Study on the Efficacy and Clinical Value of Aminophylline and Doxofylline in the Clinical Treatment of Chronic Obstructive Pulmonary Disease.

Objective: To study and compare the efficacy and clinical value of aminophylline and doxofylline in the clinical treatment of chronic obstructive pulmonary disease (COPD). Method: The study analyzed the clinical data of 92 patients with chronic obstructive pulmonary disease who received either aminophylline or doxofylline treatment in the hospital from January 2020 to June 2022. The patients were divided into a control group composed of 46 COPD patients who received aminophylline treatment and a study group composed of 46 COPD patients who received doxofylline treatment. The two groups' total effective rate and incidence of adverse reactions were compared. The serum inflammatory factor indicators, symptom scores, pulmonary ventilation function, arterial blood gas, chest and lung responsiveness, sleep status indicators, and quality of life scores of the two groups before and after treatment were compared. Results: At the end of treatment, the total effective rate was higher in the study group compared to the control group (P < .05). Regarding adverse reactions, the study group's total incidence was lower than the control group's (P < .05). After treatment, the levels of serum inflammatory factor indicators of CRP, PCT, and TNF- α in both groups were decreased compared with those before treatment; while comparing the above indicators between the groups, it was found that the values in the study group were lower (all P < .05). After treatment, the scores of symptoms such as cough, expectoration, and shortness of breath in both groups of patients were significantly lower than before treatment, while compared to the control group, the scores of all symptoms were lower in the study group (P < .05). After treatment, compared with FEV1, FEV1/FVC, PaO2, and PaCO2 before treatment, the above indicators in both groups were significantly improved. However, compared with various indicators in the control group, the values of FEV1, FEV1/FVC, and PaO2 in the study group were higher, while the values of PaCO2 in the study group were lower (all P < .05). After treatment, the measured values of indicators such as thoracic compliance, lung compliance, and total compliance in the two groups were significantly higher compared with those before the treatment, while compared to the control group, the values of all indicators in the study group were higher (P < .05). After treatment, compared with the control group's monitoring of various indicators of nighttime sleep, the study group obtained better data on monitoring of sleep latency and actual sleep duration. The group obtained lower scores in sleep quality evaluation, while the two groups significantly improved their sleep-related data in night-time monitoring and evaluation compared to those before treatment, with all P < .05. After treatment, the scores in various aspects of the quality of life of patients in both groups were significantly increased compared to those before treatment, and after comparing the scores of various quality of life between the two groups, it was found that the study group was higher than the control group (all P < .05). Conclusion: After the onset of COPD, doxofylline treatment can achieve better effects than aminophylline treatment.

Efficacy and safety of aripiprazole or bupropion augmentation and switching in patients with treatment-resistant depression or major depressive disorder: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: To report the first and largest systematic review and meta-analysis of randomized controlled trials (RCT) to evaluate the efficacy and safety of aripiprazole or bupropion augmentation and switching in patients with treatment-resistant depression (TRD) or major depressive disorder(MDD). METHODS: We conducted a systematic literature retrieval via PubMed, Embase, Web of Science, and Cochrane until April 2023 for RCT, which evaluated the efficacy and safety of aripiprazole or bupropion augmentation and switching for patients with TRD or MDD. Outcomes measured were changes in the Montgomery-Asberg Depression Rating Scale (MADRS), response and remission rate, and serious adverse events. RESULTS: Five RCTs, including 4480 patients, were included for meta-analysis. Among them, two RCTs were rated as "high risk" in three aspects (allocation concealment, blinding of participants and personnel and blinding of outcome assessment) because of the non-blind method, and the quality evaluation of the remaining works of literature was "low risk". Augmentation treatment with Aripiprazole (A-ARI) was associated with a significant higher response rate compared with augmentation treatment with bupropion (A-BUP) (RR: 1.15; 95% CI: 1.05, 1.25; P = 0.0007; I2 = 23%). Besides, A-ARI had a significant higher remission rate compared with switching to bupropion (S-BUP) (RR: 1.22; 95% CI: 1.00, 1.49; P = 0.05; I2 = 59%) and A-BUP had a significant higher remission rate compared with S-BUP (RR: 1.20; 95% CI: 1.06, 1.36; P = 0.0004; I2 = 0%). In addition, there was no significant difference in remission rate(RR: 1.05; 95% CI: 0.94, 1.17; P = 0.42; I2 = 33%), improvement of MADRS(WMD: -2.07; 95% CI: -5.84, 1.70; P = 0.28; I2 = 70%) between A-ARI and A-BUP. No significant difference was observed in adverse events and serious adverse events among the three treatment strategies. CONCLUSIONS: A-ARI may be a better comprehensive antidepressant treatment strategy than A-BUP or S-BUP for patients with TRD or MDD. More large-scale, multi-center, double-blind RCTs are needed to further evaluated the efficacy and safety of aripiprazole or bupropion augmentation and switching treatment strategies.

