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1.
Article in Chinese | WPRIM | ID: wpr-878698

ABSTRACT

Objective To compare the differences of energy spectrum CT between small cell lung cancer(SCLC)with mediastinal lymph node metastasis and mediastinal sarcoidosis.Methods Twenty-five SCLC patients with mediastinal lymph node metastasis(SCLC group)and 26 patients with mediastinal sarcoidosis(sarcoidosis group)confirmed by bronchoscopy and biopsy in Tangshan People's Hospital from January 2018 to June 2019 were selected as the research objects.The CT value,iodine concentration,water concentration and energy spectrum curve slope under different single energy levels were compared between SCLC group and sarcoidosis group.Results The single-energy CT values of 40-80 keV segments in the arterial phase of the SCLC group were significantly higher than those in the sarcoidosis group(all P 0.05).The single-energy CT values of 40-90 keV segments in venous phase of the SCLC group were significantly higher than those of the sarcoidosis group(all P 0.05).The concentrations of iodine in the arterial phase and venous phase of the SCLC group were(11.56±4.06)μg/cm


Subject(s)
Humans , Lung Neoplasms/diagnostic imaging , Lymph Nodes , Lymphatic Metastasis , Sarcoidosis/diagnostic imaging , Small Cell Lung Carcinoma/diagnostic imaging , Tomography, X-Ray Computed
2.
Rev. colomb. cancerol ; 24(2): 88-91, abr.-jun. 2020. graf
Article in Spanish | LILACS | ID: biblio-1144325

ABSTRACT

Resumen El carcinoma de célula pequeña (CPCP) o microcítico de pulmón es un subtipo de cáncer de pulmón que típicamente se ha asociado al tabaquismo y que se caracteriza por su agresividad y mal pronóstico a corto plazo. Como entidad, puede metastatizar en cualquier órgano, siendo las metástasis pancreáticas raras y la mayoría de las veces asintomáticas. Por ello, la presencia de una pancreatitis neoplásica, como en el caso presentado, es excepcional, y aún más cuando presenta refractariedad al tratamiento médico convencional y responde al tratamiento citotóxico sistémico. Por todo ello, se expone esta experiencia clínica y se debate la presencia de esta rara entidad y su manejo.


Abstract Small-cell lung carcinoma is a subtype of neoplasm that has been typically associated with smoking; it is characterized by its aggressiveness and poor prognosis in the short term. As an entity, it can metastasize in any organ, but pancreatic metastases are rare and most of the time asymptomatic. Therefore, the presence of neoplastic pancreatitis as in our case is exceptional; even more when it presents refractoriness to conventional medical treatment, responding instead to systemic cytotoxic treatment. Therefore, we expose our clinical experience and discuss the presence of this rare entity and its management.


Subject(s)
Humans , Male , Middle Aged , Pancreatic Neoplasms/secondary , Pancreatitis/etiology , Small Cell Lung Carcinoma/pathology , Lung Neoplasms/pathology , Pancreatic Neoplasms/drug therapy , Pancreatic Neoplasms/diagnostic imaging , Tobacco Use Disorder/complications , Acute Disease , Cisplatin/therapeutic use , Etoposide/therapeutic use , Small Cell Lung Carcinoma/drug therapy , Small Cell Lung Carcinoma/diagnostic imaging , Lung Neoplasms/drug therapy , Lung Neoplasms/diagnostic imaging , Antineoplastic Agents/therapeutic use
4.
São Paulo; s.n; 2020. 51 p. ilust, tabelas.
Thesis in Portuguese | LILACS, Inca | ID: biblio-1222802

