Comparison of two palliative regimens of radiation on the quality of life in metastatic non small cell lung cancer

Background: Lung cancer is one of the most common cancers in males worldwide and its number is increasing every year. Of these cases 75-80% case are of non-small cell type. Methods: This study was conducted on 30 patients of stage IV non-small cell lung cancer in the department of radiation oncology at tertiary care center, Shimla, Himachal Pradesh India from 1st Jun 2019 to 30th Jun 2020 by dividing them into study and control arm for assessing quality of life (QOL) with EORTC QLQ-C30 version3.0. Results: We observed significant improvement in Global health scale of control arm (p=0.005) but it got worse in study arm (p=0.743). All the parameters of Functional scale i.e. Physical (p=0.584; 0.170), Role (p=0.213; 0.016), Emotional (p=0.239; 0.002), Cognitive (p=0.793; 0.247) and Social functioning (p=0.030; 0.231) got worse in study arm while they improved in control arm. As far as Symptom scale is concerned, in the study arm; dyspnea (p=0.724), appetite (p=0.836), constipation (0.192), diarrhea (p=0.341) improved but other symptoms like fatigue (p=0.566), nausea (p=0.347), pain (p=0.305), insomnia (p=0.025), financial difficulties (p=0.082) got worse while in control arm; fatigue (p=0.003), pain (p=0.000), dyspnea (p=0.022), insomnia (p=0.336), appetite (p=0.028), constipation (0.019), diarrhea (p=0.336), financial difficulties (p=0.336) improved and nausea (p=0.120) got worse. Conclusion: QOL assessment by the physician before commencement of the treatment and later on at every visit seems to be beneficial for symptom relief and to allay the anxiety of both patient and their attendants.

Indication and advances of extended resection of locally advanced lung cancer / 中国癌症杂志

Lung cancer causes the highest number of cancer-related death in China. Complete surgical resection is currently the best treatment modality for lung cancer. However, only one third of patients with lung cancer can be identified as candidates for operation. The other two thirds are inoperable, because they have late disease with distant metastasis or locally advanced lung cancer involving neighboring organs. Recently introduction of the theory and technique of cardiovascular surgery into lung cancer surgery has made possible en bloc resection of the lung combined with part of the involved left atrium, aorta, superior vena cava, and pulmonary artery. It has made possible for the patients with locally advanced lung cancer, who were thought as surgical contraindication or incurable cases, to not only have complete resection of the tumor, but also achieved long term survival and good life quality without evidence of recurrence and distant metastasis of the cancer.This paper will provide a brief background at the progression of surgical theory and technology of locally advanced lung cancer in China. Besides, the indication, present methods, results of surgical management and multimodality treatment for locally advanced lung cancer, including extended resection and reconstruction of superior vena cava, left atrium, aorta and pulmonary artery will be presented. Finally, the perioperative management for the extended resection of locally advanced lung cancer will also be discussed.