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@#Madam S, who diagnosed to have stage IV lung adenocarcinoma with exon 21 L858R point mutation (T3N2M1a) was admitted for massive pericardial effusion in April 2016. She was ECOG 4 on admission. Her ECOG improved to 1 after pericardial tapping and initiation of free sample erlotinib 100 mg daily. Repeated CT thorax post treatment showed the disease was partial responded. Due to financial constraints, she had never bought any EGFR-TKI. She was given a free sample of erlotinib intermittently for total of 12 months followed by intermittent afatinib supply for 2 years. Due to this limited supply, she took half doses of afatinib by cutting a 40 mg tablet once every few days to sustain the continuation of cancer treatment. No major side effects were observed and she remained ECOG 0 with good weight gain. Up to her last clinic visit in September 2021, her PFS was more than 5 years. Intermittent doses of EGFR-TKI may prolong PFS in patients with advanced EGFRm+ NSCLC who has limited treatment options.
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A neoplasia maligna do pulmão é um dos tipos mais comuns e graves de câncer, sendo o que mais leva ao óbito em todo o mundo. O risco para o desenvolvimento desta doença depende da interação entre a exposição ao agente e a suscetibilidade individual para seu aparecimento. Acomete mais o sexo masculino e seu principal fator predisponente é o tabagismo. O objetivo deste artigo consiste em discutir a eficácia do medicamento Nivolumab no tratamento de câncer de pulmão de células não pequenas e evidenciar a imunoterapia como um tratamento promissor do câncer. Para tal, foi realizado um levantamento bibliográfico, utilizando-se como descritor: fatores de risco, câncer de pulmão, câncer de pulmão de não pequenas células em livros, artigos e revistas nas seguintes bases de dados: SCIELO, ANVISA, Periódicos da CAPES, Google Acadêmico. Em seguida, foi feita uma leitura analítica para ordenar as informações e identificar o objeto de estudo. Podemos perceber que a imunoterapia é bastante promissora, não só no tratamento do câncer de pulmão, como em muitos outros. O medicamento estudado, nivolumab, obteve ótimos resultados no tratamento de CPNPC, porém é notório que ainda falta estímulo para que o mesmo seja utilizado como primeira opção no tratamento de segunda linha do CPNPC.
Malignant neoplasm of the lung is one of the most common and serious types of cancer, and is the most deadly in the world. The risk for the development of this disease depends on the interaction between the exposure to the agent and the individual susceptibility to its onset. It affects males more and its main predisposing factor is smoking. The objective of this article is to discuss the efficacy of the drug Nivolumab in the treatment of non-small cell lung cancer and to evidence immunotherapy as a promising treatment for cancer. For that, a bibliographic survey was carried out, using as descriptor: risk factors, lung cancer, non-small cell lung cancer in books, articles and journals in the following databases: SCIELO, ANVISA, CAPES Periodicals, Google Scholar. Then, an analytical reading was made to sort the information and identify the object of study. We can see that immunotherapy is very promising, not only in the treatment of lung cancer, but also in many others. The medicament studied, nivolumab, obtained excellent results in the treatment of NSCLC, but it is well known that there is still a lack of stimulation for it to be used as the first option in the second line treatment of NSCLC.
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Humans , Male , Female , Tobacco Use Disorder , Carcinoma, Non-Small-Cell Lung , Immunotherapy , Lung NeoplasmsABSTRACT
Objective: To observe the expression changes of insulin-like growth factor 1 (IGF-1) and mammalian target of rapamycin (mTOR) in the peripheral blood of patients with advanced non-small cell lung cancer (NSCLC) treated with chemotherapy combined with metformin, and to elucidate its mechanism. Methods: Sixty patients with NSCLC were divided into chemotherapy group (15 cases of adenocarcinoma and squamous cell carcinoma, treated with chemotherapy alone) and combination group (15 cases of adenocarcinoma and squamous cell carcinoma, treated with chemotherapy combined with metformin). The expression levels of IGF-1 and mTOR protein and mRNA in peripheral blood of the patients in two groups were detected by ELISA and quantitative real-time PCR (QT-PCR) method. Pearson univariate analysis and multivariate logistic regression analysis were used to analyze the influencing factors of the treatment of patients with advanced NSCLC; the curative effect was comprehensively evaluated. Results: Compared with chemotherapy group, the differences of the levels of IGF-1 and mTOR and the mRNA expression levels of IGF-1 and mTOR of the patients in combination group before and after treatment were decreased (t=-3.207, P=0.003; t=2.414, P=0.019; t=-3.635, P= 0.001; t=-3.737, P=0.001). In adenocarcinoma, compared with chemotherapy group, the differences the levels of IGF-1 and mTOR and the mRNA expression levels of IGF-1 and mTOR of the patients in combination group before and after treatment were decreased (t=5.270, P0.05). Conclusion: Chemotherapy combined with metformin is more effective in the treatment of the patients with NSCLC and can reduce its adverse reactions, its mechanism may be related to the reduction of IGF-1 and mTOR levels in the peripheral blood of the patients.
