Unfavorable Experience with Hypofractionated Radiotherapy in Unresectable Lung Cancer

1992 ◽  
Vol 78 (5) ◽  
pp. 305-310 ◽  
Author(s):  
Luigi Pirtoli ◽  
Mirco Bindi ◽  
Antonio Bellezza ◽  
Fiorella Pepi ◽  
Enrico Tucci
Keyword(s):  
Lung Cancer ◽  
Adverse Effects ◽  
Soft Tissues ◽  
Performance Status ◽  
Hypofractionated Radiotherapy ◽  
Advanced Lung Cancer ◽  
Severe Damage ◽  
Lung Cancer Patients ◽  
Therapeutic Results ◽  
And Performance

The use of a reduced number of large-sized fractions in radiotherapy (hypofractionation) is usually associated with poor therapeutic results and severe adverse effects, in accord with radiobiologic concepts. However by some authors unresectable lung cancer patients have been treated with hypofractionated radiotherapy with the main aim of « convenience ». Result and damage rates are reported to be comparable to those of conventional treatment. In our experience, based on palliative irradiation of 86 advanced-stage, nonmicrocytoma patients, objective remission rates, subjective and performance status improvement, and survival overall were as poor as could be expected in this kind of presentation, with no striking impact of this treatment modality. Severe adverse effects were shown by a large proportion of cases involving skin and soft tissues of the chest wall (40 %) and lungs (55.5 %). The incidence of severe damage was in agreement with BED (biologic effective dose) values, differently from other experiences of radiotherapeutic management of advanced lung cancer with large fractions.

Relationship Between Symptom Change, Objective Tumor Measurements, and Performance Status During Chemotherapy for Advanced Lung Cancer

2008 ◽  
Vol 9 (1) ◽  
pp. 51-58 ◽  
Author(s):  
David Cella ◽  
David Eton ◽  
Thomas A. Hensing ◽  
Gregory A. Masters ◽  
Bhash Parasuraman
Keyword(s):  
Lung Cancer ◽  
Performance Status ◽  
Advanced Lung Cancer ◽  
Symptom Change ◽  
Tumor Measurements ◽  
And Performance

scholarly journals Analysis of advanced lung cancer patients diagnosed following emergency admission

2014 ◽  
Vol 45 (4) ◽  
pp. 1098-1107 ◽  
Author(s):  
Daichi Fujimoto ◽  
Ryoko Shimizu ◽  
Takeshi Morimoto ◽  
Ryoji Kato ◽  
Yuki Sato ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Independent Predictor ◽  
Receptor Gene ◽  
Performance Status ◽  
Emergency Admission ◽  
Hazard Ratio ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients

Data on prognosis and predictors of overall survival in advanced lung cancer patients diagnosed following emergency admission (DFEA) are currently lacking.We retrospectively analysed data from 771 patients with advanced nonsmall cell lung cancer between April 2004 and April 2012.Of the 771 patients, 103 (13%) were DFEA. DFEA was not an independent predictor of overall survival by multivariate Cox proportional hazard models, whereas good performance status (PS), epidermal growth factor receptor gene mutation, stage IIIB, adenocarcinoma and chemotherapy were independent predictors of overall survival (hazard ratio (95% CI) 0.36 (0.29–0.44), p<0.001; 0.49 (0.38–0.63), p<0.001; 0.64 (0.51–0.80), p<0.001; 0.81 (0.67–0.99), p=0.044; and 0.40 (0.31–0.52), p<0.001, respectively). Good PS just prior to opting for chemotherapy, but not at emergency admission, was a good independent predictor of overall survival in DFEA patients (hazard ratio (95% CI) 0.26 (0.12–0.55); p<0.001).DFEA is relatively common. DFEA and PS at emergency admission were not independent predictors of overall survival, but good PS just prior to opting for chemotherapy was an independent predictor of longer overall survival. Efforts to improve patient PS after admission should be considered vital in such circumstances.

