Der Einfluss des Alters auf die Morbidität und Mortalität bei operablen Lungenkrebspatienten im Stadium I

2019 ◽  
Vol 7 (3) ◽  
pp. 142-143
Author(s):  
Khosro Hekmat

Die vorliegende Studie befasst sich mit dem Einfluss des Alters auf die postoperative Morbidität und Mortalität nach Lungenresektion bei Patienten mit einem nicht kleinzelligen Bronchialkarzinom (non-small cell lung carcinoma, NSCLC) im Stadium I. Am Sloan Kettering Cancer Center (USA) wurden in den Jahren 2000-2011 insgesamt 5371 Patienten einer Lungenresektion unterzogen. 2186 Patienten befanden sich im Stadium I eines NSCLC und wurden in die Studie eingeschlossen. Die multivariate Analyse zeigte, dass die Lungendiffusion (DLCO) ein unabhängiger Prädiktor für die Morbidität, Einjahresmortalität und nicht krebsspezifische Mortalität war. Im Gegensatz dazu war die Einsekundenkapazität (FEV1) ein signifikanter Risikofaktor für die krebsspezifische Mortalität. Die vorliegende Studie zeigt die Relevanz der präoperativen Lungenfunktion mit Bestimmung der DLCO und FEV1. Bei älteren Patienten mit Lungenresektion im Stadium I eines NSCLC ist die nicht krebsspezifische Sterblichkeit in der Frühphase nach der Operation bedeutsam.

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18013-18013
Author(s):  
S. J. Feigenberg ◽  
J. Q. Yu ◽  
T. Eade ◽  
M. Buyyounouski ◽  
L. Wang ◽  
...  

18013 Background: Given the success of Stereotactic Body Radiotherapy (SBRT) for Non-Small Cell Lung Carcinoma (NSCLC), early surrogates of local failure (LF) are necessary to allow timely surgical salvage. This study tries to determine the utility of PET response as an early surrogate for LF. Methods: Eligible patients(pts) had biopsy proven NSCLC < 5 cm in size who underwent a pre- and post- SBRT PET scans. Pts treated at Fox Chase Cancer Center were either: 1. early stage (10 pts), 2. biopsy-proven local recurrences (4 patients) or 3. oligometastases (3 patients). Eleven of the 17 pts were treated on a prospective phase I dose escalation protocol and received either 40 Gy or 48 Gy in 4 fractions over 8 days. Non-protocol pts generally received 48 Gy in 4 fractions (5 of 6 pts). Treatment volumes were individualized for each pt using either 4 D or multi-phase CT simulation. As part of the prospective study design, PETs scan was obtained pre- and post-SBRT to correlate metabolic response with LF based on the work by MacManus. The post-SBRT PET scan was obtained at a median of 3 months following treatment (range, 2 to 6 months). LF was defined by my an increase in size on CT on serial imaging. Results: With a median follow up of 14 months (range 4 to 31 months), 3 LF have been documented. The median SUV max pre-SBRT was 4.7 (range 1.32 to 18.2) and 1.9 (range 0.9 to 7.0) post-SBRT. Only four pts had a post-SBRT SUV max > 2.5 (2.8, 5.1, 5.3 and 7). Overall, twelve pts had a drop in their SUV max following SBRT, while 1 pt had stabilization and 4 had an increase . Of these last 5 pts, 3 developed LF. The other two have been followed without any intervention and remain free of recurrence for > 2 years, respectively. No pt with an initial drop in post SBRT PET scan SUV has had LF. Conclusions: PET response (defined as a drop in the SUV max by 3 months) correlates with LF, and appears to be a good early surrogate of outcomes following SBRT. Larger studies are required to confirm this finding. No significant financial relationships to disclose.


2015 ◽  
Vol 3 (2) ◽  
pp. 47 ◽  
Author(s):  
Duygu Unalmış ◽  
Zehra Yasar ◽  
Melih Buyuksirin ◽  
Gulru Polat ◽  
Fatma Demirci Ucsular ◽  
...  

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 247-254 ◽  
Author(s):  
Jason Sheehan ◽  
Douglas Kondziolka ◽  
John Flickinger ◽  
L. Dade Lunsford

Object. Lung carcinoma is the leading cause of death from cancer. More than 50% of those with small cell lung cancer develop a brain metastasis. Corticosteroid agents, radiotherapy, and resection have been the mainstays of treatment. Nonetheless, median survival for patients with small cell lung carcinoma metastasis is approximately 4 to 5 months after cranial irradiation. In this study the authors examine the efficacy of gamma knife surgery for treating recurrent small cell lung carcinoma metastases to the brain following tumor growth in patients who have previously undergone radiation therapy, and they evaluate factors affecting survival. Methods. A retrospective review of 27 patients (47 recurrent small cell lung cancer brain metastases) undergoing radiosurgery was performed. Clinical and radiographic data obtained during a 14-year treatment period were collected. Multivariate analysis was utilized to determine significant prognostic factors influencing survival. The overall median survival was 18 months after the diagnosis of brain metastases. In multivariate analysis, factors significantly affecting survival included: 1) tumor volume (p = 0.0042); 2) preoperative Karnofsky Performance Scale score (p = 0.0035); and 3) time between initial lung cancer diagnosis and development of brain metastasis (p = 0.0127). Postradiosurgical imaging of the brain metastases revealed that 62% decreased, 19% remained stable, and 19% eventually increased in size. One patient later underwent a craniotomy and tumor resection for a tumor refractory to radiosurgery and radiation therapy. In three patients new brain metastases were demonstrating on follow-up imaging. Conclusions. Stereotactic radiosurgery for recurrent small cell lung carcinoma metastases provided effective local tumor control in the majority of patients. Early detection of brain metastases, aggressive treatment of systemic disease, and a therapeutic strategy including radiosurgery can extend survival.


Impact ◽  
2019 ◽  
Vol 2019 (8) ◽  
pp. 56-58
Author(s):  
Motoi Ohba

Lung cancer is one of the most prevalent and lethal forms of the disease accounting for almost 20 per cent of all deaths from cancer. It is therefore the leading cause of cancer death in men and second most fatal in women. There are between 1.5 and 2 million new cases of cancer globally every year. A similar number die from the disease annually. There are two forms of lung cancer – small-cell lung carcinoma (SCLC) and non-small-cell lung carcinoma (NSCLC). SCLC is the more aggressive form being faster growing and more metastatic, however it also responds more effectively to treatments such as chemotherapy. NSCLC is the more common form of the disease, accounting for 85 per cent of cases. They develop more slowly than SCLCs, however they are largely unresponsive to chemotherapy and require precise surgical removal. Both present a huge medical problem in terms of diagnosis and treatment. Due to its far higher prevalence, NSCLC is the most studied of the two forms. A chemotherapeutic treatment has been developed that targets the epidermal growth factor receptor (EGFR). EGFR is majorly upregulated in most cases and plays a key role in the tumour's growth and survival. The treatment blocks the receptor and is usually very effective in the first instances. However, it is typically unable to clear the cancer as a single nucleotide mutation is capable of rendering the inhibitor unable to act on the receptor. Therefore, the cancer returns and continues to develop. New treatments are also required. This is the work of Dr Motoi Ohba of the Advanced Cancer Translational Research Institute, Showa University, Japan. His work is aimed at both uncovering novel targets for cancer treatment and finding and developing molecules that could effectively manipulate these targets.


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