ABSTRACT

Câncer de pulmão de não pequenas células (CPNPC) é o tipo mais frequente de câncer de pulmão, acometendo por volta de 85% à 90% de todos os cânceres de pulmão, sendo o tabagismo o fator de risco mais relevante para a doença. O sistema imune possui um papel importante na resposta antitumoral, porém, as células do tumor fazem uso de mecanismos para evadir da imunovigilância através de células imunossupressoras e produção de citocinas. A análise de células imunes e de citocinas pode auxiliar em um conhecimento mais abrangente do microambiente tumoral como um todo, permitindo um melhor entendimento da doença e a proposta de tratamentos que possam ser mais eficazes. Neste trabalho, foi avaliando o perfil imune sistêmico de pacientes com CPNPC, comparando pacientes não metastáticos (estágios I, II, III) e pacientes metastáticos (estágio IV). Nós avaliamos a frequência de células linfoides e mieloides por meio de citometria de fluxo, além das concentrações plasmáticas de citocinas por meio da análise multiplex a partir de amostras de sangue de pacientes coletadas antes do início do tratamento. Foram incluídos 39 pacientes com CPNPC, sendo 28 no grupo de metastáticos e 11 no grupo de não metastáticos. Foi possível verificar um aumento da frequência de monócitos inflamatórios no sangue de pacientes metastáticos, se comparados a pacientes não metastáticos, indicando um microambiente mais favorável ao desenvolvimento de metástase. Além disso, foram observados níveis mais elevados de monócitos não-clássicos, conhecidos como patrulhadores e das citocinas TRAIL E IL-1Ra em pacientes não metastáticos, indicando um microambiente mais protetor. Concluindo, este estudo propõe mecanismos imunológicos relacionados ao desenvolvimento de metástase para pacientes com CPNPC, sugerindo biomarcadores que podem auxiliar no prognóstico e acompanhamento desse grupo de pacientes


Non-small cell lung cancer (NSCLC) is the most common type of cancer among lung cancers, accounting for about 85% to 90% of cases, with smoking being the most relevant risk factor related to the disease. The immune system plays an important role in anti-tumoral response; however, tumor cells use mechanisms that allow escape from immune surveillance, such as the presence of immunosuppressive cells and production of inhibitory cytokines in the tumor microenvironment. Analyzing the immune cells and cytokines can be helpful to better understand the tumor microenvironment and diseases development allowing a more effective treatment. In this work it was determine the immune cells profile of patients with NSCLC, comparing non-metastatic (stages I, II and III) and metastatic (stage IV) patients. We evaluated the frequencies of lymphocytes and myeloid cells in patients using flow cytometry and plasmatic cytokines concentration cytokines using multiplex analysis in blood samples collected before treatment begins. It was including 39 NSCLC patients, of which 28 from the metastatic group and 11 from the non-metastatic group. There was an increase in inflammatory monocytes frequency in metastatic patients when compared to metastatic patients indicating a more favorable microenvironment for tumor metastasis. Moreover, it was found discovered a higher level of non-classic monocytes also known as patrolling monocytes, and TRAIL and IL-1Ra Cytokines in non-metastatic patients in compare with metastatic patients, indicating a more protective microenvironment. In conclusion, this study demonstrated immunological mechanisms related to metastasis in NSCLC patient suggesting helpful biomarker for prognosis and patient flow up


Subject(s)
Humans , Male , Female , Prognosis , Biomarkers, Tumor , Small Cell Lung Carcinoma , Tumor Microenvironment , Neoplasm Metastasis
5.
Article in English | WPRIM | ID: wpr-880594

ABSTRACT

Small cell lung cancer belongs to neuroendocrine tumors and is the most malignant one in lung cancer. It possesses clinical features such as rapid growth, easy early metastasis, and poor prognosis. PET/CT is a molecular imaging technique that combines morphological and metabolic imaging. It has been widely used in the diagnosis, staging, treatment planning, efficacy and prognosis evaluation of tumors. This article reviews the efficacy, prognostic parameters, evaluation criteria, possible influencial factors, clinical application and value of


Subject(s)
Fluorodeoxyglucose F18 , Humans , Lung Neoplasms/pathology , Neoplasm Staging , Positron Emission Tomography Computed Tomography , Positron-Emission Tomography , Prognosis , Radiopharmaceuticals , Retrospective Studies , Small Cell Lung Carcinoma/pathology
6.
Arq. bras. oftalmol ; 82(5): 422-424, Sept.-Oct. 2019. graf
Article in English | LILACS | ID: biblio-1019438

