Comparing docetaxel plus cisplatin with paclitaxel plus carboplatin in chemotherapy-naive patients with advanced non-small-cell lung cancer: a single institute study

The backbone of treatment in advanced non-small cell lung cancer is platinum-based doublet chemotherapy. We intended to compare the effectiveness of two commonly used regimens in real world practice. This single institute, parallel comparative post marketing study included 100 patients with chemo-naTve advanced [stage IIIB, IV] non-small cell lung cancer and Eastern Cooperative Oncology Group performance status of 0 to 2. They were randomly assigned by stratified blocks to receive Docetaxel/ Cisplatin [DC, n=50] on day 1 or Paclitaxel/Carboplatin AUC 5 [PC, n=50] on day 1, every 3 weeks for up to six cycles. Primary end point was progression free survival [PFS]; secondary end points were objective response rate, overall survival [OS] and toxicity. The administered dosage could be modified according to clinician's discretion for each individual patient. PFS was similar between DC and PC arms [4.5 +/- 0.3 v 4.6 +/- 1.8 months, respectively; HR= 1.337; 95% CI: 0.874 to 2.046, P = 0.181]. Although median overall survival for DC arm was longer [17.2 +/- 4.4 m] than PC arm [10.6 +/- 0.7 m] but was not statistically significant [P = 0.300]. The 1-year survival rates were in favor of DC arm [53.1% v 37.9%]. Objective response rates were similar in both groups. In our study, hematologic toxicity and neuropathy were more frequent in DC and PC arms, respectively. In our study two commonly used regimens of DC and PC showed statistically similar outcomes in terms of PFS and OS, albeit numerically results of OS and 1-year survival were in favor of DC arm

Relationship between XPD Lys 751 Gln polymorphism and colorectal cancer risk: a case-control study in a population-based study

In our study, we analyzed the allelic frequency of XPD Lys751Gln polymorphism of the XPD gene and the correlation between its variant alleles with colorectal cancer in patients and control groups. Human cells are routinely exposed to mutagenic and carcinogenic aromatic amines via smoking, pollution areas and other sources. These chemicals can form DNA adducts in vivo and thus lead to DNA damage. Amongst the known genetic polymorphisms of the DNA-repair genes the xeroderma pigmentosum group D [XPD, also known as ERCC2] has been the most extensively studied most commonly. This study has examined the relationship between the XPD Lys 751 Gin polymorphism and colorectal cancer in 88 patients and their 88 age and sex-matched controls. Genomic DNA from peripheral whole blood was extracted using Miller method to determine the genotype of subjects with RFLP-PCR analysis. This study shows cancer patients have more of the heterozygous genotype [XPD Lys 751 Gin] compared to control group. However the results are not statistically significant. Furthermore, colorectal cancer was less common in individuals with recessive homozygous genotype [P< 0.0001]. This study suggests that individuals with heterozygous polymorphism [Lys/Glri] may have an increased susceptibility to colorectal cancer compared to other polymorphisms [Lys/Lys and Gin/Gin]

Primary anaplastic large cell lymphoma of trachea with subcutaneous emphysema and progressive dyspnea

Primary anaplastic large cell lymphoma of the trachea is a rare tumor. Common complaints are dyspnea and cough that could mimic a partially refractory asthma in some cases. We report a 16-year-old female with an anaplastic large cell lymphoma [null cell type] in which tracheal involvement was presented with life-threatening airway obstruction and subcutaneous emphysema. After debulking the tumor by endobronchial curettage, the patient was treated with chemotherapy followed by local radiotherapy. She had no evidence of local or distant recurrence after 25 months. Primary anaplastic large cell lymphoma of the trachea is a rare life-threatening disease. Nevertheless, this condition has a good prognosis if diagnosed immediately and treated with chemotherapy and radiotherapy

Conventional giant cell tumor of the rib with pulmonary metastases: a case report and review of literature

We report a 25-year-old female with a giant cell tumor originating from the anterior arc of the rib who presented with bilateral pulmonary metastases. She underwent extensive resection of the thoracic wall, attached right middle lobe and right upper lobe metastases. She was treated with Interferon-alpha-2b [INF] followed by systemic chemotherapy. After 23 months, she had no complaint and no significant disease progression was detected through imaging studies

Inflammatory myofibroblastic tumor of the lung: case series

Inflammatory myofibroblastic tumor is a rare occurrence in general practice. Its biologic nature, natural history and response to different treatment modalities are obscure. We retrospectively reviewed clinical and pathological features of 5 patients with inflammatory myofibroblastic tumor of the lung observed between 1999 and 2006. Under-study patients were 3 women and 2 men with a median age of 32.6 years. All patients were symptomatic. Computed tomography [CT] scan demonstrated a mass in all cases. Four patients underwent surgery [tumor resection in 1, lobectomy in 1, bilobectomy in 1 and lobectomy with mediastinal mass debulking also in 1]. Complete resection was achieved in 2 patients who are currently alive with no evidence of disease. One died due to progressive disease. Another is alive with disease after incomplete resection, and one refused any kind of surgery. There was no operative mortality. All patients were under follow-up [range, 5 to 60 months; median 39 months]. This study illustrates that some inflammatory myofibroblastic tumors behave aggressively and have a poor prognosis. It also confirms that radical resection is the treatment of choice for this malignancy