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Background: Outcome of various treatment regimen are dismal in non-small cell lung cancer. This analysis is done to find possible care in authors institutional set up and to see how these protocols have effect in Indian patients in term of toxicity.Methods: Medical records and data on patients who had been diagnosed with non-small cell lung cancer histologically or cytologically, and who had been treated with sequential chemoradiation and concurrent chemoradiation at the hospital from January 2007 to March 2015 was retrospectively reviewed and analyzed. Two groups of sequential chemoradiotherapy and concurrent chemoradiotherapy were formed and compared for outcomes.Results: Of the 114 evaluable patients in sequential chemoradiotherapy group, the median survival time was 16.0 months and the 1, 3- and 5-years overall survival were 57.0, 26.9 and 21.2%, respectively. Median progression free survival (PFS was 13.0 months and the 1, 3 and 5 years PFS were 52.6, 14.6 and 7.8%, respectively. In concurrent chemoradiotherapy group (105 patients), the overall median survival time was 15 months and the 1, 3- and 5-year overall survival were 56.2, 20.6 and 14.7%, respectively. Median PFS was 13 months and the 1, 3 and 5-year PFS were 48.8, 19.7 and 10.3%, respectively. Grade 3 and 4 toxicity in both regimen groups are same and statistically not significant.Conclusions: Analysis confirm dismal outcome with standard treatment and signifies to search for care beyond conventional chemoradiotherapy.
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Objective@#To investigate the expression of fragile-site associated tumor suppressor (FATS) in non-small cell lung cancer and its relationship with clinicopathological features and prognosis.@*Methods@#A total of 140 non-small cell lung cancer (NSCLC) cases and 30 adjacent normal tissues were used to detect the expression level of FATS protein, and to analyze the relationship of FATS protein expression and clinicopathological features and prognosis of NSCLC.@*Results@#Western blot showed that the expression of FATS in adjacent normal tissues was significantly higher than that in non-small cell lung cancer tissues. The results of immunohistochemistry showed that the high expression rate of FATS in 140 cases of NSCLC was 40.0%, and the high expression rate of FATS in 30 cases of adjacent tissues was 73.3%. The difference was statistically significant (P=0.01). Further analysis showed that the TNM stage (P=0.044) and lymph node metastasis (P=0.022) were significant difference between FATS high expression group and low expression group. The 6-year overall survival (OS) rates of NSCLC patients with FATS high-expression and low-expression were 57.1% and 23.8%, respectively, and the 6-year disease-free survival (DFS) rates were 53.6% and 21.4%, respectively, with statistically significant differences (P=0.001). In Cox multivariate analysis, we found gender (HR=1.658, P=0.028; HR=1.684, P=0.023), TNM staging (HR=2.327, P=0.019; HR=2.332, P=0.013) and FATS expression (HR=0.532, P=0.010; HR=0.538, P=0.009) were independent prognostic factors for both OS and DFS of NSCLC patients.@*Conclusions@#The expression of FATS protein is associated with the development and is an independent prognostic factor of NSCLC patients. The detection of FATS protein is expected to be a new biomarker for evaluating the prognosis of NSCLC patients.