ABSTRACT

ABSTRACT Bilateral orbital metastases restricted to the extraocular muscles (EOMs) are exceedingly rare. We report a case of bilateral extraocular muscle metastases from a small cell lung carcinoma and provide a review of the relevant literature. A 56-year-old smoker presented with proptosis, motility changes, and a relative afferent pupillary defect of the left eye, with a previous history of a small cell lung carcinoma. An orbital computerized tomography scan revealed a mass restricted to the left medial rectus. An incisional biopsy confirmed metastasis. Visual acuity of the left eye decreased rapidly, and right globe proptosis became evident. Orbital magnetic resonance imaging at two months follow-up showed marked left orbital mass enlargement and a new right lateral rectus mass. The patient was maintained on palliative care and died from metastatic disease-related complications.


RESUMO As metástases orbitárias bilaterais restritas aos mús­culos extraoculares são extremamente raras. Os autores apresentam um caso de metástases bilaterais, localizadas aos musculares extraoculares com base num carcinoma de pequenas células do pulmão e revisão da literatura relevante. Um homem, fumador, de 56 anos recorreu ao serviço de urgência por proptose, alterações de motilidade ocular extrínseca e um defeito pupilar aferente relativo do olho esquerdo, com história pessoal de carcinoma de pequenas células do pulmão. A tomografia computadorizada orbitária revelou uma massa restrita ao reto medial esquerdo. Uma biópsia incisional confirmou o diagnóstico de metástase. A acuidade visual do olho esquerdo diminuiu rapidamente e surgiu uma proptose do globo ocular direito. A ressonância magnética orbitária aos dois meses de seguimento revelou um aumento da massa orbitária esquerda e uma nova massa no reto lateral direito. O paciente foi mantido em cuidados paliativos e faleceu devido a complicações relacionadas com doença metastática.


Subject(s)
Humans , Male , Middle Aged , Orbital Neoplasms/secondary , Exophthalmos/etiology , Small Cell Lung Carcinoma/pathology , Lung Neoplasms/pathology , Oculomotor Muscles/pathology , Biopsy , Orbital Neoplasms/pathology , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Exophthalmos/pathology , Fatal Outcome
7.
Autops. Case Rep ; 9(2): e2019089, Abr.-Jun. 2019. ilus, tab
Article in English | LILACS | ID: biblio-1015106

ABSTRACT

Liver metastases are commonly found in advanced cancer patients; however, acute liver failure secondary to diffuse liver infiltration is rare. Small cell lung carcinoma accounts for 15% of lung carcinomas. We describe the ninth case of small cell lung carcinoma massively metastatic to the liver, reported in the scientific literature, with sudden clinical onset and death after a few days. An autopsy was performed to understand the cause of death.


Subject(s)
Humans , Male , Aged , Small Cell Lung Carcinoma/pathology , Lung Neoplasms/pathology , Autopsy , Liver Failure, Acute/pathology , Hepatomegaly , Neoplasm Metastasis
8.
Int. braz. j. urol ; 45(2): 299-305, Mar.-Apr. 2019. tab
Article in English | LILACS | ID: biblio-1002199

ABSTRACT

ABSTRACT Purpose: To describe the clinical characteristics, treatment patterns, and outcomes in patients with small cell bladder cancer at our institution, including those who received prophylactic cranial irradiation (PCI) for the prevention of intracranial recurrence. Materials and Methods: Patients with small cell bladder cancer treated at a single institution between January 1990 and August 2015 were identified and analyzed retrospectively for demographics, tumor stage, treatment, and overall survival. Results: Of 44 patients diagnosed with small cell bladder cancer, 11 (25%) had metastatic disease at the time of presentation. Treatment included systemic chemotherapy (70%), radical surgery (59%), and local radiation (39%). Six patients (14%) received PCI. Median overall survival was 10 months (IQR 4 - 41). Patients with extensive disease had worse overall survival than those with organ confined disease (8 months vs. 36 months, respectively, p = 0.04). Among those who received PCI, 33% achieved 5 - year survival. Conclusion: Outcomes for patients with small cell bladder cancer remain poor. Further research is indicated to determine if PCI increases overall survival in small call bladder cancer patients, especially those with extensive disease who respond to chemotherapy.