Forearm bone mineral density predicts screw loosening after lumbar fusion similar to lumbar Hounsfield unit value in patients with lumbar spondylolisthesis.

Preoperative bone density assessment is necessary to predict screw loosening. The forearm BMD is a useful predictor of BMD-related complications after lumbar operation. Our results show that the forearm BMD is as effective a predictor of screw loosening as the lumbar average HU value. Measurement of the forearm BMD may be a useful adjunct in predicting screw loosening following lumbar fusion. PURPOSE: To determine the relationship between forearm bone mineral density (BMD) and the risk of pedicle screw loosening in patients with lumbar spondylolisthesis. METHODS: We retrospectively evaluated 270 patients who underwent posterior lumbar interbody fusion for lumbar spondylolisthesis. The patients were divided into two groups on the basis of the with or without loose screws: the loosening group and the non-loosening group. The patient's gender, age, BMI, smoking and diabetes histories, and the operative segment were recorded as the basic information. The Hounsfield unit (HU) value for the BMD of the L1-4 lumbar was measured using computed tomography. The patient's distal one-third of the length of the radius and ulna of the non-dominant forearm was chosen as the site for dual-energy X-ray (DXA) bone density testing. RESULTS: The rate of screw loosening was 13% at a minimum 12 months follow-up. Average forearm BMD (0.461 ± 0.1 vs 0.577 ± 0.1, p < 0.001) and mean HU value (L1-4) (121.1 ± 27.3 vs 155.6 ± 32.2, p < 0.001) were lower in the screw loosening group than those in the non-loosening group. In multivariate logistic regression analysis, the forearm BMD (OR 0.840; 95%CI 0.797-0.886) and HU value (L1-4) (OR 0.952; 95%CI 0.935-0.969) were independent risk factor for screw loosening. The area under the curve (AUC) for the forearm BMD and HU value for prediction of pedicle screw loosening was 0.802 and 0.811. The forearm BMD cut-off for predicting pedicle screw loosening was 0.543 (sensitivity, 0.800; specificity, 0.864). CONCLUSIONS: The forearm BMD was an independent risk factor for loosening of the lumbar pedicle screws. The forearm BMD was a valid predictor of pedicle screw loosening in patients undergoing lumbar fusion, as was the CT HU value.

K-line tilt as a novel potential risk factor for cervical Modic change: a retrospective study.

BACKGROUND: Cervical sagittal parameters are important parameters that reflect the mechanical stress in the sagittal plane of the cervical spine and are an important basis for predicting the clinical status and prognosis of patients. Although it has been confirmed that there is a significant correlation between cervical Modic changes and some sagittal parameters. However, as a newly discovered sagittal parameter, there is no report on the relationship between the K-line tilt and the Modic changes of cervical spine. METHODS: A retrospective analysis was performed for 240 patients who underwent cervical magnetic resonance imaging scan for neck and shoulder pain. Among them, 120 patients with Modic changes, namely the MC(+) group, were evenly divided into three subgroups of 40 patients in each group according to different subtypes, namely MCI subgroup, MCII subgroup and MCIII subgroup. One hundred twenty patients without Modic changes were included in MC(-) group. We measured and compared the sagittal parameters of cervical spine among different groups, including K-line tilt, C2-C7 sagittal axial vertical distance (C2-C7 SVA), T1 slope and C2-7 lordosis. Logistic regression was used to analyse the risk factors of cervical Modic changes. RESULTS: The K-line tilt and C2-7 lordosis were significantly different between MC(+) group and MC(-) group (P < 0.05). The K-line tilt greater than 6.72° is a risk factor for Modic changes in cervical spine (P < 0.05). At the same time, the receiver operating characteristic curve showed that this change had moderate diagnostic value when the area under the curve was 0.77. CONCLUSION: This study shows that the K-line tilt greater than 6.72° is a potential risk factor for Modic changes in cervical spine. When the K-line tilt is greater than 6.72°, we should be alert to the occurrence of Modic changes. TRIAL REGISTRATION NUMBER: 2022ER023-1.

