Gefitinib combined biologic therapy for advanced lung adenocarcinoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19098-e19098
Author(s):  
Baoping Li ◽  
Lei Zhang
Keyword(s):  
Quality Of Life ◽  
Genetic Testing ◽  
Lung Adenocarcinoma ◽  
Response Rate ◽  
Cox Regression ◽  
Immune Therapy ◽  
Fluid Pressure ◽  
Smoking History ◽  
Cox Regression Analysis

e19098 Background: Gefitinib is an effective treatment for non-small cell lung cancer patients with epidermal growth factor receptor (EGFR) mutations. However, due to the limited genetic testing methods and other constraints, a large proportion of patients did not benefit from it. In order to overcome the limitation of genetic testing and other constraints, we use gefitinib with the immune-biotherapy to treatment advanced lung adenocarcinoma. Methods: From February 2011 to December 2012, we use gefitinib combined with immune-therapy to treat 59 cases with advanced lung adenocarcinoma. These patients completes at least one cycle of therapy. The efficacy and quality of life were investigated. The prognostic factors were analyzed using Cox regression model. Results: CRF0, PR:46, SD:13, the PD:0. The overall response rate = 77.97%. FACT-L: 100%. The response rate and scores of quality of life are higher than the reported data. COX regression analysis showed that the complete remission after the treatment is significant factor(P <0.01), but the factors such as the disease control status, gender, tumor stage, smoking history were not significant. Conclusions: Gefitinib and biological therapy combined, can significantly improve short-term effect of advanced lung adenocarcinoma. Its possible mechanism of gefitinib to reduce interstitial fluid pressure may increase immunocompetent cells into the tumor tissues, thereby enhancing efficacy.

scholarly journals Long-Term Outcomes in Patients with Stroke after in-Hospital Treatment—Study Protocol of the Prospective Stroke Cohort Augsburg (SCHANA Study)

Medicina ◽  
2020 ◽  
Vol 56 (6) ◽  
pp. 280
Author(s):  
Michael Ertl ◽  
Christa Meisinger ◽  
Jakob Linseisen ◽  
Sebastian-Edgar Baumeister ◽  
Philipp Zickler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Recurrent Events ◽  
Cox Regression ◽  
University Hospital ◽  
Hospital Treatment ◽  
Invasive Treatment ◽  
Cox Regression Analysis ◽  
Relative Risks

Introduction: In Germany, stroke is the third leading cause of death, with more than 60,000 fatalities out of approximately 260,000 cases (first-ever and recurrent strokes) each year. So far, there are only a few long-term studies investigating determinants of the natural course of the disease, especially in the era of mechanical thrombectomy. Materials and Methods: The prospective single-center stroke cohort Augsburg (SCHANA) study will include about 1000 patients treated for stroke in the University Hospital of Augsburg. Patients aged 18 years or older with a confirmed diagnosis of ischemic or hemorrhagic stroke are included in the study. Information on demographic characteristics, onset of symptoms, etiologic factors, comorbidities, quality of life, invasive and non-invasive treatment, complications, and laboratory parameters are collected during a personal interview conducted during the patients’ hospital stay and via a medical chart review. About 30 mL of blood is collected from each patient, and after processing and aliquoting, all blood specimens are frozen at −80° C. The study participants will be followed-up via postal questionnaires at three and 12 months after discharge from the hospital. Furthermore, mortality follow-ups will be conducted. Cox-regression analysis will be used to estimate relative risks. Conclusion: The SCHANA study will generate comprehensive data on the long-term course of the disease. In addition to the main outcomes, recurrent events and survival, patient-oriented outcomes such as health-related quality of life and depression are the focus of the study.

scholarly journals Trigeminal Neuralgia: Outcomes after Gamma Knife Radiosurgery

2009 ◽  
Vol 36 (1) ◽  
pp. 78-82 ◽  
Author(s):  
Henri Knafo ◽  
Brendan Kenny ◽  
David Mathieu
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Pain Relief ◽  
Trigeminal Neuralgia ◽  
Gamma Knife ◽  
Cox Regression ◽  
Statistical Significance ◽  
Gamma Knife Radiosurgery ◽  
Cox Regression Analysis