Subject(s)
Humans , Male , Aged , Aged, 80 and over , Urinary Bladder Neoplasms/radiotherapy , Cranial Irradiation/methods , Carcinoma, Small Cell/radiotherapy , Urinary Bladder Neoplasms/mortality , Urinary Bladder Neoplasms/pathology , Survival Analysis , Retrospective Studies , Carcinoma, Small Cell/mortality , Carcinoma, Small Cell/pathology , Small Cell Lung Carcinoma/pathology , Small Cell Lung Carcinoma/radiotherapy , Lung Neoplasms/mortality , Lung Neoplasms/pathology , Lung Neoplasms/radiotherapy
10.
Yonsei Medical Journal ; : 898-904, 2019.
Article in English | WPRIM | ID: wpr-762043

ABSTRACT

PURPOSE: Sonic hedgehog (Shh) signaling pathway is known to play a crucial role in carcinogenesis in various malignancies, including lung cancer regarding tumorigenesis, angiogenesis, and cellular differentiation. The aim of this study was to investigate the value of components of Shh pathway as a prognostic marker in extensive stage small cell lung cancer (ES-SCLC) patients. MATERIALS AND METHODS: We retrospectively analyzed data of 36 patients who were diagnosed with ES-SCLC between 2008 and 2012 at a single center. We performed immuo-histochemistry for glioma-associated oncogene homolog zinc finger protein 1 (Gli1), patched, Shh, and Ptch-mediated repression of smoothened (Smo) proteins using formalin-fixed, paraffin-embedded tissue derived from primary tumors. We then conducted survival analysis to evaluate the prognostic impact of these markers. RESULTS: All 36 patients received platinum-based doublet chemotherapy. The median progression free survival and median overall survival were 6.9 months [95% confidence interval (CI), 6.5–7.3] and 11.7 months (95% CI, 9.1–14.3), respectively. The overall response rate was 84%. Of the 36 tissue specimens examined, over-expression of Gli1, Patched, Shh, and Smo was found in 12 (33.3%), five (13.9%), five (13.9%), and six (16.7%) cases, respectively. We found that high expression of Shh was associated with worse progression free survival (6.3 vs. 7.6 months, p=0.005) and overall survival (9.2 vs. 12.0 months, p=0.039) by both univariate and multivariate analyses, whereas other markers were not related to patient prognosis. CONCLUSION: A high proportion of small cell lung cancer tumors express proteins related to Shh pathway, and over-expression of Shh is correlated with poor prognosis.


Subject(s)
Carcinogenesis , Disease-Free Survival , Drug Therapy , Hedgehog Proteins , Hedgehogs , Humans , Lung Neoplasms , Multivariate Analysis , Oncogenes , Prognosis , Repression, Psychology , Retrospective Studies , Small Cell Lung Carcinoma , Zinc Fingers
11.
Radiation Oncology Journal ; : 156-165, 2019.
Article in English | WPRIM | ID: wpr-761014

ABSTRACT

PURPOSE: Prophylactic cranial irradiation (PCI) is a standard treatment for limited-stage small cell lung cancer (LS-SCLC) showing a response to initial treatment, but many patients do not receive PCI due to comorbidities or refusal. This study aims to define the patient group for whom PCI can be omitted with minimal risk. MATERIALS AND METHODS: Patients with LS-SCLC who underwent radiotherapy with curative aim at our institution between January 2004 and December 2015 were retrospectively reviewed. Patients who did not receive PCI were evaluated for brain metastasis-free survival (BMFS), progression-free survival (PFS), overall survival (OS), and prognostic factors for survival, and treatment outcomes were compared with a patient cohort who received PCI. RESULTS: A total of 350 patients achieved a response following thoracic radiotherapy, and 190 of these patients did not receive PCI. Stage I–II and a complete response (CR) to initial therapy were good prognostic factors for BMFS and OS on univariate analysis. Patients with both stage I–II and a CR who declined PCI showed comparable 2-year BMFS to those who received PCI (92% vs. 89%). In patients who achieved CR, PCI did not significantly improve OS or PFS. CONCLUSION: There should be less concern about omitting PCI in patients with comorbidities if they have stage I–II or a CR, with brain metastasis control being comparable to those patients who receive PCI.