High expression of 14-3-3Æ¡ indicates poor prognosis and progression of lung adenocarcinoma.

Lung adenocarcinoma (LUAD) is one of the leading causes of cancer-related death worldwide. 14-3-3Æ¡ is an intracellular phosphoserine-binding protein that has been proposed to be involved in tumorigenesis. However, the biofunctional role of 14-3-3Æ¡ and its clinicopathological/prognostic significance in LUAD have remained elusive. In the present study, western blot and immunohistochemical analyses of cancer tissues/cells and the corresponding normal controls were performed to verify that 14-3-3Æ¡ was upregulated in LUAD. Univariate and multivariate logistic regression analysis indicated that high expression of 14-3-3Æ¡ predicted poor overall survival and progression-free survival of patients with LUAD. Furthermore, in vivo and in vitro experiments demonstrated that overexpression of 14-3-3Æ¡ markedly promoted cell proliferation, colony formation, anchorage-independent growth and tumor growth, whereas 14-3-3Æ¡ depletion produced the opposite effects. Of note, 14-3-3Æ¡ was identified as an independent prognostic factor for patients with LUAD. Collectively, the present results revealed that high expression of 14-3-3Æ¡ may serve as an independent biomarker, contributing to poor prognosis and progression of LUAD.

Connexin 43 affects thoracic ossification of ligamentum flavum by regulating the p38 MAPK-RUNX2 signaling pathway.

This study aimed to investigate the role of connexin 43 (CX43) in thoracic ossification of ligamentum flavum (TOLF) based on the p38 mitogen-activated protein kinase (p38MAPK)-runt-related transcription factor 2 (RUNX2) pathway. Immunohistochemistry was used to detect CX43 expression in TOLF and non-TOLF patients, fibroblasts of TOLF were isolated and induced osteogenic differentiation, and CX43 expression was detected by western blot analysis (WB). In addition, si-CX43 was used to intervene CX43, and SB203580 was used to inhibit the p38MAPK. The expressions of bone differentiation marker protein were detected by WB, and the ossification ability was analyzed by alizarin red staining. The interaction between RUNX2 and CX43 was identified by dual-luciferase reporter assay. Results found that CX43 was highly expressed during TOLF, and si-CX43 could inhibit the expression of alkaline phosphatase (ALP) and osteopontin (OPN), as well as inhibit TOLF and the p38MAPK-RUNX2 pathway. In addition, SB203580 showed a synergistic effect with si-CX43 to further inhibit TOLF and the expression of RUNX2. The dual-luciferase reporter assay confirmed that RUNX2 could bind to the CX43 promoter. In conclusion, CX43 promotes TOLF, which may be mediated by p38MAPK-RUNX2, and RUNX2 binds to the CX43 promoter to form a positive feedback regulatory loop during TOLF.

[Study on the safety and effectiveness of low-dose tranexamic acid in operation of multi-level continuous thoracic ossification of ligament flavum].

OBJECTIVE: To investigate the safety and effectiveness of low-dose tranexamic acid (TXA) in operation of multi-level continuous thoracic ossification of ligament flavum (TOLF). METHODS: A clinical data of 26 patients who underwent operation for multi-level continuous TOLF and met the selection criteria between July 2015 and January 2019 was retrospectively analyzed. Among them, 13 cases (group A) were received intravenous infusion of TXA (10 mg/kg) at 15 minutes before operation, and maintained the infusion at 1 mg/(kg·h) until the end of the operation; 13 cases (group B) were received the same dose of normal saline before and during operation. There was no significant difference in gender, age, body mass index, diseased segment, and preoperative hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, international normalized ratio (INR) between the two groups ( P>0.05). The hemoglobin, platelet count, activated partial thromboplastin time, prothrombin time, INR, the number of deep vein thrombosis of the lower extremities, operation time, intraoperative blood loss, postoperative drainage volume, total blood loss, and the time of drainage tube extubation in the two groups were recorded and compared. RESULTS: All operations in the two groups were successfully completed. Compared with group B, the operation time and time of drainage tube extubation in group A were shortened, and the intraoperative blood loss, postoperative drainage volume, and total blood loss were reduced. The differences between the two groups were significant ( P<0.05). None of the two groups received blood transfusion, and the hemoglobin level of group A at 24 hours after operation was significantly higher than that of group B ( t=5.062, P=0.000). The incisions in both groups healed and sutures were removed within 2 weeks after operation, and no complications occurred. There was no significant difference between the two groups in activated partial thromboplastin time, prothrombin time, INR, and platelet count at 24 hours after operation ( P>0.05). CONCLUSION: In multi-level continuous TOLF operation, intravenous administration of low-dose TXA can effectively reduce blood loss, shorten postoperative drainage time, and does not increase the risk of complications.

Preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced oral mucositis: A protocol for systematic review and meta analysis.

BACKGROUND: Oral mucositis (OM), one of the most common side effects for cancer patients who have undergone chemotherapy, can cause severe impairment to patients' functional ability and impact their quality of life, resulting in delayed and/or incomplete treatment. Traditional Chinese medicine offers empirical herbal decoctions to gargle for the prevention of chemotherapy-induced OM; however, evidence for its clinical efficacy and safety is lacking. Therefore, we provide a protocol to evaluate the preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced OM. METHODS: We will comprehensively retrieve relevant articles published till August 15, 2020, in the following electronic databases: the Cochrane Library, PubMed, EMBASE, Chinese National Knowledge Infrastructure Database, Chinese Biomedical Literature Database, Chinese Science and Technique Journals Database, and the Wan-fang Database. Only randomized controlled trials will be included. We will use the criteria provided by the Cochrane Handbook for quality assessment and risk assessment of the included studies and use the RevMan 5.3 software for meta-analysis of the preventive effect and safety. RESULTS: This study will assess the preventive effect and safety of Chinese herbal medicine mouthwash in chemotherapy-induced OM. CONCLUSION: This systematic review will provide evidence-based medical corroboration for the clinical application of the Chinese herbal medicine mouthwash in chemotherapy-induced OM. PROSPERO REGISTRATION NUMBER: CRD42020206614.

Efficacy of low molecular weight heparin for chronic obstructive pulmonary disease and respiratory failure: A protocol of systematic review of randomized controlled trials.

BACKGROUND: Evaluating the efficacy and safety of low molecular weight heparin (LMWH) for patients with chronic obstructive pulmonary disease (COPD) and respiratory failure (RF) is a major purpose of this study. METHODS: The following electronic databases will be comprehensively retrieved from the inception to July 1, 2019: Cochrane Library, PUBMED, EMBASE, Google Scholar, Web of Science, Allied and Complementary Medicine Database, WANGFANG, and China National Knowledge Infrastructure without language restrictions. All randomized controlled trials related to LMWH for COPD and RF will be included. Two authors will carry out study selection, data collection, and risk of bias assessment independently. RESULTS: This study will systematically explore the efficacy and safety of LMWH for COPD and RF. The primary outcome is lung function. The secondary outcomes are severity of dyspnea on exertion, quality of life, body mass index, airflow obstruction; and any expected and unexpected adverse events. CONCLUSION: The findings of this study will provide evidence to judge whether LMWH is an effective treatment for patients with COPD and RF. PROSPERO REGISTRATION NUMBER: PROSPERO CRD42019 139631.

Efficacy of urapidil for the treatment of patients with senile hypertension and acute heart failure.

BACKGROUND: Previous clinical studies have reported that urapidil can effectively treat patients with senile hypertension (SH) and acute heart failure (AHF). However, no studies have systematically assessed the efficacy and safety of urapidil for patients with SH and AHF. Thus, this study will investigate the efficacy and safety of urapidil for SH and AHF. METHODS: In this study, we will search the following electronic databases from inception to the June 30, 2019: MEDLINE, EMBASE, Cochrane Library, Google scholar, Springer, WANGFANG, and China Knowledge Resource Integrated Database. We will search all these electronic databases without language limitations. We will also search grey records to avoid missing potential literature. In this study, only randomized controlled trials on assessing efficacy and safety of urapidil for SH and AHF will be considered. We will use RevMan 5.3 software and STATA 15.0 software to carry out statistical analysis. RESULTS: This study will evaluate the efficacy and safety of urapidil for SH and AHF by assessing all-cause mortality, change in body weight, urine output, change in serum sodium; and incidence of all adverse events. CONCLUSION: This study will provide latest evidence of the efficacy and safety of urapidil for patients with SH and AHF. DISSEMINATION AND ETHICS: This study will only analyze published data; therefore, no ethical approval is needed. The findings of this study will be published at peer-reviewed journals. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019139344.