Background:Trigeminal neuralgia (TN) often remains difficult to treat despite multiple available medications, and can severely impact on the quality of life of affected patients. Gamma knife radiosurgery has recently emerged as a minimally-invasive alternative to surgery for patients suffering from drug-resistant TN. The goal of this study was to report the short-term efficacy of gamma knife radiosurgery for TN and assess its impact on the quality of life of patients treated in the first 18 months of our experience.Methods:Patients with medically-refractory TN or with unacceptable drug side effects were considered for radiosurgery. A maximum dose of 80 Gy was administered to the affected nerve using a single 4-mm isocenter. Follow-up assessments were made at 2, 4 and 6 months, with evaluation of pain relief, drug reduction and quality of life. Factors impacting treatment response were assessed using Cox regression analysis.Results:A total of 67 patients were treated. Significant pain relief was seen in 77.6% of patients, including 32.6% who became pain-free. Patients were able to discontinue all medications in 34.3% or reduce drug intake by more than 50% in an additional 28.4% of cases. No variable was found to predict pain relief although older age (>66 years) approached statistical significance. Sensory side effects were seen in 14.9% of patients. Quality of life improved in the majority of patients after radiosurgery.Conclusions:Gamma knife radiosurgery is a safe and effective management alternative for trigeminal neuralgia, providing good or excellent pain relief and improvement in quality of life in the majority of patients with few side effects.

scholarly journals Cognitive Impairments and Risk Factors After Ruptured Anterior Communicating Artery Aneurysm Treatment in Low-Grade Patients Without Severe Complications: A Multicenter Retrospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Ning Ma ◽  
Xin Feng ◽  
Zhongxue Wu ◽  
Daming Wang ◽  
Aihua Liu
Keyword(s):  
Quality Of Life ◽  
Cognitive Impairment ◽  
Cox Regression ◽  
Cognitive Impairments ◽  
Anterior Communicating Artery ◽  
Low Grade ◽  
Loss Of Consciousness ◽  
Cox Regression Analysis ◽  
Microsurgical Clipping

Background: Cognitive impairment is the main factor affecting quality of life in patients with low-grade aneurysmal subarachnoid hemorrhage.Objective: We explored cognitive impairments and risk factors after treatment for ruptured anterior communicating artery (AComA) aneurysms in low-grade (Hunt-Hess grade of 1–3) patients without severe complications.Methods: One-hundred-twenty-six patients with a Hunt-Hess grade of 1–3 who underwent microsurgical clipping or endovascular embolization for ruptured AComA aneurysm treatment at three academic institutions in China from January 2015 to December 2017 were assessed with the modified Telephone Interview for Cognitive Status (TICS-m), the modified Rankin Scale (mRS), and the instrumental activities of daily living (IADL) scale 2 or more years after microsurgical clipping or endovascular coiling. Multiple cox-regression analysis was used to identify variables independently associated with cognitive impairment.Results: Of the total of 126 patients, 115 (91.3%) achieved good clinical outcomes (mRS score 0–2) and 109 (86.5%) had excellent quality of life (IADL score 8). Twenty-eight (22.2%) patients showed cognitive impairments (TICS-m≤27). The multivariate COX regression analysis showed that the female patients and longer duration of loss of consciousness at onset of subarachnoid hemorrhage (SAH) were independently associated with cognitive impairment. Cognitive outcome at the latest follow-up was not significantly different between patients treated after surgical clipping and coiling.Conclusion: About one in five patients showed cognitive impairments after treatment for ruptured AComA aneurysms. Patients who are of the female sex, and who have a longer duration of a loss of consciousness at the onset of SAH may be at risk of cognitive impairment.

HPV and （ Neutrophil-to-lymphocyte ratio ） NLR are Prognostic Indicators of Laryngeal Cancer Patients Receiving Concurrent Chemoradiotherapy

2021 ◽  
Author(s):  
Ke-jie Li ◽  
Qi-yuan Lv ◽  
Yu-yan Xu ◽  
Zhen-yong Shao ◽  
Chang-Lin Zou ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Regression Analysis ◽  
Laryngeal Cancer ◽  
Roc Curve ◽  
Concurrent Chemoradiotherapy ◽  
Cox Regression ◽  
Individualized Treatment ◽  
Cox Regression Analysis

