scholarly journals Clinical Research on Systemic Chemotherapy Combined With Bronchoscopic Seed Implantation in the Treatment of Advanced Lung Cancer

2020 ◽  
Vol 19 ◽  
pp. 153303382097160
Author(s):  
Feng Xu ◽  
Jian Yang ◽  
Beizheng Xu ◽  
Zhenzhen Li ◽  
Xuanmei Li ◽  
...  

Objective: This study aims to explore the clinical value of systemic chemotherapy combined with bronchoscopic seed implantation in advanced lung cancer treatment. Methods: The study enrolled 253 patients with advanced lung cancer in Cangzhou People’s Hospital from March 2018 to March 2020, and they were divided into test group and control group. Test group was given systemic chemotherapy combined with bronchoscopic seed implantation, while control group was given systemic chemotherapy. The objective response rate of tumor (ORR), disease control rate (DCR), serum tumor marker level, survival time and adverse reactions of 2 groups were compared. Results: After treatment, the levels of serum tumor markers including carcino-embryonic antigen, neuro-specific enolase, cytokeratin-19 and pro-gastrin-releasing peptide were markedly decreased in test group compared with those in control group ( P < 0.05). Therein, the serum tumor marker level of non-small cell lung cancer (NSCLC) patients was significant decreased compared with that of small cell lung cancer (SCLC) patients in test group. Meanwhile, in test group, the serum tumor marker level of lung adenocarcinoma (LUAD) patients was significant decreased compared with that of lung squamous cell carcinoma (LUSC, P < 0.05). The ORR and DCR in test group were superior to those in control group (63.4%, 92.5% vs 38.7%, 72.3%, P < 0.05), while those were much higher in patients with NSCLC and LUAD relative to those in patients with SCLC and LUSC, respectively ( P < 0.05). Furthermore, the progression-free survival (PFS) and overall survival (OS) in test group were significantly greater than those in control group. In test group, the PFS and OS of patients with NSCLC and LUAD were higher than those of patients with SCLC and LUSC. Conclusion: The efficacy of systemic chemotherapy combined with bronchoscopic seed implantation was superior to that of systemic chemotherapy, which is worthy of promoting in clinical practice.

BMC Cancer ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Feng Xu ◽  
Jian Song ◽  
Beizheng Xu ◽  
Jiang Wang ◽  
Jianjun Mao ◽  
...  

Abstract Background This study is designed to investigate the clinical value of systemic chemotherapy combined with bronchoscopic interventional cryotherapy in the treatment of lung cancer. Methods A total of 412 lung cancer patients admitted to Cangzhou People’s Hospital from March 2018 to March 2020 were collected and divided into test group and control group based on their treatment schedules. The test group received systemic chemotherapy combined with bronchoscopic interventional cryotherapy, while the control group received systemic chemotherapy alone. Tumor objective response rate (ORR), disease control rate (DCR), serum tumor marker levels, serum matrix metalloproteinase (MMP) content, T cell subset level, survival time and adverse reactions of the two groups were observed. Results The ORR and DCR of the test group were better than those of the control group, while those of the non-small cell lung cancer (NSCLC) patients in the test group were better than patients with small-cell lung cancer (SCLC) (P <  0.05). There was no significant difference in serum tumor marker levels, MMP content and T cell subset level between the two groups before treatment. After treatment, the serum tumor marker levels along with serum MMP-2, MMP-9 and CD8+ levels in the test group decreased more remarkably, while CD4+ and CD4+/CD8+ levels increased more significantly than those in the control group (P <  0.05). The serum MMP-2 and MMP-9 of NSCLC patients in the test group decreased more remarkably than those of SCLC patients, while there was no significant difference in CD8+, CD4+ and CD4+/CD8+. The progression-free survival and overall survival of the test group were obviously longer than those of the control group. The same trend was observed in NSCLC patients compared with SCLC patients in the test group (P <  0.05). Conclusions Systemic chemotherapy combined with bronchoscopic interventional cryotherapy for lung cancer has good clinical efficacy and safety, and can be widely used in clinical practice.


2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 654-654
Author(s):  
Toshiyasu Watanabe ◽  
Eiji Shinozaki ◽  
Sho Kijima ◽  
Yoshihito Ohhara ◽  
Yasutoshi Kuboki ◽  
...  

654 Background: Panitumumab and cetuximab can be used in metastatic colorectal cancer (mCRC) and these drugs are IgG2 fully human and IgG1 chimeric (mouse/human) monoclonal antibody against the epidermal growth hactor receptor (EGFR) respectively. The efficacy of panitumumab as a salvage chemotherapy after cetuximab-based chemotherapy failure is not clarified. Methods: This study aimed to evaluate the panitumumab efficacy to KRAS wild-type mCRC patients who failed cetuximab-based chemotherapy. Response, progression-free survival (PFS) and serum tumor marker level (CEA and CA19-9), were assesed. We studied response by days from last cetuximab-based chemotherapy to panitumumab induction (C-P days). Results: 22 patients (11 men, 11 women, median age 54 years m4 0-78 n) were enrolled. All of thease patients were cetuximab-based chemotherapy refractory KRAS wild-type mCRC. After progression, they received panitumumab monotherapy (6 mg/kg every 2 weeks).The best response was SD 10/22 (45.5%), PD 11/22 (50%) and NE 1/22 (4.5%). Overall median PFS was 90 days (13 to 182). The patients C-P days less than 30 days were 15 patients(5:SD, 10:PD). The patients more than 79 days were 7 patient(5:SD, 1:PD, 1:NE). Serum tumor marker level was decreased more than 50% patients. Conclusions: This study suggested that it might be limited as possibility of clinical benefit with panitumumab administration after cetuximab failure.