Cervical epidural hematoma after spinal manipulation therapy: a case report.

BACKGROUND: Cervical spinal manipulation therapy is a common non-invasive treatment for neck pain and stiffness, and has been widely used in the population. However, most people do not pay attention to the potential risks of neck manipulation, such as ligament damage, fractures, and spinal cord injuries. Epidural hematoma is a disease in which blood accumulates in the epidural space of the vertebral body. This disease is usually caused by trauma or iatrogenic surgery, and may be associated with blood coagulopathies, neoplasms, or degenerative spinal disease. Reports of epidural hematoma caused by cervical spinal manipulation are rare. CASE PRESENTATION: We present the case of a patient with tetraplegia and spinal shock after neck manipulation. A physical examination of the patient on admission found tenderness in the neck and increased muscle tension in both upper limbs. The superficial sensation of the upper limb disappeared, but the deep sensation still remained. The lower extremity had 0/5 power on both sides. The sensation below the T2 level completely disappeared. A cervical magnetic resonance imaging scan showed an acute posterior epidural hematoma from the C3-T3 vertebrae. Ultimately, the patient underwent emergency hematoma removal and showed partial improvement in symptoms of paralysis during follow-up. CONCLUSIONS: Although spinal manipulation is simple and neck pain is common and recurrent in the general population, the basic condition and disease history of patients should be determined before manipulation. For high-risk patients, caution should be applied for cervical spinal manipulation or it should be prohibited. For a suspected hematoma, MRI should be used at an early stage to diagnose and locate the hematoma.

Efficacy of methylprednisolone for treatment of persistent vertigo.

BACKGROUND: This study will systematically investigate the efficacy and safety of methylprednisolone for treatment of persistent vertigo (PV). METHODS: All following electronic databases will be searched from inception to the June 30, 2019 without language restrictions: MEDILINE, EMBASE, Cochrane Library, Web of Science, and Chinese Biomedical Literature Database. All randomized controlled trials focusing on assessing the efficacy and safety of methylprednisolone for patients with PV will be fully considered for inclusion. Cochrane risk of bias tool will be used for assessing methodological quality, and RevMan 5.3 software (Cochrane Community, London, UK) will be utilized for statistical analysis. RESULTS: This study will assess the efficacy and safety of methylprednisolone for PV via assessing primary outcome of vertigo, and secondary outcomes of somatization, depression, anxiety, health-related quality of life, and adverse events. CONCLUSION: This study will provide a high-quality evidence to judge whether methylprednisolone is an effective and safety therapy for patients with PV. DISSEMINATION AND ETHICS: No individual data will be utilized in this study, thus, it does not need ethical approval. The results of this study will be published at peer-reviewed journals. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019138890.

A retrospective study of concurrent radiotherapy plus S-1 for treating advanced non-small cell lung cancer.

We investigated the efficacy of concurrent radiotherapy plus S-1 (CRS) for treating unresectable stage III advanced non-small-cell lung cancer (ANSCLC).Seventy five ANSCLC patients were included in this retrospective study. Of those, 40 patients were assigned to an intervention group, and received S-1 (orally at 40 mg/m) twice daily for 14 consecutive days. Then, concurrent radiotherapy was administered in 2 Gy fractions, 5 times weekly for a total dose of 60 Gy. The other 35 patients were assigned to a control group, and underwent concurrent radiotherapy (the same as the intervention group) and cisplatin (60 mg/m on day 1 (CRC). The outcome measurements included overall response rate (ORR), overall survival (OS), progression-free survival (PFS), and toxicity.The 3-year ORR was 60.7% and 43.9% for intervention group and control group, respectively (P = .031). The median OS was 34.1 months and 25.3 months in the intervention and control groups, respectively (P = .041). The median PFS was 31.5 months for intervention group, while it was 22.4 months for control group (P = .048). No significant difference in toxicity was found between the 2 groups.The results demonstrated that the efficacy of CRS was superior to the CRC in ANSCLC patients with similar toxicity.