Abstract Background and objectives: After receiving radical concurrent radiotherapy and chemotherapy, some patients with laryngeal cancer still have recurrence, and the recurrence time of different patients is different, which will pose a threat to the quality of life and survival of patients. The purpose of our study is to find out the factors that can predict the recurrence of laryngeal cancer, provide more accurate and individualized treatment for patients with laryngeal cancer, and improve the quality of life of patients.Methods：We collected follow-up data from 123 patients with laryngeal cancer who were admitted to the First Affiliated Hospital of Wenzhou Medical University between 2010 and 2015. These patients received only radical concurrent chemoradiotherapy after diagnosis. Univariate Cox analysis was used to find the factors related to Progression-free survival（PFS）in patients with laryngeal cancer. Multivariate Cox regression analysis was used to determine the factors and indicators that could predict patients' PFS. The Receiver Operating Characteristic curve（ROC curve） was used to determine the optimal truncation value of the forecast index.Results：Univariate Cox regression analysis showed that HPV, lymph node metastasis, NLR, （lymphocyte-to-monocyte Ratio）LMR and white blood cell count were related to PFS in patients with laryngeal cancer. Multivariate Cox regression analysis showed that positive HPV and NLR were effective predictors of PFS in laryngeal cancer. According to the ROC curve, the area under the curve of NLR is 0.743, and the optimal truncation value is 2.26.Conclusions：HPV and NLR are reliable predictors of PFS in patients with laryngeal cancer receiving concurrent chemoradiotherapy, which can provide help and suggestions for follow-up and individualized treatment of laryngeal cancer after treatment.

Physical function and quality of life in frail and/or elderly metastatic colorectal cancer patients treated with bevacizumab and capecitabine: An exploratory analysis.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 627-627
Author(s):  
Peter Richard Ward ◽  
Andre K. D. Liem ◽  
He-jing Wang ◽  
Ravi Patel ◽  
Eddie Hong-Lung Hu ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Colorectal Cancer ◽  
Regression Analysis ◽  
Elderly Patients ◽  
Metastatic Colorectal Cancer ◽  
Functional Status ◽  
Cox Regression ◽  
Cox Regression Analysis ◽  
Functional Measures

627 Background: Optimal treatment strategies in frail and/or elderly patients with metastatic colorectal cancer have not been well defined. Although the safety and efficacy of bevacizumab and capecitabine in this population has been reported, the impact on functional measures and quality of life has not been well described. In a prospective, phase II study of elderly metastatic colorectal patients with ECOG performance status (PS) 1 or 2 treated with first-line bevacizumab and capecitabine, we collected data on geriatric functional status and quality of life. The primary aim of this analysis was to explore the differences in geriatric health measures between patients with ECOG status 1 and 2. Methods: Functional status was measured by patient-reported limitations in ADLs and IADLs and ECOG PS was assessed. A “Get up and Go” test, hearing test, and 3-item recall exam was also performed. Quality of life (QoL) was assessed by means of the FACT-C questionnaire and patient-rated health status was measured by the EQ-5D questionnaire. The prognostic impact of baseline characteristics on survival was studied using univariate Cox-regression analysis. Results: The majority (62%) of the 45 participants treated were ECOG 2. This group had more limitations in IADLs, lower baseline QoL, and a lower patient-rated health score. For all participants, QoL significantly improved from baseline to the start of cycle 2 (FACT-C: 99.9 vs. 105.4, p=0.01) and did not deteriorate when baseline scores were compared to when participants went off study. (FACT-C: 99.9 vs. 98.6, p=0.59). In the Cox-regression analysis, the participant’s ability to perform the “Get up and Go” test was the only baseline characteristic that was prognostic for improved survival (HR = 0.31, p = 0.01). Conclusions: Our analysis shows that in this study of frail and/or elderly patients with metastatic colorectal cancer treated with bevacizumab and capecitabine, there is a significant amount of heterogeneity between the ECOG 1 and 2 groups in both functional measures and quality of life. We also showed that the “Get up and Go” test may be a useful prognostic indicator for survival in this population.

Real-life results from the prospective QoliXane trial of the platform for outcome, quality of life, and translational research on pancreatic cancer (PARAGON) registry.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4625-4625
Author(s):  
Salah-Eddin Al-Batran ◽  
Ralf Dieter Hofheinz ◽  
Alexander Reichart ◽  
Claudia Pauligk ◽  
Rudolf Schlag ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Cox Regression ◽  
Real Life ◽  
Progression Free Survival ◽  
Response Analysis ◽  
First Line ◽  
Cox Regression Analysis ◽  
First Line Therapy

