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CT guided FNAC is a simple and safe procedure of diagnostic value in patients with lung lesionssuspected to have lung malignancy. We undertook a study on 41 patients and were able to diagnose/rule out malignancy in 85.37% of these patients, while in 14.63 % of patients the smears were nondiagnostic. Once malignancy was diagnosed in these patients, then the next most important step wasto categorize the lesions. 44% of patients had squamous cell carcinoma, 12.12 % had adenocarcinoma,9.75% had small cell carcinoma, 7.31 % had poorly differentiated carcinoma, 4.87% each hadmetastasis & tuberculosis and 2.43% had aspergillosis. Squamous cell carcinoma was the commonestsubtype in our study, which is contrary to changing trends in incidence of lung carcinoma whereadenocarcinoma has replaced squamous cell carcinoma as the commonest lung malignancy. Threeof our patients had minor complication in the form of mild pneumothorax, and it resolved in all patientswithin 24 hours.
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Objective To evaluate the high?risk factors for brain metastases after prophylactic cranial irradiation ( PCI), and to provide a basis for personalized treatment. Methods A retrospective analysis was performed in 188 patients with limited?stage small?cell lung cancer who received PCI in our hospital from 2005 to 2010. The Kaplan?Meier method was used to calculate the cumulative rate of brain metastases. The log?rank test and the Cox model were used for the univariate and multivariate analyses of the potential factors for the cumulative incidence of brain metastases, respectively. Results In the 188 patients, 31 ( 16?5%) had brain metastases. The 1?, 2?, and 3?year cumulative incidence rates of brain metastases were 4%, 15%, and 20%, respectively. The univariate analysis showed that staged Ⅲ disease before treatment, elevated levels of tumor markers, incomplete remission after chemoradiotherapy, and local?regional relapse were risk factors for high incidence of brain metastases ( P= 0?044, 0?037, 0?005, 0?007) . The multivariate analysis revealed that incomplete remission after chemoradiotherapy and local?regional relapse after chemoradiotherapy were risk factors for high incidence of brain metastases after PCI ( P= 0?003, 0?040 ) . Conclusions Patients with incomplete remission or local?regional relapse after chemoradiotherapy have high incidence of brain metastases after PCI. For those patients, a frequent follow?up of the central nervous system plus salvage cranial irradiation might provide an alternative to PCI.
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Objective: A retrospective study was performed to compare the efficacy and adverse effects between NIP regimen (navelbine + ifosfamide + cisplatin) and EP regimen (etoposide+cisplatin) as the first-line treatment of advanced combined small-cell lung cancer. Methods: A retrospective study was performed in 167 patients with advanced combined small-cell lung cancer (stages III-IV) eligibly enrolled between January 2006 and December 2010. These patients received NIP regimen (n = 76) or EP regimen (n = 91) as the first-line treatment of advanced combined small-cell lung cancer. All the patients received 2-6 cycles of chemotherapy, and the response was evaluated every two cycles. The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (FPS), objective response rate (ORR) and adverse effects. Results: There was no significant difference in ORR between the NIP group (28.9%, 22/76) and the EP group (40.7%, 37/91) (P = 0.115). The median PFS of the EP group was little longer than that of the NIP group (6.5 vs 5.8 months, P = 0.177). The median survival and one-year survival rates of the NIP group and the EP group were 9.8 months and 35.6% (27/76), and 10.8 months and 49.4% (45/91), respectively; the EP regimen exerted a better survival benefit than the NIP regimen, but it failed to reach a statistical difference (P = 0.883; P = 0.090). The adverse effects of the two regimens could both be well tolerated. The rates of grade I/II leucopenia and alopecia for the NIP regimen were both significantly higher than those for the EP regimen (32.9% vs 11.0%, P <0.001; 35.5% vs 13.2%, P <0.001). Conclusion: The ORR, PFS and OS for NIP regimen are little inferior to those of EP regimen as the first-line treatment of advanced combined small-cell lung cancer, but the differences are not significant. The toxicity of NIP regimen is less tolerable as compared with EP. Thus, the role of NIP regimen in the first-line treatment of advanced combined small-cell lung cancer need to be further comfirmed. Copyright© 2012 by TUMOR.