Efficacy of budesonide/formoterol and tiotropium combination for the treatment of Chinese patients with chronic obstructive pulmonary disease.

This study investigated the efficacy and safety of budesonide/formoterol (B/F) and tiotropium combination in the management of chronic obstructive pulmonary disease (COPD) in Chinese patients.Between January 2015 and November 2017, 113 eligible Chinese patients with COPD were included and divided into an intervention group and a control group. Sixty-three patients in the intervention group underwent B/F combined tiotropium, while 50 patients in the control group received tiotropium alone. The primary outcome was severity of dyspnea on exertion (DOE), measured by the 6-minute walk test (6MWT) scale. The secondary outcomes included lung function, measured by the forced expiratory volume in 1 second (FEV1), quality of life, measured by the St. George's Respiratory Questionnaire (SGRQ), and adverse events. All outcomes were measured at the end of 12-week treatment.B/F and tiotropium combination showed greater efficacy in DOE (P < .01), lung function (P < .01), and quality of life (P < .01), compared with tiotropium alone at the end of 12-week treatment. In addition, adverse events in both groups were similar and tolerable.The findings suggest that B/F and tiotropium combination can be used as an effective treatment in Chinese patients with COPD.

Acupuncture for chronic obstructive pulmonary disease (COPD): A multicenter, randomized, sham-controlled trial.

BACKGROUND: Acupuncture has been suggested to treat chronic obstructive pulmonary disease (COPD) in China. However, current evidence is insufficient to draw a firm conclusion regarding the effectiveness of acupuncture in COPD. Therefore, this multicenter, randomized, sham-controlled study was designed to evaluate the efficacy of acupuncture for treating patients with COPD. METHODS: This is a two-arm, parallel group, multicenter, randomized, sham-controlled trial with concealed allocation, and participants, assessor, and analyst blinding. Seventy-two participants with COPD were recruited and randomly divided into 2 groups (real acupuncture group and sham acupuncture group) in a 1:1 ratio. Patients received either real or sham needling at the same acupoints 3 times weekly for 8 weeks. The primary outcome was dyspnea on exertion evaluated using the 6-minute walk test. In addition, health-related quality of life was also evaluated. Measurements were obtained at baseline and after 8 weeks of treatment. RESULTS: Six-minute walking distance measurements and health-related quality of life were significantly better in the real acupuncture group than that in the sham acupuncture group. CONCLUSION: The findings suggest that acupuncture can be used as an adjunctive therapy to reduce dyspnea in patients with COPD.

S-1 plus cisplatin with concurrent radiotherapy versus cisplatin alone with concurrent radiotherapy in Chinese patients with nonsmall-cell lung cancer: A multicentre randomized controlled trial.

BACKGROUND: The aim of this study was to investigate the efficacy and safety of S-1 plus cisplatin combined with concurrent radiotherapy (SCCCR) versus cisplatin alone combined with concurrent radiotherapy (CCCR) in Chinese patients with unresectable stage III nonsmall-cell lung cancer (NSCLC). METHODS: Between January 2012 and December 2014, 72 eligible Chinese patients with NSCLC were included and randomly divided into 2 groups, each having 36 patients. Patients in the SCCCR group received S-1 plus cisplatin with concurrent, radiotherapy. The other 36 patients in the CCCR group were administered cisplatin with concurrent radiotherapy. The primary outcome was the overall response rate. The secondary outcomes were overall survival (OS), progression-free survival (PFS), and adverse events. RESULTS: The 3-year overall response rates for the SCCCR and CCCR groups were 60.1% and 53.3%, respectively (P = 0.041). The median OS was 35.1 (range, 6.5-47.2) months and 24.6 (range, 2.8-24.3) months for the SCCCR and CCCR groups, respectively (P = 0.016). The median PFS for the SCCCR and CCCR groups was 31.4 (range, 5.6-39.3) months and 22.3 (range, 2.4-36.5) months, respectively (P = 0.023). The toxicity profiles were similar for both groups. CONCLUSION: The efficacy and safety of SCCCR was more encouraging compared to those of CCCR in Chinese NSCLC patients. In addition, the toxicities in both groups were tolerable.