4625 Background: Gemcitabine and nab-paclitaxel (NPG) is standard first-line therapy for metastatic pancreatic cancer (mPC), but the pivotal study did not include quality of life (QoL) analyses. Methods: The QOLIXANE-PARAGON study started as a prospective, non-interventional, multicenter study conducted in Germany and transitioned into a permanent registry for pancreatic cancer patients (pts) considering all types of treatments. This report focuses on the pts enrolled into the QOLIXANE portion of the study. Pts were recruited from 95 German centers. QoL was prospectively measured via EORTC-C30 questionnaires (prior to and every month thereafter): therapy and efficacy parameters were prospectively collected. QoL and efficacy endpoints were analyzed in the intention-to-treat population (ITT). The primary endpoint was the rate of pts without deterioration of QoL/Global Health Score (QoL/GHS) at 3 months. Results: 600 pts were enrolled. Mean GHS/QoL score at baseline was low and was 46.2 (SD 22.8). Median progression-free survival was 5.85 months (95% CI, 5.23 to 6.25). Median overall survival (OS) was 8.91 months (95% CI, 7.89 to 10.19). The KM-analysis showed that 61% and 41% of pts had maintained QoL/GHS after 3 and 6 months, respectively. Median time to deterioration of QoL/GHS was 4.68 months (95% CI, 4.04 to 5.59). Mean QoL/GHS improved from 46.1 (SD 22.7) at baseline to 52.8 (SD 21.3) after 6 months. In the QoL response analysis, 34.6%, 37.4% and 28% of evaluable pts had improved, stable and worse QoL/GHS after 3 months, respectively. In the Cox regression analysis, GHS/QoL scores strongly predicted survival with a HR of 0.86 (p < 0.0001). Conclusions: QoliXane the largest study on QoL of mPC. It shows that time to deterioration of QoL is short but that a relevant group of mPC in first line have improved or maintained QoL after 3 and 6 months and that QoL is a predictor of pts outcome. Clinical trial information: NCT02691052 .

Clinical prognostic factors in advanced non-small cell lung cancer (NSCLC): Cox regression analysis based on 789 patients treated in three consecutive randomized trials

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7648-7648
Author(s):  
L. R. Pilz ◽  
N. Thatcher ◽  
C. Kortsik ◽  
G. Koschel ◽  
J. Mezger ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Lung Cancer ◽  
Retrospective Analysis ◽  
Prognostic Value ◽  
Cox Regression ◽  
Performance Status ◽  
Eligibility Criteria ◽  
Cox Regression Analysis ◽  
The Impact

7648 Background: Treatment efficacy and toxicity of the three studies have been presented at ASCO (2006, Abstract # 7035). Patients (pts) received gemcitabine or docetaxel either as single agents in different schedules and doses or as a platinum free doublet. Our retrospective analysis is to identify the clinical factors which would influence patient prognosis. Methods: Patients eligibility criteria included histologically confirmed stage IIIB or IV, performance status (PS) 0–2, and no prior chemotherapy. Overall survival (OS) was similar in all three studies. 819 pts were enrolled in 1998–2004 and 798 pts of them were evaluable for this analysis: 85% of pts had stage IV disease and PS=1. Univariate and multivariate (stepwise) Cox regression analyses were performed to evaluate the impact of baseline characteristics and quality of life (QoL) on OS. Results: Factors which have a significant impact on OS are the laboratory parameters hemoglobin (HGB) and LDH (p<0.0001), WHO performance status (PS) (p=0.001) and the quality of life measure for lung cancer of the EORTC, LC13, (p=0.0006), respectively (see table ). Gender measured univariately also influences significantly OS (p=0.0085) but has less impact in the multivariate model (p=0.07). Age (<65 vs 65 and older) is not of prognostic value with OS (HR=0.92, p=0.39), as well as histology (adeno/sqamous/other) (HR=0.99, p=0.90). Other factors as tumor stage (wet IIIB vs IV), presence of extra-thoracic metastases, number of co-morbidities, and surgical and radiological pretreatment also have no prognostic influence on OS. Analysis for the effect of smoking on OS could not be performed since only few pts never smoked. Conclusions: Our retrospective analysis confirms the prognostic value of serum HGB, and LDH, WHO-PS, and QoL LC13 as clinical determinants for OS. [Table: see text] [Table: see text]

scholarly journals Prognostic value of health-related quality of life in patients with acute dyspnea

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Belkin ◽  
D Wussler ◽  
I Strebel ◽  
E Michou ◽  
N Kozhuharov ◽  
...  
Keyword(s):  
Prognostic Value ◽  
Cox Regression ◽  
Acute Dyspnea ◽  
Cox Regression Analysis ◽  
Prognostic Accuracy ◽  
Related Quality ◽  
Health Related ◽  
Complete Set ◽  
Eq Vas