Subject(s)
Brain , Cohort Studies , Comorbidity , Cranial Irradiation , Disease-Free Survival , Humans , Neoplasm Metastasis , Radiotherapy , Retrospective Studies , Small Cell Lung Carcinoma
12.
Radiation Oncology Journal ; : 185-192, 2019.
Article in English | WPRIM | ID: wpr-761011

ABSTRACT

PURPOSE: The effectiveness of thoracic radiation therapy (TRT) in extensive-stage small cell lung cancer (ES-SCLC) patients is increasingly reported, but there is no definite consensus on its application. The aim of this study was to identify factors associated with better outcomes of TRT among patients with ES-SCLC, focusing on whether a higher TRT dose could improve treatment outcome. MATERIALS AND METHODS: The medical records of 85 patients with ES-SCLC who received TRT between January 2008 and June 2017 were retrospectively reviewed. Eligibility criteria were a biological effective dose with α/β = 10 (BED) higher than 30 Gy₁₀ and completion of planned radiotherapy. RESULTS: During a median follow-up of 5.3 months, 68 patients (80.0%) experienced disease progression. In univariate analysis, a BED >50 Gy₁₀ was a significant prognostic factor for overall survival (OS; 40.8% vs. 12.5%, p = 0.006), progression-free survival (PFS; 15.9% vs. 9.6%, p = 0.004), and intrathoracic PFS (IT-PFS; 39.3% vs. 20.5%, p = 0.004) at 1 year. In multivariate analysis, a BED >50 Gy₁₀ remained a significant prognostic factor for OS (hazard ratio [HR] = 0.502; 95% confidence interval [CI], 0.287–0.876; p = 0.015), PFS (HR = 0.453; 95% CI, 0.265–0.773; p = 0.004), and IT-PFS (HR = 0.331; 95% CI, 0.171–0.641; p = 0.001). Response to the last chemotherapy was also associated with better OS in both univariate and multivariate analysis. CONCLUSION: A TRT dose of BED >50 Gy₁₀ may be beneficial for patients with ES-SCLC. Further studies are needed to select patients who will most benefit from high-dose TRT.


Subject(s)
Consensus , Disease Progression , Disease-Free Survival , Drug Therapy , Follow-Up Studies , Humans , Medical Records , Multivariate Analysis , Radiotherapy , Radiotherapy Dosage , Retrospective Studies , Small Cell Lung Carcinoma , Treatment Outcome
14.
Article in English | WPRIM | ID: wpr-766121

ABSTRACT

OBJECTIVES:: Investigating the survival of patients with cancer is vitally necessary for controlling the disease and for assessing treatment methods. This study aimed to compare various statistical models of survival and to determine the survival rate and its related factors among patients suffering from lung cancer. METHODS:: In this retrospective cohort, the cumulative survival rate, median survival time, and factors associated with the survival of lung cancer patients were estimated using Cox, Weibull, exponential, and Gompertz regression models. Kaplan-Meier tables and the log-rank test were also used to analyze the survival of patients in different subgroups. RESULTS:: Of 102 patients with lung cancer, 74.5% were male. During the follow-up period, 80.4% died. The incidence rate of death among patients was estimated as 3.9 (95% confidence [CI], 3.1 to 4.8) per 100 person-months. The 5-year survival rate for all patients, males, females, patients with non-small cell lung carcinoma (NSCLC), and patients with small cell lung carcinoma (SCLC) was 17%, 13%, 29%, 21%, and 0%, respectively. The median survival time for all patients, males, females, those with NSCLC, and those with SCLC was 12.7 months, 12.0 months, 16.0 months, 16.0 months, and 6.0 months, respectively. Multivariate analyses indicated that the hazard ratios (95% CIs) for male sex, age, and SCLC were 0.56 (0.33 to 0.93), 1.03 (1.01 to 1.05), and 2.91 (1.71 to 4.95), respectively. CONCLUSIONS:: Our results showed that the exponential model was the most precise. This model identified age, sex, and type of cancer as factors that predicted survival in patients with lung cancer.