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Objective: To investigate the relationship between the expression of glucose-regulated protein 78 (GRP78) and gemcitabine chemotherapy in the patients with non-small cell lung cancer (NSCLC) and the effects of GRP78 on the viability of lung adenocarcinoma SPCA1 cells and the chemosensitivity of gemcitabine, and to elucidate its mechanisms. Methods: The positive expression rates of GRP78 in 32 cases of cancer tissue of the NSCLC patients were detected by immunohistochemical staining. The SPCA1 cells with high expression of GRP78 were selected as the subjects. RNA interference technique was used to down-regulate the expression of GRP78 in SPCA1 cells (interference group) and the cells treated with shNC were used as control group. MTT assay was used to detect the viabilities of SPCA1 cells in various groups. Negative control group, interference group, control + gemcitabine group, and interference+ gemcitabine group were set up; colone formation assay was used to detect the colone formation rates of SPCA1 cells in various groups; Western blotting method was used to detect the expression amount of Akt, p-Akt, PI3K, and p-PI3K in the SPCA1 cells in various groups. Results: The immunohistochemical staining results showed that the positive expression rate of GRP78 in cancer tissue in the remission NSCLC patients was significantly higher than that in the no-remission NSCLC patients after treated with gemcitabine (P<0. 05). The MTT assay results showed that compared with negative control group, the viability of SPCA1 cells in interference group was decreased significantly (P<0. 05), and the viability of SPCA1 cells in interference + gemcitabine group was significantly decresed (P<0. 05). The Western blotting results showed that compared with negative control group, the expression amounts of p-Akt and p-PI3K in the SPCA1 cells in interference group were decreased, and the expression amounts of p-Akt and p-PI3K in the SPCA1 cells in interference+gemcitabine group were decreased significantly. Conclusion: Interference of GRP78 may increase the sensitivity of gemcitabine to chemotherapy, and GRP78 may reduce the sensitivity of NSCLC patients to gemcitabine through PI3K/Akt pathway.
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Objective: To explore the expression charateristics of long non coding RNA bladder cancer associated transcript-1 (BLACAT1) in the cancer tissue and cancer cells in the patients with non small cell lung cancer (NSCLC) and the regulation mechanism, and to elucidate the effect and clinical significance of BLACAT1 in the occurrence and development of NSCLC. Methods: Gene Expression Omnibus (GEO) database was used to analyze the expression characteristics of BLACAT1 in the NSCLC tissue. Kmplot website was used to analyze the correlations between the expression of BLACAT1 and the survival and prognosis of the NSCLC patients. Real time quantitative PCR (qRT PCR) method was applied to detect the expressions of BLACAT1 in cancer tissue and corresponding adjacent normal tissue and NSCLC cell lines of the NSCLC patients. The specific small interfering RNA for BLACAT1 (si BLACAT1 group) or negative control sequence C si NC group) were transfected into the A549 cells. The mRNA expression level of BLACAT1 in A549 cells in various groups were detected by qRT PCR method; the percentages of A549 cells in different cell cycles were detected by flow cytometry; the clone formation abilities of A549 cells in various groups were detected by cell clone formation experiment. The proliferation activities of cells in various groups were detected by CCK8 assay. qRT PCR and Western blotting methods were used to detect the expression level of CyclinDl and CDKN2B mRNA and protein in the A549 cells in various groups. Results; The results of GSE18842 and GSE19804 in GEO datatase. qRT PCR and Kmplot analysis showed that the expression level of BLACAT1 in NSCLC tissue was significantly increased compared with adjacent normal lung tissue C P< 0.05); the survival time in the patients with low expression of BLACAT1 in cancer tissue was significantly longer than that in the patients with high expression of BLACAT1 ( P= 0. 011). Compared with si NC group, the BLACAT1 expression level in the A549 cells in si BLACAT1 group was significantly decreased ( P< 0. 05). Compared with si NC group, the percentage of A459 cells in Gi phase in si BLACAT1 group was increased C P<0. 05) . and the percentage of A549 cells in S phase was decreased ( P<0. 05); the cell clone formation ability and the cell proliferation activity were decreased ( P<-0. 05 or P<0.01). Compared with si NC group, the expression levels of CyclinDl mRNA and protein in the A549 cells in si BLACAT1 group were significantly decreased C P<0. 05). and the expression levels of CDKN2B mRNA and protein were significantly increased C P< 0.05). Conclusion: LncRNA BLACAT1 is up regulated in cancer tissue and cancer cells of the NSCLC patients, and down regulation of BLACAT1 expression can inhibit the proliferation of A549 cells via modulating the CyclinDl/CDKN2B axis, which may serve as a potential therapeutic target for the NSCLC patients.
