Cancer of the lung.

Long-term disease-free survival in patient with laryngeal small cell neuroendocrine carcinoma: A case report and literature review / 吉林大学学报(医学版)

Objective: To analyze the clinical characteristics of patient with laryngeal small cell neuroendocrine carcinoma (LSCNC) with long-term disease-free survival, and to provide the basis for the diagnosis and treatment of LSCNC. Methods: The clinical materials of a patient with primary LSCNC were collected, and the clinical features, diagnosis and treatment of LSCNC and extrapulmonary small cell cancer (EPSCC) combined with the relative literatures were analyzed. Results: The patient was a 55-year-old man who had a long history of heavy smoking and drinking, and presented with neck mass. The laryngoscope revealed the uneven mass on the left side of epiglottic laryngeal surface. The subsequent biopsy of the neck mass indicated lymph node metastasis. The patient underwent laryngectomy and bilateral cervical lymph node dissection. The postoperative pathology indicated LSCNC; the immunohistochemistry results showed CD56 (NK-1) (+), CK-pan (+), CgA (-), Syn (-) and Ki-67 (+ 90%). The patient underwent radiotherapy to the tumor bed and lymph node drainage area and 6 courses of chemotherapy with EP regimen. No prophylactic cranial irradiation (PCI) was conducted. Regular follow-up with laryngoscope, crainial MRI and other examinations showed no recurrence and metastasis. The patient still alive with disease-free survival of 38 months now. Conclusion: LSCNC is highly malignant. The diagnosis mainly depends on the pathohistomorphology and immunohistochemistry examination. The combination of surgery, chemotherapy and radiotherapy is commonly used for LSCNC at present. PCI is not recommended routinely. Multimodality treatment can improve the prognosis.

Clinical Analysis of Small Cell Lung Cancer with Bone Marrow Metastases / 中国肺癌杂志

BACKGROUND@#Small cell lung cancer (SCLC) is highly malignant and prone to bone marrow metastasis in early stage, but its related reports are limited. This study analyzed the clinical feature, laboratory examination, treatment and prognosis of SCLC patients with bone marrow metastasis.@*METHODS@#The clinical data of 26 SCLC patients with bone marrow metastasis were analyzed retrospectively. Prognostic factors were evaluated.@*RESULTS@#The median age of 26 patients was 57 years and the median time from diagnosis of SCLC to confirmed bone marrow metastases was 8 d. Most patients (96.2%) were accompanied by other organ metastases. The most common laboratory abnormalities were elevated lactate dehydrogenase in 19 cases (73.1%), thrombocytopenia and elevated alkaline phosphatase respectively in 11 cases (42.3%) and anemia in 7 cases (26.9%). Twenty patients had received chemotherapy and the remaining 6 patients had not. Of this group, 16 patients received at least 2 cycles of chemotherapy after the diagnosis of bone marrow metastasis. The median survival time was 15.7 wk (0.1 wk-82.9 wk) after diagnosis of bone marrow metastasis. The survival of patients with chemotherapy was significantly better than that of those without chemotherapy (χ²=33.768, P<0.001). Multivariate analysis showed that no chemotherapy was independent poor prognostic factors (P<0.05).@*CONCLUSIONS@#The SCLC patients with bone marrow metastasis have short survival, whereas chemotherapy can extend the survival of patients.

Establishment and identification of radioresistant non-small cell lung cancer model / 解剖学报

Objective: To establish a radioresistant model of non-small-cell cancer A549, and to provide the experimental basis for further researchonradioresistance. Methods: The cell number and the dose of radiation therapy were confirmed. The intermittent radiation were used to induce the radioresistant cell model. The morphology of cells were observed with an inverted phase contrast microscope. Colony formation was used to identify the radioresistance of the RA549 cell. Results: RA549 cells were longer and bigger than A549 cells; surviving fraction of RA549 was significantly increased than A549. Conclusion: Intermittent radiation can successfully induce the radioresistant cell model of lung cancer cells.