clinicopathologic study of lung cancer cases in Iran

Lung cancer remains the leading cause of cancer-related deaths in the world. In Iran, lung cancer is the fifth leading cancer and its prevalence rate has been increasing steadily. In this study, the clinicopathological aspects of lung cancer are discussed. Between October 2002 and November 2005, 242 [178 men, 64 women] patients with histologically confirmed lung cancer were interviewed according to a questionnaire. Women developed the disease at an earlier age than men [55.9 +/- 14.2 versus 61.3 +/- 12.3 years; p=0.004]; 66.5% of lung cancer patients [85.4% of men and 14.1% of women] were smokers [p<0.0001]; 76.3% of participants, who had exposure to secondhand smoke, were females. Among the environmental carcinogens, the most exposures were to inorganic dusts [49.8%] and chemical compounds [34.9%].Most male and female patients suffered from adenocarcinoma [28.9%] and non small cell carcinoma [28.5%]. The prevalence of adenocarcinoma was higher in the non-smoker group, whereas incidence of squamous cell carcinoma and small cell carcinoma was higher among smokers [p<0.0001]. In this study, most patients [74.0%] presented with an advanced-stage tumor [IIIB or IV]. Our results suggest that in addition to cigarette smoking, other environmental, occupational and socioeconomic factors may play a role in the development of lung cancer

Solitary fibrous tumor of the pleura: a case report and review of the literature

Solitary fibrous tumor of the pleura [SFTP] is a rare mesenchymal cell tumor that can be benign or malignant. The best treatment of this tumor is a complete surgical resection. We present clinical and histopathologic characteristics of the 4 patients and their outcomes

Phase II trial of celecoxib in combination with paclitaxel and carboplatin in advanced non-small cell lung cancer

Prostaglandins [PGs] can enhance tumor growth and metastasis by stimulating angiogenesis and invasiveness, in addition to apoptosis and immune surveillance. Microtubule-interfering agents induce cyclooxygenase-2 [COX-2] and PG biosynthesis and this might reduce the efficacy of paclitaxel. Preclinical studies suggest that treatment with a selective COX-2 inhibitor may augment the antitumoral effects of chemotherapy. Thus, we designed a phase II trial to evaluate the efficacy of the combination of paclitaxel, carboplatin and celecoxib in advanced non-small cell lung cancer. Thirty-seven patients were enrolled in this trial. The inclusion criteria were: chemotherapy-na‹ve advanced NSCLC [non-resectable locally advanced stage IIIA, stage IIIB and IV], age > 18 yrs. and performance status [PS] of 0-2 [ECOG]. All patients were given paclitaxel [200 mg/m[2]] and carboplatin [AUC 6] on day 1, every 21 days and celecoxib [400 mg] daily. Most of the patients were male and the mean age was 58 yrs. Old. Performance status 0, 1, and 2 were 8.2%, 40.5% and 51.3%, respectively. Four patients were in stage IIIA [10.8%], 12 patients in stage IIIB [32.4%] and 21 [56.8%] in stage IV. The overall response rate was 54%. Time to progression and median overall survival were 5.7 and 9 months, respectively. Only one patient had grade 3 anemia. There was no grade 4 cytotoxicity. Three patients had cytotoxic drug allergy. Based on this study, adding 400 mg celecoxib to the standard regimen [paclitaxel plus carboplatin] does not enhance time to progression and overall survival compared to historical data. Thus, we recommend combining higher dosage of celecoxib with other targeted agents in phase I/II trials

Pulmonary carcinoid tumor

Pulmonary carcinoid tumor is a low-grade malignant neoplasm comprised of neuroendocrine cells. The aim of this study was to determine the clinical features; radiological and bronchoscopic findings, as well as treatment in patients. Material and Method: The hospital records of 21 patients with pulmonary carciniod tumor, who admitted to NRITLD between 1995 and 2001, were evaluated. 19 patients had typical and 2 had atypical carcinoid tumor. Male to female ratio was 1.1. The mean age

Echocardiographic evaluation in mediastino-pulmonary malignancy

As any cardiac involvement may worsen the prognosis of mediastino-pulmonary tumors, this study was designed to evaluate the function and anatomy of heart by ehocardiography in this group of patients. Medical records of 76 patients were reviewed for age, sex, type of malignancy, and cardiac consultation report. The patients underwent transthoracic echocardiography. Moreover, descriptive statistical methods were used for data analysis. The study population included 58 males and 18 females, with the mean [

Infantile histiocytosis X: Case reoprt

Langerhans cell histiocytosis [LCH] is a disease of unknown etiology that presents in three forms: Letterer- Siwe disease, Hand-Schuller-Christian disease, and Eosinophilic Granuloma. It is a multifocal disease that usually affects several organs and unifocal forms are rare. Pulmonary involvement occurs in approximately 40% of cases and almost always in young adults. Lungs are rarely affected in infant patients. This report presents a 15-month-old male infant that was admitted for cyanosis and respiratory distress. Diagnostic work up revealed a primary pulmonary histiocytosis and the treatment made a significant improvement of signs and symptoms by the time of discharge