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Objective To investingate the effect of SGK1 expression level on the prognosis of patients with NSCLC,and provide new biological predictors for the prognosis assessment of patients with NSCLS.Methods One hundred and twenty patients with NSCLC received radical resection in Hanzhong 3201 hospital from Jan 2011 to Dec 2013 were selected.There were 75 males and 45 females,age (63.15 ± 16.44) years,age range 45-80 years.According to the results of immunohistochemical staining,the SGK1 cut-off value determined by the integral was determined,and NSCLC patients were divided into SGK1 high expression group (n =70) and SGK1 low expression group(n =50).The relationship between the expression of SGK1 and clinicopathological features (age,sex,smoking history,alcoholism history,BMI,tissue type,tumor diameter,T stage,N stage,TNM stage,differentiation degree) in NSCLC were analyzed,and the overall survival rate in NSCLC were also analyzed.Followup was carried out by telephone or patient admission.The follow-up period was up to June 1,2018.Chest X-ray and ultrasonography were reviewed every 3 to 6 months after operation,and enhanced CT or MRI were performed if the results were abnormal.The measurement data conforming to normal distribution were expressed by t test and showed by (Mean ± SD);the counting data were tested by x2 test;the 5-year overall survival rate was used as the endpoint event for univariate analysis,and the significant variables for univariate analysis were analyzed by COX risk ratio model for multivariate analysis.The cumulative survival curve was drawn by Kaplan-Meier method,and the difference was tested by Log-rank method.Results The expression level of SGK1 in tissues was not related to age,sex,smoking history,alcoholism,BMI,tissue type and tumor diameter (P ＞ 0.05),but it was related to T stage,N stage,TNM stage and differentiation degree (P ＜ 0.05).The univariate and multivariate COX risk ratio model showed that TNM stage and SGK1 expression were independent factors affecting the 5-year overall survival rate of NSCLC patients (P ＜ 0.05).The results of Kaplan-Meier survival curve showed that the 5-year overall survival rate in NSCLC with low expression of SGK1 was significantly higher than that in NSCLC with high expression of SGK1 (P ＜ 0.05).Conclusions The expression of SGK1 in tissues is closely related to the prognosis of patients with NSCLC.The high expression of SGK1 in tissues is not conducive to the prognosis of patients with NSCLC.
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Objective To discribe the technique for uniportal video-assisted thoracoscopic pneumonectomy and lymphadenectomy,and to evaluate the feasibility,safety and the short-term clinical outcomes of this approach.Methods The clinical data of 283 patients with resectable non-small cell lung cancer who received uniportal or three-port video-assisted thoracoscopic pneumonectomy between January 2015 and December 2016 was analyzed retrospectively.Of those 283 patients,151 underwent uniportal video-assisted thoracoscopic pneumonectomy and 132 underwent three-port video-assisted thoracoscopic pneumonectomy.The clinicopathologic factors,operatinal factors,postoperative complications,the number of total lymph nodes dissected or the stations of the total lymph nodes dissected,and conversive rate of the two groups were compared by t test and x2 test.Results The two groups were similar in terms of clinicopathologic data,postoperative complications,length of opertion and conversive rate(P ＞ 0.05).The approach of uniportal video-assisted thoracoscopic pneumonectomy was associated with a significant decrease in surgical blood loss [(126.12 ± 212.13) ml vs.(178.61 ± 173.17) ml,P =0.02],volume of 3 days of post operative chest drainage [(505.25 ± 109.60) ml vs.(566.67 ± 233.35) ml,P =0.004],chest tube duration [(4.31 ±3.12)dvs.(6.93 ±3.10)d,P＜0.001] and postoperative stay [(5.49 ± 4.77) d vs.(7.23±4.24)d,P=0.001].There was no significant difference between the two groups in the number of total lymph nodes dissected or the stations of the total lymph nodes dissected (P ＞ 0.05).The stations of 4L and 5-13 in left lymphadenectomy and the stations of 2 R,3,4R and 7-13 in the right lymphadenectomy did not differ between the two groups(P ＞ 0.05).Conclusion Our uniportal video-assisted thoracoscopic pneumonectomy can be safety and effectively performed for resectabte non-small cell lung cance with favorable early outcomes.
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Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have become the preferred treatment option for advanced non-small-cell lung cancer (NSCLC) patients with activating mutations in epidermal growth factor receptor (EGFR) according to major practice guidelines. Gefitinib, elortinib and icotinib formed the cornerstone of first-line EGFR-TKIs in the clinical practice in our country. Now, with the continuously emerging of new types of EGFR-TKIs and ever-increasing publication of clinical trial results on afatinib, AZD9291 and other TKIs, we have more first-line choices for patients with EGFR mutations. Meanwhile, the development of gene detection technology is facilitating investigators to get insights on the molecular biological behavior of NSCLC and to elucidate the mechanism of drug resistance. This review will focus on precision first-line therapy for advanced NSCLC patients harboring EGFR mutation.