2021 ◽  
Vol 20 ◽  
pp. 153473542199525
Author(s):  
Shih Ming Tsao ◽  
Tz Chin Wu ◽  
JiZhen Chen ◽  
Feichi Chang ◽  
Thomos Tsao

Objectives: The neutrophil-to-lymphocyte ratio (NLR) is a prognostic marker in patients with cancer receiving immunotherapy. Recent studies have shown that a high NLR was associated with a poor response and decreased survival. However, there is no intervention to reverse abnormally high NLR and improve clinical outcomes. Astragalus polysaccharide injection (PG2) is an immunomodulatory therapy for cancer-related fatigue. This study aimed to examine whether PG2 might normalize the NLR and affect the overall survival of patients with lung cancer treated with immunotherapy. Materials and Methods: We retrospectively examined the medical records of patients with lung cancer treated with immune checkpoint inhibitors (ICIs) between October 1, 2015 and November 30, 2019. All patients received ICI combination chemotherapies, and some similarly received PG2 (Control vs PG2). The NLR was assessed before treatment and 6 weeks after ICI initiation, and the survival data was collected at least 4 years after treatment initiation for the first enrolled patient. Results: Fifty-three patients were included. Six weeks after ICI initiation, 91.3% of the patients in the PG2 group exhibited a predefined “Decrease or no change” in the NLR, which was 28% higher than that in the Control group (63.3%) ( P = .028). The NLR significantly decreased by 31.60% from baseline in the PG2 group ( P = .012), whereas it increased by 5.80% in the Control group ( P = .572). Six weeks after ICI treatment initiation, both groups had a median NLR of 3.73, and the overall survival was also similar (PG2 vs Control, 26.1 months vs 25.4 months, respectively); however, the PG2 group had a higher median baseline NLR than the Control group (PG2 vs Control, 4.51 vs 2.81, respectively). Conclusion: This study demonstrated that PG2 could normalize the NLR in patients with lung cancer receiving ICI combination treatments.


2019 ◽  
Author(s):  
Lizet Sanchez ◽  
Patricia Lorenzo-Luaces ◽  
Claudia Fonte ◽  
Agustin Lage

Abstract Progress in immunotherapy revolutionized the treatment landscape for advanced lung cancer, raising survival expectations beyond those that were historically anticipated with this disease. In the present study, we describe the methods for the adjustment of mixture parametric models of two populations for survival analysis in the presence of long survivors. A methodology is proposed in several five steps: first, it is proposed to use the multimodality test to decide the number of subpopulations to be considered in the model, second to adjust simple parametric survival models and mixture distribution models, to estimate the parameters and to select the best model fitted the data, finally, to test the hypotheses to compare the effectiveness of immunotherapies in the context of randomized clinical trials. The methodology is illustrated with data from a clinical trial that evaluates the effectiveness of the therapeutic vaccine CIMAvaxEGF vs the best supportive care for the treatment of advanced lung cancer. The mixture survival model allows estimating the presence of a subpopulation of long survivors that is 44% for vaccinated patients. The differences between the treated and control group were significant in both subpopulations (population of short-term survival: p = 0.001, the population of long-term survival: p = 0.0002). For cancer therapies, where a proportion of patients achieves long-term control of the disease, the heterogeneity of the population must be taken into account. Mixture parametric models may be more suitable to detect the effectiveness of immunotherapies compared to standard models.


2019 ◽  
Vol 26 (1) ◽  
Author(s):  
X. Huang ◽  
A. Yan ◽  
Q. Liu ◽  
L. Wu

Objectives We examined the effects of magnanimous therapy on psychological coping, adjustment, living function, and survival rate in patients with advanced lung cancer.Methods Patients with advanced lung cancer (n = 145) matched by demographics and medical variables were randomly assigned to an individual computer magnanimous therapy group (ic-mt), a group computer magnanimous therapy group (gc-mt), or a control group (ctrl). Over 2 weeks, the ic-mt and gc-mt groups received eight 40-minute sessions of ic-mt or gc-mt respectively, plus usual care; the ctrl group received only usual care. The Cancer Coping Modes Questionnaire (ccmq), the Psychological Adjustment Scale for Cancer Patients (pascp), and the Functional Living Index–Cancer (flic) were assessed at baseline and 2 weeks later. The relationships of changes in those indicators were analyzed, and survival rates were compared.Results The psychological coping style, adjustment, and living function of the ic-mt and gc-mt groups improved significantly after the intervention (p < 0.01). After 2 weeks, significant (p < 0.01) differences between the treatment groups and the ctrl group in coping style, adjustment, and living function suggested successful therapy. The changes in living function were correlated with changes in psychological coping and adjustment. No difference in efficacy between ic-mt and gc-mt was observed. The survival rate was 31.84% in the ic-mt group and 9.375% in the ctrl group at 2 years after the intervention.Conclusions In patients with advanced lung cancer, ic-mt and gc-mt were associated with positive short-term effects on psychological coping style, adjustment, and living function, although the magnitude of the effect did not differ significantly between the intervention approaches. The effects on living function are partly mediated by improvements in psychological coping and adjustment.


