Impact of TNM staging and treatment mode on the prognosis of non-small cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the impact of TNM staging and combined treatment mode on the survival of non-small cell lung cancer (NSCLC) patients.</p><p><b>METHODS</b>From January 1997 to December 2002, 987 NSCLC patients were surgically treated in this hospital. Of those, 574 received combined modality therapy (surgery + chemotherapy/radiotherapy), while 413 underwent operation alone. Their clinicopathological data were retrospectively analyzed.</p><p><b>RESULTS</b>The 1-, 3-, 5-, and 10-year overall survival rates were 87.7%, 57.5%, 54.6% and 54.5%, respectively, for the whole group, which were 90.6%, 57.5%, 54.3% and 54.1% for the combined therapy group versus 83.8%, 57.6%, 55.2% and 55.2% for the group treated by surgical resection alone. The 1-year survival rate of the combined therapy group was significantly higher than that of the surgical resection alone group (90.6% vs. 83.8%) (P<0.01). With regard to the T factor, 5-year survival rate of the combined therapy group (surgery + radiotherapy) was higher than that of surgery alone group, especially in T4 cases (43.6% vs. 12.7%), with a significant difference between them (P<0. 05). As for the N factor, the 1-year survival rate of NO patients in the combined therapy group (surgery + chemotherapy/radiotherapy) was significantly higher than that of surgery alone group (94.4%, 97.9% vs. 90.0%) (P<0.05). The 1-year survival rate of N1 patients in the combined therapy group (surgery + chemotherapy or + chemotherapy and radiotherapy) was 91.7% and 100% versus 82.9% in the surgery alone group (P<0.01); The 1- and 3-year survival rates of N2 patients in the combined modality therapy group (surgery + chemotherapy) were 82.1% and 37.3%, while those of the surgery alone group were 69.4% and 26.5%, respectively, with a significant difference (P<0.05, P<0.01). All the severity of primary tumor, distance of lymph node involvement, and distant tumor metastasis significantly worsen the prognosis of the patients.</p><p><b>CONCLUSION</b>The prognosis in NSCLC patients treated with combined modality therapy (surgery + chemotherapy/radiotherapy) is better than that with surgery alone. The larger the original tumor and the farther the lymph node and tumor metastases, the worse the prognosis is for NSCLC patients.</p>

Second-line Hycamtin in the treatment of lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To discuss the therapeutic effect and toxicity of second line Hycamtin for lung cancer patients.</p><p><b>METHODS</b>Ten of these 21 patients had been treated with operation. All these 21 patients received second line Hycamtin treatment; given at the dose of 1.2 mg/m(2) per day, four consecutive days as one cycle and 21 days as one course. A total of 1 - 4 courses were given according to the patient's tolerance. Four of these 21 patients also received combination of cisplatin.</p><p><b>RESULTS</b>Among the 13 un-operated patients, two patients showed CR, six showed PR, three SD and two PD, giving an effective rate of 62%. Among the 8 operated patients, seven showed SD but one developed distant metastasis. The 1-year survival rate was 88%.</p><p><b>TOXICITY</b>leukopenia I-II degree 14 (66.7%), leukopenia III-IV degree 5 (23.8%), thrombocytopenia III-IV degree 1 (4.8%) and one patient died of high fever and neutocytopenia. Nausea 8 (38.1%), vomiting 3 (14.3%) and diarrhea 2 (9.5%) alopecia 4 (19.1%). Were the other side-effects.</p><p><b>CONCLUSION</b>Hycamtin is indicated for second line therapy for lung cancer giving tolerable toxicity.</p>