A retrospective cohort study of inpatient chemotherapy utilization in hospitalized advanced lung cancer patients in the United States.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6611-6611
Author(s):  
Hyunseok Kang ◽  
Sungjin Kim ◽  
Zhengjia Chen ◽  
Bassel F. El-Rayes ◽  
Johann Christoph Brandes ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Performance Status ◽  
The United States ◽  
Advanced Lung Cancer ◽  
Loss Of Function ◽  
Lung Cancer Patients ◽  
Risk Of Death ◽  
Chemotherapy Administration ◽  
Co Morbidity

6611 Background: The administration of chemotherapy to patients with limited performance status and within 6 weeks of death is considered an indicator of poor quality care. We assessed predictors of inpatient chemotherapy use and the risk of death in hospitalized lung cancer patients treated with chemotherapy in the US. Methods: Data were obtained from all US states that contributed to the Nationwide Inpatient Sample (NIS) by Agency for Health Care Research and Quality (AHRQ) in 2006 and 2010. Lung cancer diagnoses and inpatient chemotherapy were identified using Clinical Classification Software (CCS) code which is based on ICD9 and CPT codes. Univariate and multivariate analyses were performed to compare patients based on chemotherapy administration using ANOVA, chi-square test, and logistic regression. Initial analysis in the 2006 NIS data was validated in the 2010 NIS data. Results: 24,025 and 24,323 eligible hospitalized lung cancer patients including 1,005 (4.2 %) and 869 (3.6 %) patients treated with chemotherapy were identified in 2006 and 2010 respectively. Female gender, radiation use, urban location and longer length of stay (LOS) were significantly associated with receipt of chemotherapy. Chemotherapy administration was associated with prolonged hospital stay (14.1 ± 9.8 vs. 8.8 ± 8.1 days, p<.001) and increased odds of death in unadjusted analyses. Adjusted analysis showed significant increased odds of death in chemotherapy-treated patients with metastatic disease (vs. no metastasis); poor performance status indicated by severe loss of function (vs. minor/moderate loss of function) and increased LOS (Table). Conclusions: Inpatient administration of chemotherapy to hospitalized US lung cancer patients is associated with higher mortality and can be explained by treatment given to patients with high co-morbidity and disease burden. [Table: see text]

Platinum Combination Chemotherapy Is Poorly Tolerated in Malnourished Advanced Lung Cancer Patients with Poor Performance Status

2019 ◽  
Vol 71 (5) ◽  
pp. 767-771
Author(s):  
Takayuki Fujio ◽  
Kazuhisa Nakashima ◽  
Tateaki Naito ◽  
Haruki Kobayashi ◽  
Shota Omori ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Combination Chemotherapy ◽  
Performance Status ◽  
Poor Performance ◽  
Advanced Lung Cancer ◽  
Poor Performance Status ◽  
Lung Cancer Patients

scholarly journals Low alanine transaminase is not associated with increased rate of mortality in patients with advanced lung cancer

2017 ◽  
Vol 2 (1) ◽  
Author(s):  
Amir Dagan ◽  
Tal Sella ◽  
Demian Urban ◽  
Yair Bar ◽  
Amir Onn ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Advanced Disease ◽  
Performance Status ◽  
Alanine Transaminase ◽  
Advanced Lung Cancer ◽  
Activity Levels ◽  
Lung Cancer Patients ◽  
Risk Of Mortality ◽  
Increased Risk

Background: Low alanine transaminase (ALT) has been shown to serve as a marker for sarcopenia and frailty in both healthy populations and in patients with chronic illness. Its yield in cancer patients in general and in particular in lung-cancer patients was not assessed. Methods: Lung cancer patients presenting to an outpatient thoracic oncology clinic in a tertiary hospital were included. ALT plasma levels as well as other potential prognostic factors were collected retrospectively. Associations of those factors with survival were examined by univariate and multivariate analyses. Results: 203 patients were eligible for analysis, of which 149 (73.4%) were diagnosed to have advanced disease. During median follow-up period of 15.4 months, 79 (38.9%) died. The mean ALT level of activity was 17.53±7.8 IU/L. The following parameters were found to be associated with increased risk of mortality: histologic type, male gender, advanced disease and low performance status upon diagnosis. Low ALT levels were not found to be associated with increased risk of mortality. Conclusion: Low ALT activity levels, associated with sarcopenia, frailty and shortened survival in other patients' populations might not be predictive for shortened survival in lung cancer patients.  

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