Subject(s)
Cohort Studies , Female , Follow-Up Studies , Humans , Incidence , Iran , Lung Neoplasms , Lung , Male , Models, Statistical , Multivariate Analysis , Retrospective Studies , Small Cell Lung Carcinoma , Survival Rate
15.
Chinese Journal of Lung Cancer ; (12): 132-136, 2019.
Article in Chinese | WPRIM | ID: wpr-775653

ABSTRACT

BACKGROUND@#The aim of this study was to investigate the clinical features of paraneoplastic limbic encephalitis (PLE) with small cell lung cancer (SCLC) and improve clinical diagnosis and treatment.@*METHODS@#The clinical data of 15 patients with SCLC combined with PLE from January 1980 to May 2017 were collected from Beijing Union Hospital. Their symptoms and laboratory data were analyzed and the prognosis of the patients was followed.@*RESULTS@#PLE is a rare disease, the incidence rate in SCLC is about 0.842%. The data may be underestimated because of misdiagnose or missed diagnosis; High incidence crowd of the disease is the middle-aged male smoker, the tumor-node-metastasis (TNM) stages of them are later than others; Typical neurological symptoms include varying degrees of short-term memory loss, seizures and varying degrees of mental disorders; neurological symptoms usually occur before the onset of cancer or respiratory symptoms appear, an average of about 2 months be taken from onset to diagnosis; Serum antibody (anti-Hu, GABA-R-Ab), cerebrospinal fluid, head magnetic resonance imaging (MRI) and electroencephalogram (EEG) of the patients has abnormalities; Videography, especially computed tomography (CT) is a good means of screening the primary tumor, pathology diagnosis mainly rely on bronchoscopy; The treatment of primary tumors can be more effective in alleviating the nervous system symptoms than immunotherapy.@*CONCLUSIONS@#Paraneoplastic limbic encephalitis is a rare paraneoplastic syndrome in nervous system caused by malignant neoplasms often characterized by facial neurological symptoms. The disease are usually associated with lung cancer (especially SCLC). Its nervous system symptoms occur earlier than the tumor diagnosis. Early diagnosis and treatment for primary tumors will increase the benefit.


Subject(s)
Adult , Aged , Female , Follow-Up Studies , Humans , Limbic Encephalitis , Lung Neoplasms , Diagnosis , Therapeutics , Male , Middle Aged , Prognosis , Retrospective Studies , Small Cell Lung Carcinoma , Diagnosis , Therapeutics
16.
Chinese Journal of Lung Cancer ; (12): 239-244, 2019.
Article in Chinese | WPRIM | ID: wpr-775637

ABSTRACT

With the in-depth study of tumor immunity, immunotherapy represented by immune checkpoint inhibitors has made a great breakthrough in solid tumors. Small cell lung cancer (SCLC) accounts for about 15%-20% of all lung cancers, with high malignancy, early metastasis and lack of effective treatment strategy. The appearance of immune checkpoint inhibitors brings new hope for SCLC. Several clinical trials have demonstrated the persistent efficacy and clinical activity of the programmed death receptor/ligand 1 (PD-1/L1) and cytotoxic T-lymphocyte antigen 4 (CTLA-4) in the treatment of SCLC. However, its efficacy and safety are not very accurate, and the markers that can effectively predict the efficacy of immunotherapy have not been concluded. In this paper, for further changing the treatment strategy of SCLC clinical practice and providing theoretical basis of research, we reviewed the progress of immune checkpoint inhibitors, related markers in the treatment of SCLC by exploring the value, problems and challenges of immunotherapy in SCLC.
.