New First-line Treatment Drug for Advanced Non-small Cell Lung Cancer-Afatinib / 中国药师

Afatinib is an irreversible inhibitor for the ErbB family of tyrosine kinases with oral administration. In two randomized, open-label and multinational phase III trials, the progression-free survival was significantly prolonged by afatinib compared with peme-trexed plus cisplatin (LUX-Lung 3) or gemcitabine plus cisplatin (LUX-Lung 6) in the treatment-naive patients with advanced non-small cell lung cancer ( NSCLC) with activating EGFR mutations. The patient-reported symptoms such as cough and dyspnoea, and certain health-related quality of life after the treatment by afatinib were also better than those treated by control dugs. Afatinib was ap-proved by FDA in July 2013 as the first-line treatment drug for the patients with metastatic NSCLC with EGFR exon 19 deletions or exon 21 (L858R) mutations. The action mechanisms, pharmacokinetics, clinical trials and adverse events were reviewed in this paper.

Research progresses on K-RAS mutation of non-small cell lung cancer / 基础医学与临床

Mutated K-RAS is found in 15%～30% NSCLC patients, the mutations of K-RAS and EGFR are mutually exclusive,K-RAS mutations have poor sensitivity to EGFR-TKIs. The response of C-225 is not restricted to mutated K-RAS, NSCLC patients with K-RAS mutations are associated with unfavorable prognosis. A number of different approaches such as Ftase inhibitors, RAF inhibitors, MEK inhibitors aimed at abrogating K-RAS activity to improve clinical response have been explored in clinical trials.

A case of Wegener's granulomatosis complicated by non-small cell lung cancer / 대한내과학회지

Vasculitis may be a manifestation of the paraneoplastic syndrome in association with solid and hematological cancers. There are few reports of paraneoplastic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis in patients with solid tumors. Wegener's granulomatosis is a systemic vasculitis characterized by necrotizing granulomatous vasculitis of the upper and lower respiratory tracts together with glomerulonephritis and are ANCA-positive. We experienced a case of Wegener's granulomatosis complicated by non-small cell lung carcinoma (NSCLC) and we report this case with a brief review of the literature.

Expression of LUNX and CK19 in non-small cell lung cancer and its significance / 中国癌症杂志

Background and purpose:Conventional cytology is valuable in diagnosing the cancer cells in lymph nodes of patients with lung cancer. However , the diagnostic value of detecting lymph node and paracancer micrometastasis was limited. Our study was to investigate the mRNA expression level of lung specif ic X protein(LUNX) and cytokeratin 19(CK19) and its signifi cance in the carcinogenesis,metastasis and prognosis of NSCLC. Methods: Quantitative analysis with reverse transcriptase polymerase chain reaction(Real-Time RT-PCR) was used to detect the mRNA expression level of LUNX and CK19 in 20 tumor tissues and 42 regional lymph nodes from 20 patients with NSCLC, and 6 lymph nodes from 9 patients with pulmonary benign diseases as control. Meanwhile, all lymph nodes were also examined by conventional pathological method. Results:①the mRNA level of Lunxin in cancer Tissue was signifi cantly higher than that in the control group, but there was no association with Lymphatic Metastasis,Tumor Size and TNM grade.②the mRNA level of Lunx in the cancer Tissues was signif icantly higher than that in the control group, and was associated with Lymphatic Metastasis,Tumor Size and TNM grade.③the mRNA of CK19 in lymph nodes was almost the same as control, and not associated with tumor size,lymphatic metastasis and TNM grade.④the mRNA of LUNX in lymph nodes was almost the same as control, which has no acossiation with lymphatic metastasis,tumor size and TNM grade.⑤ mRNA of CK19 and LUNX was unrelated to age,sex and histological type .⑥there was signifi cant difference between using Real-Time RT-PCR methods and the routine pathological methods to detect lymph node metastasis in lung cancer. Conclusion:This result suggested that the detection of LUNX message RNA and CK19message RNA might be helpful to diagnose NSCLC micrometastasis in lymph nodes. LUNX was superior to CK19 both in sensitivity and specifi city. The establishment of this method may increase the positive rate of detecting metastatic regional lymph nodes in non small cell lung cancer.