Abstract Background Previous studies have shown the prognostic value of health-related quality of life (HRQL) in stable and ambulatory chronic heart failure patients. However, it is unknown whether HRQL can predict all-cause mortality in patients presenting to the emergency department (ED) after acute onset of symptoms. In order to address this unmet need, the aim of this study was to assess the prognostic value of HRQL in patients with acute dyspnea caused by acute heart failure (AHF) and other dyspnea aetiologies for 360-day mortality. Purpose To assess prognostic value of HRQL using the generic EQ-5D and visual analogue scale (EQ VAS) in patients with acute dyspnea. Methods Basics in Acute Shortness of Breath EvaLuation (BASEL V) is a prospective, multicenter, diagnostic study enrolling adult patients presenting with acute dyspnea to the ED. For this analysis, only patients with a complete set of variables necessary for calculation of EQ-5D (range 0–10; with higher score indicating worse HRQL) and EQ VAS (range 0–100; with 100 being the best imaginable health state) at baseline were included. The endpoint was the prognostic value of EQ-5D and EQ VAS at 360 days of follow-up regarding all-cause death. Prognostic accuracy was calculated using c-statistics. In a cox regression analysis EQ-5D was treated as both, a continuous and categorical variable. Adjustments were made for clinically relevant covariates (age, sex, orthopnoea, edema, level of N-terminal pro-B-type natriuretic peptide (NT-proBNP) at presentation, history of coronary artery disease and chronic obstructive pulmonary disease, diuretics, β-blockers and ACE-inhibitors at discharge). Results Among 2605 patients enrolled, 1141 (43,8%) had a complete set of variables allowing the calculation of EQ-5D and EQ VAS. Of these patients 594 (52.1%) had an adjudicated final diagnosis of AHF. 211 (18.5%) patients died within 360 days of follow-up. Median EQ-5D was 3 (interquartile range (IQR) 1.5–5) and median EQ VAS was 50 (IQR 40–70). The prognostic accuracy for 360-day mortality was 0.65 (95% confidence interval ((CI) 0.61–0.69) and 0.58 (95% CI 0.54–0.62) for EQ-5D and EQ VAS, respectively (p=0.002). After combining EQ-5D and EQ VAS in a logistic regression model c-statistics regarding all-cause mortality within 360 days did not improve. The prognostic accuracy of EQ-5D was comparable to that of NT-proBNP (c-statistics 0.69, p=0.385). In an adjusted cox regression analysis the hazard ratio for patients with EQ-5D &gt;4 was 2.2 (95% CI 1.7–2.9; p&lt;0.001). Conclusions In patients presenting with acute dyspnea HRQL is a strong prognostic instrument. Independently of the aetiology of the dyspnea the prognostic value of the generic EQ-5D for 360-day mortality is comparable to NT-proBNP. Patients with an EQ-5D &gt;4 are at significantly higher risk for mortality within 360 days. Figure 1. Prognostic value of HRQL Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation, Swiss Heart Foundation

scholarly journals Prediction of all-cause mortality from 24 month trajectories in patient-reported psychological, clinical and quality of life outcomes in uveal melanoma patients

2021 ◽  
Author(s):  
Stephen L. Brown ◽  
Peter L. Fisher ◽  
Laura Hope-Stone ◽  
Heinrich Heimann ◽  
Rumana Hussain ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Life Expectancy ◽  
Uveal Melanoma ◽  
Cox Regression ◽  
Multivariate Analyses ◽  
Tumor Diameter ◽  
Control Variables ◽  
Patient Reported ◽  
All Cause Mortality

AbstractA number of patient-reported outcomes (PROs) predict increased mortality after primary cancer treatment. Studies, though, are sometimes affected by methodological limitations. They often use control variables that poorly predict life expectancy, examine only one or two PROs thus not controlling potential confounding by unmeasured PROs, and observe PROs at only a single point in time. To predict all-cause mortality, this study used control variables affording good estimates of life expectancy, conducted multivariate analyses of multiple PROs to identify independent predictors, and monitored PROs two years after diagnosis. We recruited a consecutive sample of 824 patients with uveal melanoma between April 2008 and December 2014. PROs were variables shown to predict mortality in previous studies; anxiety, depression, visual and ocular symptoms, visual function impairment, worry about cancer recurrence, and physical, emotional, social and functional quality of life (QoL), measured 6, 12 and 24 months after diagnosis. We conducted Cox regression analyses with a census date of December 2018. Covariates were age, gender, marital and employment status, self-reported co-morbidities, tumor diameter and thickness, treatment modality and chromosome 3 mutation status, the latter a genetic mutation strongly associated with mortality. Single predictor analyses (with covariates), showed 6-month depression and poorer functional QoL predicting mortality, as did 6–12 month increases in anxiety and 6–12 month decreases in physical and functional QoL. Multivariate analyses using all PROs showed independent prediction by 6-month depression and decreasing QoL over 6–12 months and 12–24 months. Elevated depression scores six months post-diagnosis constituted an increased mortality risk. Early intervention for depressive symptoms may reduce mortality.

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