Subject(s)
Humans , Lung Neoplasms , Diagnosis , Drug Therapy , Allergy and Immunology , Molecular Targeted Therapy , Methods , Prognosis , Small Cell Lung Carcinoma , Diagnosis , Drug Therapy , Allergy and Immunology
17.
Chinese Journal of Lung Cancer ; (12): 355-362, 2019.
Article in Chinese | WPRIM | ID: wpr-775620

ABSTRACT

Small cell lung cancer (SCLC) is a refractory cancer with high degree of malignancy, rapid disease progression, poor prognosis and easy recurrence. In the past 30 years, the traditional treatment of SCLC, mainly chemotherapy and radiotherapy, has not changed significantly, and the effective treatment method for clinical needs is extremely urgent. The rapid development of precision medicine has revealed the molecular biological characteristics of SCLC, so its diagnosis and treatment will into a new era. At present, some studies have shown that anti-angiogenic drugs, immunotherapy and so on have improved the efficacy of SCLC treatment to some extent, and there are more studies on the diagnosis and treatment of SCLC, so a new field of SCLC treatment are coming and bringing more survival benefits to patients. New studies on targeted therapy, anti-angiogenesis drugs and immunotherapy of molecular pathology of SCLC are emerging. This paper reviews the new diagnosis and treatment methods of SCLC to provide new guidance for its clinical treatment.
.


Subject(s)
Angiogenesis Inhibitors , Animals , Humans , Immunologic Factors , Immunotherapy , Lung Neoplasms , Diagnosis , Drug Therapy , Small Cell Lung Carcinoma , Diagnosis , Drug Therapy
18.
Article in Chinese | WPRIM | ID: wpr-772338

ABSTRACT

BACKGROUND@#Small cell lung cancer (SCLC) is characterized by poor differentiation, high malignancy and rapid growth fast, short double time, early and extensive metastatic malignancy. In clinical, chemotherapy is the main treatment method, while resistance to multiple chemotherapy drugs in six to nine months has been a major clinical challenge in SCLC treatment. Therefore, It has important clinical value to building SCLC aninimal model which is similar to patients with SCLC. Animal model of xenotransplantation (PDX) from the patients with small cell lung cancer can well retain the characteristics of primary tumor and is an ideal preclinical animal model. The study is aimed to establish SCLC PDX animal model and induce the chemoresistance model to help to study the mechanism of chemoresistance and individual treatment.@*METHODS@#Fresh surgical excision or puncture specimens from SCLC patients were transplanted into B-NSGTM mice subcutaneous tissues with severe immunodeficiency in one hour after operation the B-NSGTM mice subcutaneous in 1 hour, and inject chemotherapy drugs intraperitoneally after its tumor growed to 400 mm³ with EP which is cisplatin 8 mg/kg eight days and etoposide 5 mg/kg every two days until 8 cycles. Measure the tumor volum and mice weights regularly, then re-engrafted the largest tumor and continue chemotherapy.@*RESULTS@#Nine cases were conducted for B-NSG mice modeling. Three of nine cases could be engrafted to new B-NSG mice at least two generation. The SCLC PDX animal models have been established successfully. After adopting chemotherapy drugs, the chemoresistance PDX models have been established. High homogeneity was found between xenograft tumor and patient's tumor in histopathology, immunohistochemical phenotype (Syn, CD56, Ki67).@*CONCLUSIONS@#The SCLC PDX animal model and the chemoresistance PDX animal model have been successfully constructed, the success rate is 33%, which provides a platform for the clinical research, seeking for biological markers and choosing individual treatment methods of SCLC.