Feasibility Study on Effect of Lowering Dose of Hormone in Weekly Docetaxel Chemotherapy on Patients with Advanced Non-small Cell Lung Cancer / 中国药房

0.05).CONCLUSION:It is feasible to reduce the dose of hormone in weekly docetaxel chemotherapy

Small Cell Cancer of the Duodenum

Primary small cell cancer of the duodenum is very rare. Only six cases have been reported previously. The patient of this case report was a twenty-year-old male who suffered from frequent nausea and vomiting being accompanied by weight loss. The poorly differentiated neuroendocrine cancer was initially diagnosed by endoscopic biopsy and the patient underwent pancreaticoduodenectomy. The diagnosis was refined as primary small-cell neuroendocrine cancer of which the histological appearance was identical to pulmonary and extrapulmonary small-cell carcinoma. The neuroendocrine differentiation was demonstrated by the positive immunoreactions for neuron-specific enolase. This case emphasizes the need to include the duodenum as a possible primary site when metastatic small cell neuroendocrine carcinoma is seen in the absence of apparent pulmonary disease.

Clinical Trial of Paclitaxel Combined with Radiotherapy for the old Patients with Advanced Non - Small Cell Lung Cancer / 重庆医科大学学报

Objective; To evaluated the effects and toxicity of Taxol + radiotherapy( RT) regimen and Taxol + CBP regimen for the old patients of advanced non - small cell lung cancer. Methods: 51 old patients of advanced non - small cell lung cancer were randomized into two groups. There are 25 cases in Taxol + CBP group, administrated with Taxol 135mg/m2 ,d1, CBP AUC5 ,d2. The regimen was repeated every 21 days. There are 26 cases in Taxol + RT group, administrated with Taxol 135mg/m2 ,dl ,d30, radiotherapy started on second day, DT65 -70Gy. Results; The total effective rate and clinical benefit response(CBR) in Taxol + RT group were much higher than Taxol + CBP group. 1 - year,2 - year survival rate of Taxol + CBP group were 49. 8% ,21. 7% .while 52. 3% ,23.2% in Taxol + RT group respectively. There was significant difference between two groups in median survival time (MST) (P

The Results of Radiation Therapy in Locally Advanced Non-Small Cell Lung Cancer / 대한치료방사선과학회지

PURPOSE: This study was done to evaluate the survival rate and prognostic factors of patients with inoperable non-small cell lung cancer (NSCLC) treated with radiation therapy. MATERIALS AND METHODS: A retrospective analysis was undertaken of 62 patients who had inoperable NSCLC treated with radiation therapy from January 1991 through December 1993. According to AJCC staging, stage III A was 14 patients and stage IIIB was 48 patients. Forty Gy to 70.2Gy to the primary tumor site was delivered with daily fractions of 1.8Gy or 2Gy, 5 days per week. Thirty-seven patients received neoadjuvant chemotherapy. RESULTS: Complete, partial and no response to radiation therapy were 3 patients, 34 patients and 25 patients, respectively. The median survival period of all patients was 11 month. One year survival rate, 2 year survival rate and 5 year survival rate for all patients were 45.0%, 14.3%, and 6.0% respectively. The median survival period was 6.5 months in stage IIIA and 13 months in stage IIIB. One year survival rates were 28.6% in stage IIIA and 50.3% in stage IIIB. In univariaite analysis, prognostic factors affecting survival were T-staging, AJCC staging, and response after radiation therapy (P<0.05). Pretreatment peformance status affected survival but was not statistically significant (0.05