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Objective To investigate the clinical effect of induction chemotherapy plus concurrent radiochemotherapy in the treatment of locally advanced non-small cell lung cancer (NSCLC) through a meta-analysis.Methods CBM, CNKI, Cochrane Library, PubMed, and EMbase were searched for the articles on comparison between induction chemotherapy plus concurrent radiochemotherapy and concurrent radiochemotherapy for patients with locally advanced NSCLC.According to the inclusion and exclusion criteria, the data on short-term outcome and survival were collected.A Meta-analysis was performed to evaluate the clinical effect of induction chemotherapy followed by concurrent radiochemotherapy.Results A total of 5 articles were included, which involved 845 patients.The results showed that the short-term outcome and the 2-and 3-year survival rates were similar between patients receiving induction chemotherapy plus concurrent radiochemotherapy and those receiving concurrent radiochemotherapy ( OR=0.875, 95% CI 0.507-1.510, P=0.631;HR=0.770, 95% CI 0.515-1.151, P=0.203;HR=0.809, 95% CI 0.559-1.172, P=0.262), but the patients receiving induction chemotherapy plus concurrent radiochemotherapy showed a significantly higher incidence rate of grade ≥ 3 leukopenia than those receiving concurrent radiochemotherapy alone ( OR=0.637, 95% CI 0.435-0.931, P=0.020).Conclusions Induction chemotherapy plus concurrent radiochemotherapy shows no significant advantages over concurrent radiochemotherapy alone in the short-term outcome and 2-and 3-year survival rates, but it significantly increases myelosuppression.Since there are few studies involving a limited number of cases included in this analysis, more multicenter randomized trials are needed to provide more detailed data and further clarify the clinical value of induction chemotherapy plus concurrent radiochemotherapy.
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Objective To compare the advanced non -small cell lung cancer (NSCLC)patients before and after chemotherapy peripheral blood EGFR mutation status,we understand whether the chemotherapy drug impacts the EGFR mutation status of the advanced NSCLC patients,so as to improve the precision of EGFR TKIs -drug use. Methods To collect the peripheral blood of 30 cases of advanced NSCLC before chemotherapy and after chemotherapy for 6 cycles.DHPLC technique was used to detect the EGFR mutation states of EGFR exon 19 and in exon 21.Results In 30 patients,chemotherapy prior EGFR mutation positive rate was 53.3% (16 /30).After 6 cycles of chemotherapy, the EGFR mutation positive rate was 36.6% (11 /30),the consistent rate was 56.6 (17 /30)before and after chemo-therapy,inconsistent rate was 53.4% (13 /30).10 cases from positive to negative before chemotherapy,3 cases from negative into positive before chemotherapy with statistical significance (P =0.046).Six EGFR19 exons changed, change rate of 20%,8 EGFR21 exons shift changed at a rate of 26%.EGFR19,21 shift in 1 case,with no statistical significance(P =0.39,P >0.05).Conclusion (1)The late NSCLC patients before and after peripheral blood of EGFR mutation status change,so before starting the targeted therapy we must recive real -time detection of peripheral blood EGFR mutation status,so as to decide whether to choose EGFR TKIs targeted drug therapy.(2)EGFR21 exons transformation rate is higher than EGFR19 exons conversion rate,but with no statistical difference,this phenomenon may be related to EGFR19 exons patients who with EGFR mutations -TKIs treatment efficiency is higher.
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Objective To observe the therapeutic effect of Shenqi Fuzheng injection combined with EP chemotherapy in the treatment of non small cell lung cancer (NSCLC),and to improve the quality of life and side effects.Methods 60 cases of NSCLC were randomly divided into observation group and control group,30 cases in each group.The two groups were treated with EP,the observation group was treated with Shenqi Fuzheng injection for two courses.The life quality and adverse effects were observed.Results The quality of life of the two groups after treatment was compared,the difference was statistically significant (93.3% vs 70.0%,χ2 =2.83,P <0.05),the quality of life in the observation group was significantly higher than that in the control group.The white blood cell reduction,anemia and liver and kidney function damage between the two groups had statistically significant differences (P =0.011,0.025,0.016),the adverse reaction of the observation group was less than the control group.Conclusion Shenqi Fuzheng injection combined with EP regimen in the treatment of NSCLC can protect bone marrow hematopoietic function and improve the quality of life of patients with NSCLC chemotherapy.It can be used as one mean of Chinese and western treatment for patients with NSCLC in clinical application.