Subject(s)
Animals , Antineoplastic Combined Chemotherapy Protocols , Pharmacology , Cisplatin , Disease Models, Animal , Drug Resistance, Neoplasm , Etoposide , Female , Humans , Interleukin Receptor Common gamma Subunit , Genetics , Lung Neoplasms , Drug Therapy , Metabolism , Pathology , Mice, Inbred BALB C , Mice, Inbred NOD , Mice, Knockout , Mice, SCID , Small Cell Lung Carcinoma , Drug Therapy , Metabolism , Pathology , Transplantation, Heterologous , Methods , Xenograft Model Antitumor Assays
19.
Article in English | WPRIM | ID: wpr-742451

ABSTRACT

BACKGROUND: Lung cancer is a leading cause of morbidity and mortality worldwide, and the incidence continues to rise. Although many prognostic factors have been identified, the clinical characteristics and outcomes in Korean lung cancer patients are not well defined. METHODS: Of the 23,254 new lung cancer cases registered at the Korea Central Cancer Registry in 2013, total 489 patients from 19 hospitals were abstracted by the Korean Central Cancer Registry. The clinical data retrospectively analyzed, patients were followed up until December 2015. RESULTS: The median age was 69 years (interquartile range, 60–74 years); 65.4% were male and 62.1% were ever-smokers. Cough was the most common initial symptom (33.5%); 13.1% of patients were asymptomatic. While squamous cell carcinoma was the most common subtype in male patients (37.2%), adenocarcinoma was the most frequent histological type in all patients (48.7%) and females (76.3%). The majority of patients received treatment (76.5%), which included surgery, radiation therapy, and chemotherapy. Older age (hazard ratio [HR], 1.037), lower body mass index (HR, 0.904), ever-smoker (HR, 2.003), small cell lung cancer (HR, 1.627), and distant metastasis (HR, 3.990) were independent predictors of mortality. Patients without symptoms (HR, 0.387) and without treatment (HR, 0.364) were associated with a favorable outcome in multivariate Cox analysis. CONCLUSION: Lung cancer in Korea occurs predominantly in elderly patients, with adenocarcinoma being the most frequent subtype. The prognosis was poorer in ever-smokers and older, malnourished, and untreated patients with advanced lung cancer.


Subject(s)
Adenocarcinoma , Aged , Body Mass Index , Carcinoma, Squamous Cell , Cough , Drug Therapy , Epidemiology , Female , Humans , Incidence , Korea , Lung Neoplasms , Lung , Male , Mortality , Neoplasm Metastasis , Pilot Projects , Prognosis , Retrospective Studies , Small Cell Lung Carcinoma
20.
Article in English | WPRIM | ID: wpr-719712

ABSTRACT

PURPOSE: This randomized phase III study was designed to compare the efficacy and safety of irinotecan plus cisplatin (IP) over etoposide plus cisplatin (EP) in Korean patients with extensive-disease small-cell lung cancer (SCLC). MATERIALS AND METHODS: Patients were randomly assigned to receive IP, composed of irinotecan 65 mg/m2 intravenously on days 1 and 8+cisplatin 70 mg/m2 intravenously on day 1 every 3 weeks, or EP, composed of etoposide 100 mg/m2 intravenously on days 1, 2, 3+cisplatin 70 mg/m2 intravenously on day 1, every 3 weeks for a maximum of six cycles, until disease progression, or until unacceptable toxicity occurred. The primary endpoint was overall survival. RESULTS: A total of 362 patients were randomized to IP (n=173) and EP (n=189) arms. There were no significant differences between IP and EP arms for the median overall survival (10.9 months vs. 10.3 months, p=0.120) and the median progression-free survival (6.5 months vs. 5.8 months, p=0.115). However, there was a significant difference in response rate (62.4% vs. 48.2%, p=0.006). The pre-planned subgroup analyses showed that IP was associated with longer overall survival in male (11.3 months vs. 10.1 months, p=0.036), < 65 years old (12.7 months vs. 11.3 months, p=0.024), and Eastern Cooperative Oncology Group performance status 0/1 (12.4 months vs. 10.9 months, p=0.040) patient groups. The severity of treatment-related adverse events such as grade 3/4 anemia, nausea and diarrhea was more frequent in patients treated with IP. CONCLUSION: The IP chemotherapy did not significantly improve the survival compared with EP chemotherapy in Korean patients with extensive-disease SCLC.


Subject(s)
Anemia , Arm , Cisplatin , Diarrhea , Disease Progression , Disease-Free Survival , Drug Therapy , Etoposide , Humans , Lung Neoplasms , Male , Nausea , Small Cell Lung Carcinoma
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