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Objective To analyze the clinical efficacy of neoadjuvant chemotherapy in patients with stageⅢA non-small cell lung cancer (NSCLC). Methods From March 2008 to October 2015, there were 92 cases of stageⅢA NSCLC patients received 2 cycles of neoadjuvant chemotherapy and underwent radical surgery for lung cancer 3-4 weeks late ( observation group) , and another group of 65 cases of stage ⅢA NSCLC patients ( control group) underwent surgery for lung cancer without preoperative chemotherapy. The clinical data as well as early and meddle term surgical outcome of both groups were analyzed retrospectively. Results The neoadjuvant chemotherapy effective rate was 73. 9％ in the observation group. All surgeries for lung cancer patients were undertaken either with video-assisted thoracotomy or traditional thoracotomy. No operative mortality and the postoperative pathology findings were in accordance with NSCLC. The bleed-ing amount and operation time of two groups were similar; the resection rate of the observation group was greater than that of the control group. All patients were followed up at least 3 years, and the 2 years and 3 years survival rate of the observation group was slightly higher than that of the control group. Conclusions Preoperative neoadjuvant chemotherapy in patients with NSCLC can improve the resection rate and prolong the survival time, which is worthy of clinical application.
ABSTRACT
Immunotherapy is revolutionizing the treatment of non-small cell lung cancer (NSCLC).Programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) monoclonal antibodies have recently led to significant and durable improvements in the clinical outcome of NSCLC,and the anti-PD-1 antibody has been approved to use in first-line and second-line treatment of NSCLC.However,there are still many problems to be solved.The role of PD-L1 as a predictive biomarker remains unclear.Combination treatment models are being explored.This review summarizes the clinical efficacy,drug adverse reaction,combined treatment,and potential immune biomarkers of anti-PD-1/PD-L1 antibody research progress in the treatment of NSCLC.
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Objective To explore the efficacy and safety of human recombinant vascular endothelial inhibition (en) combined with gamma knife in the treatment of elderly advanced non-small cell lung cancer patents.Methods Totally 38 cases of senile non-small cell lung cancer patients were divided into two groups:A group was treatment group with 17 cases of recombinant human endostatin combined with gamma knife,group B was control group with 21 cases of patients receiving body gamma knife alone.Recombinant human endostatin was given intravenously 15 mg per day in 500 ml of saline for 3 ～ 4 hours for 14 days a cycle,and the total dose of body gamma knife therapy was 36 ～ 48 Gy/10 ～ 12f.Results The response rate (RR) of groups A and B were 58.82％ and 57.14％ without statistical difference.One-year survival rate of groups A and B were 47.06％ and 38.09％,respectively;and there was no statistical significance.The main side-effects of both groups were bone marrow suppression and gastrointestinal reactions,but no statistical difference was observed.Two groups of patients'quality of life were improved without statistical difference (P ＞ 0.05).Conclusions Body-gamma knife therapy combined with recombinant human endostatin in elderly advanced non-small cell lung cancer patients has better efficacy such as CR rate and long-term survival,and similar side-effects.
ABSTRACT
At present,the treatment for non-small cell lung cancer (NSCLC) consists of surgery,radiation,chemotherapy,targeted therapy,etc.The epidermal growth factor receptor (EGFR) gene mutation opened a new era of individualized treatment.Multidisciplinary treatment come next after the combination of different treatment approaches,and the modality of targeted therapy like epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in combination with radiation was included.The present work reviews clinical progress for the EGFR-TKI combined with radiotherapy in advanced NSCLC.
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Objective To investigate the effect of hyperthermia combined with chemotherapy on the changes of immunity balance of Th1/Th2 and cytokines such as interleukin-2 (IL-2),interferon-γ (IFN-γ),IL-4,IL-10,and vascular endothelial growth factor (VEGF) in non-small cell lung cancer (NSCLC) patients.Methods Fifty patients with advanced NSCLC were randomly divided into thermochemotherapy group (n =25,received whole body hyperthermia combined TP chemotherapy),and chemotherapy group (n =25,received TP chemotherapy alone).The immunity balance of Th1/Th2,IL-2,IFN-γ,IL-4,IL-10,and VEGF levels before therapy and 1 week after therapy were observed.At the same time,the above observation indices were also detected as normal control in 20 healthy volunteers.Results Compared to the chemotherapy group,the proportion of Th1 cells from thermochemotherapy group was significantly increased after therapy (P =0.002) and that of Th2 cells was dropped markedly (P =0.006).There was no difference in the levels of IL-2,IFN~,IL4,IL-10,and VEGF between thermochemotherapy and chemotherapy groups before therapy (P ＞ 0.05).However,the expressions of ILA,IL-10,and VEGF in the NSCLC group were significantly higher than normal group (P ＜ 0.01).The IL-2 and IFN-γ levels were significantly decreased in NSCLC group (P ＜0.01).After therapy 1 week,the concentration of IL-2 and IFN-γfrom thermochemotherapy and chemotherapy groups were higher than before,with statistical significance (P ＜0.01).In addition,IL-4 and IL-10 levels of two groups were significantly decreased in comparison with before therapy (P ＜ 0.01),and it showed a striking difference in cytokines (IL-2,IFN-γ,IL-4,and IL-10) between two groups (P ＜ 0.05).However,the concentration of VEGF in chemotherapy group patients before and after chemotherapy had no significant difference (P ＞ 0.05).The concentration of VEGF from thermochemotherapy group patients after therapy were lower than chemotherapy group patients,the difference had statistical significance (P ＜ 0.01).Conclusions Thermochemotherapy can significantly prompt the Th2 to Th1 shift in both cells and cytokines of advanced NSCLC compared to chemotherapy alone.Moreover,thermochemotherapy also reduces the expression of VEGF,which may prevent the formation of new blood vessels in tumor tissue.