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Objective To observe the clinical effects of pemetrexed alone or pemetrexed combined with platinum in the treatment of advanced non -squamous non -small cell lung cancer who failed first line therapy. Methods 34 patients with advanced NSCLC who had failed to previous chemotherapy and all of these patients had been confirmed with pathology or cytology.Pemetrexed monotherapy group included 14 cases and pemetrexed plus platinum group included 20 cases.21 days as one cycle.All patients who received 2 or more cycles could be evaluated. Results No complete response (CR)occurred.There were 3 cases of partial response (PR),15 cases of stable disease(SD)and 16 cases of progressive disease(PD)in the 34 patients.The disease control rate was 52.9%(18 /34).The median progressive free survival was 2.7 months.The major toxic reaction included leucopenia,anemia and gastrointestinal response.Conclusion Pemetrexed or pemetrexed combined with platinum can prolong the survival time of some patients of non -squamous non -small cell lung cancer who failed first line therapy.The toxic effects can be tolerated.
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Objective:To investigate the expression of hypoxia-inducible factor-2α (HIF-2α)in non-small cell lung cancer (NSCLC)tissue,and to analyze its relationships with angiogenesis,cell proliferation and chemotherapy resistance. Methods: Total 112 cases of NSCLC and 20 cases of normal lung tissues were selected, immunohistochemical method was used to detect the expressions of HIF-2α,CD31,Ki67 and GST-π in 112 cases of cancer tissue and 20 cases of normal lung tissue,and the correlations of HIF-2α expression with microvessel density (MVD),Ki67, and GST-π were analyzed.Results:The positive expression rate of HIF-2α in NSCLC tissue was significantly higher than that in normal lung tissue (P < 0.05 ), the expression rate of HIF-2α in 112 cases of NSCLC was 47.3% (53/112).The MVD in HIF-2α protein high expression NSCLC group (31.1 ± 14.7)was higher than that in HIF-2αprotein low expression NSCLC group (24.3±15.8)(P <0.05).The cases of high expression of Ki67 in HIF-2αhigh expression group occupied 54.7% (29/53),and it was higher than that in HIF-2αlow expression group (16/59,27.1%);there was significant difference (r = 0.281,P = 0.003).The high expression of HIF-2α had no obvious correlation with the expression of GST-π (r = 0.122,P = 0.202). Conclusion:HIF-2αmay play an important role in the carcinogenesis and development of NSCLC by promoting the angiogenesis and enhancing the cell proliferation of NSCLC,but it may have no correlation with chemotherapy resistance.
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Objective To explore the effect of improving nursing evaluation system on the quality of life in patients with stage Ⅲ and Ⅳ stage non small cell lung cancer (NSCLC).Methods From January 2011 to December 2014,100 patients with NSCLC were randomly divided into observation group and control group , 5 0 cases in each group.The observation group was treated with 1 month as a treatment course.The control group was treated with rou-tine treatment and nursing.Before treatment and 2 months after treatment,serum tumor markers (CEA,CYFRA21 -1,NSE,CA125) were detected,the clinical symptom score,quality of life (KPS score) and body weight were recor-ded.Results (1)The total effective rates of the observation group and the control group were 88% and 90% respec-tively,the difference was not statistically significant (χ2 =0.381,P >0.05);(2)There were no significant differences in the clinical symptoms between the two groups (t =0.382,1.521,all P >0.05) before and after intervention.After intervention,the clinical symptoms of the two groups were lower than before intervention,the difference was statistical-ly significant (t =6.493,4.398,all P 0.05);After 6 months of intervention,the KPS score and body weight of the observation group were significantly higher than those in the control group,the differences were statistically significant (t =5.493,4.326,all P 0.05);(4) Before the intervention,there were no significant differences in serum tumor markers (t =0.483,1.264,1.762,1.264,1.795,1.678,1.253,1.469,all P >0.05);After intervention,ser-um markers in the two groups were significantly lower than before intervention,the differences were statistically signifi-cant (t =6.393,3.490,4.728,7.943,4.883,5.478,7.684,11.383,all P 0.05).Conclusion For patients with stage III,IV NSCLC,improving nursing evaluation and implementation system has no significant difference in reduce the level of tumor markers and long -term survival compared with the control group,and improve the nursing evaluation and implementation system has certain advantages in maintaining the quality of life of patients.