2017 ◽  
Vol 12 (1) ◽  
pp. S676-S677
Author(s):  
Takeshi Honda ◽  
Hirofumi Uehara ◽  
Maika Natsume ◽  
Yoko Fukasawa ◽  
Takahiko Sakamoto ◽  
...  

2002 ◽  
Vol 20 (2) ◽  
pp. 371-378 ◽  
Author(s):  
Hendrik J. Agteresch ◽  
Trinet Rietveld ◽  
Leon G.M. Kerkhofs ◽  
J. Willem O. van den Berg ◽  
J. H. Paul Wilson ◽  
...  

PURPOSE: In a randomized clinical trial in patients with advanced non–small-cell lung cancer (NSCLC), infusion with adenosine 5′-triphosphate (ATP) inhibited loss of body weight and quality of life. In the present article, the effects of ATP on body composition, energy intake, and energy expenditure as secondary outcome measures in the same patients are reported. PATIENTS AND METHODS: Patients with NSCLC, stage IIIB or IV, were randomized to receive either 10 intravenous, 30-hour ATP infusions every 2 to 4 weeks or no ATP. Fat mass (FM), fat-free mass (FFM), and arm muscle area were assessed at 4-week intervals for 28 weeks. Food intake, body cell mass (BCM), and resting energy expenditure (REE) were assessed at 8-week intervals for 16 weeks. Between-group differences were tested for statistical significance by repeated-measures analysis of covariance. RESULTS: Fifty-eight patients were randomized (28 ATP, 30 control). No change in body composition over the 28-week follow-up period was found in the ATP group, whereas, per 4 weeks, the control group lost 0.6 kg of FM (P = .004), 0.5 kg of FFM (P = .02), 1.8% of arm muscle area (P = .02), and 0.6% of BCM/kg body weight (P = .054) and decreased 568 KJ/d in energy intake (P = .0001). Appetite also remained stable in the ATP group but decreased significantly in the control group (P = .0004). No significant differences in REE between the ATP and control groups were observed. CONCLUSION: The inhibition of weight loss by ATP infusions in patients with advanced NSCLC is attributed to counteracting the loss of both metabolically active and inactive tissues. These effects are partly ascribed to maintenance of energy intake.


2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21030-21030 ◽  
Author(s):  
A. Nogal ◽  
A. Coelho ◽  
A. Araújo ◽  
I. Azevedo ◽  
A. Faria ◽  
...  

21030 Background: Lung cancer is the most common cancer in Europe (381.500 new cases in 2004) and the third in the U.S.A (172.570 new cases in 2005). Smoking is one of the major causes of lung cancer: there are many procarcinogens present in tobacco smoke that, when activated, contribute to the development of this disease. The CYP3A subfamily represents a group of enzymes responsible for the metabolism of many currently used drugs, exogenous carcinogens and endogenous molecules such as steroids. Two of the major enzymes in this family, CYP3A4 and CYP3A5, activate polycyclic aromatic hydrocarbons such as benzo[a]pyrene and other procarcinogens present in tobacco smoke. Functional polymorphisms, such as CYP3A5*3 (associated with the lack of the CYP3A5 protein), could alter individual susceptibility to lung cancer. The aim of our study was to evaluate the influence of this polymorphism in the development of lung cancer. Methods: DNA samples were extracted from peripheral blood cells of 203 patients with non small cell lung cancer, including 42 non- smokers and 156 smokers or former smokers (no data available for the other 5 patients) and 162 blood donors. The CYP3A5*3 polymorphism was analysed through PCR-RFLP (SspI). Analysis of data was performed using the computer software SPSS for windows. The odds ratio (OR) and its 95% confidence interval (CI) were calculated as a measure of the association between CYP3A5*3 genotypes and NSCLC progression. Results: We found significant statistical differences between the control group and the patients with advanced stages (III and IV) of epidermoid and undifferentiated NSCLC (p=0.04; OR = 0.48; 95% CI = 0.232–0.977). Conclusions: Individual differences in the metabolism of carcinogens may influence the susceptibility to cancer development and behaviour. Our preliminary results suggest that the carriers CYP3A5*3 polymorphism are at lower risk of developing advanced lung cancer. This is probably due to a decreased activation of procarcinogens present in tobacco smoke in result of the lack of CYP3A5 caused by the CYP3A5*3 polymorphism. This is consistent with the hypothesis of a cumulative effect of carcinogens on the aggressive behaviour of the disease. No significant financial relationships to disclose.


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