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Objective To evaluate the clinical value and safety of radiotherapy combined with tyrosine kinase inhibitors (TKI) in non-small cell lung cancer (NSCLC) with brain metastasis driven by epidermal growth factor receptor (EGFR) mutation.Methods A retrospective cohort of 21 non-small cell lung cancer (NSCLC) patients with EGFR mutation-driven brain metastasis was recruited.10 patients (treatment group) were randomly selected for radiotherapy combined with TKI treatment,and 11 patients (control group) were treated with radiotherapy.Tumor size was measured and clinical efficacy was evaluated by MRI in the four weeks after radiotherapy.Since then,a clinical response was evaluated every three months until disease progression,and the median overall survival time was calculated.Results The objective remission was 8 cases in treatment group and 4 cases in control group.The disease control was 9 cases in treatment group and 8 cases in control group.The median overall survival time of treatment and control groups was 11.2 months and 6.4 months,respectively.Adverse reactions in treatment group mainly contained nausea,diarrhea and rash,which all were tolerated.Conclusion Radiotherapy combined with TKI is superior to radiotherapy alone in effect and safety for treatment of NSCLC with EGFR mutation-driven brain metastasis.
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Objective To study of cellular immune function change of elderly patients with non-small car-cinoma after chemotherapy.Methods 62 patients with non-small carcinoma by age was divided into elderly group (≥60 years old)and youth group (0.05);There was no significant difference with CD3 level of the two groups of patients after chemotherapy (P>0.05);The CD3 level of the two groups of patients after chemo-therapy was no significant difference (P>0.05),the elderly group patients after chemotherapy with CD4 levels was lower than young patients (t=7.130,P0.05);The CD3 levels of patient withⅠ-Ⅱ stage were significantly better than patients withⅢ-Ⅳstage (t=1.584,1.721,all P0.05).Conclusion The senile non-small carcinoma patients need assistance targeted immunotherapy,also need to adjust according to the patient's age and clinical staging in patients with chemotherapy drug doses.
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Objective To explore the risk factors of skeletal related events (SREs) in non small cell lung cancer with bone metastases and its effect on the prognosis .Methods Totally 223 cases of NSCLC patients with bone metastasis were retrospective studied from January 2010 to December 2012 in our hospital .The clinical features ,predictive factors for SREs were analysed by sin‐gle factor and multifactor analysis .Results Among 223 cases of NSCLC patients with bone metastasis ,119 cases occured with SREs(53 .4% ) .Univariate analysis showed that the occurrence of SREs in female ,no smoker ,adenocarcinoma ,solitary bone metas‐tasis lesions were less than the male ,smoker non‐adenocarcinoma ,and multiple bone metastases (P0 .05) .The multivariate analysis revealed only multiple bone metastases was an independent risk factor for SREs .The median survival time of the NSCLC patients with bone metastasis was 15 .3 months .Moreover ,survival analysis showed that SREs had no statistical significance on the prognosis of bone metastasis in NSCLC patients (P>0 .05) .Conclusion The female ,adenocarcinoma ,smoking history ,solitary bone metastasis lesions occurred in patients with lower risk SREs .Multiple bone metastasis is an independent risk factor for SREs ,attention should be paid to monitoring and prevention .
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Objective To analyze the correlative factors of anemia in patients with non-small-cell lung cancer (NSCLC), and to explore the impact of anemia on prognosis.Methods The clinical data of 473 patients with NSCLC treated at the first time from January 2008 to November 2012 in the Fourth Hospital of Hebei Medical University were analyzed retrospectively.Results There were 273 patients (57.72 ％) with anemia.Anemia occurred in different age (x2 =3.459, P =3.459), different albumin level (x2 =70.648, P =70.648), different PS score (x2 =10.222, P =10.222), whether recent surgery (x2 =4.956, P =4.956), whether recent chemotherapy (x2 =3.627, P =0.037), and other factors.By multiple factors analysis, hypoalbuminemia was an independent risk factor for anemia (P ＜ 0.05).The median OS of the anemia patients was shorter than that of the patients without anemia (15 months vs 17 months, P ＜ 0.05).Conclusions Hypoalbuminemia is the independent risk factor for emergence of anemia.Anemia is the prognosis indicator of shorten survival period, which is an independent factor of prognosis in the NSCLC.