Observation of clinical efficacy and survival of lung cancer patients with UMIPIC combined with low-dose chemotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e21605-e21605
Author(s):  
Jianbin Feng ◽  
Peng Jing ◽  
Feng Gao ◽  
Jian Liu ◽  
Wei Han ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Survival Time ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Low Dose ◽  
Survival Rates ◽  
Lung Cancer Patients ◽  
Group A ◽  
Group B ◽  
Low Dose Chemotherapy

e21605 Background: To observe the clinical efficacy and survival of UMIPIC combined with low-dose chemotherapy in patients with lung cancer. Methods: 840 patients with lung cancer underwent UMIPIC treatment from January 2011 to December 2015 were selected as the study subjects, 341 cases combined with low-dose chemotherapy in group A and 499 cases not combined with chemotherapy in group B. All patients were diagnosed with lung cancer and signed a consent form for treatment. The patients were treated according to the UMIPIC treatment guidelines. This study was mainly to observe the adverse reactions, clinical efficacy, survival time and survival rate of lung cancer patients after receiving UMIPIC combined with or without low dose chemotherapy. Results: The common adverse reactions in group A were fever 38.12%, followed by pain 9.38%, hemoglobin 7.94%, white blood cells 5.01%, nausea 2.35%, liver function damage 1.19%, vomiting 1.17%, and kidney function damage 0.30%; Common adverse reactions in group B were fever 38.68%, followed by pain 13.23%, hemoglobin reduction 12.87%, white blood cell reduction 5.29%, nausea 2.00%, vomiting 2.00%, liver function damage 1.92%. The hemoglobin reduction in group A was significantly lower than that in group B (P < 0.05), and there was no difference in the other adverse reactions (P > 0.05). Clinical efficacy of the two groups revealed that the benefit rate of group A was 95.45% higher than that of group B 93.47% (P > 0.05). After follow-up, it was found that the average survival time and median survival time of patients in group A were 20.744 and 13.270 months, respectively, which were significantly higher than those of group B at 19.514 and 10.070 months (P < 0.05). The survival rates of the two groups of patients, The 1-year, 2-year, and 5-year survival rates of group A patients are 52.48%, 23.60%, and 16.95%, and the 1-year, 2-year, and 5-year survival rates of group B patients are 42.96% and 17.07 % And 10.26%, the one-year survival rate of group A was significantly higher than that of group B (P < 0.05). Conclusions: UMIPIC combined with low-dose chemotherapy has a good clinical effect in treating lung cancer without increasing the incidence of adverse reactions, and a significant effect on extending survival time and improving survival rate of lung cancer patients.

Observation on the clinical effect and survival period of patients with esophageal cancer treated with UMIPIC combined with low dose radiotherapy.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e16517-e16517
Author(s):  
Jian Liu ◽  
Peng Jing ◽  
Feng Gao ◽  
Wei Shang ◽  
Peicheng Zhang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Survival Rate ◽  
Adverse Reactions ◽  
Low Dose ◽  
Clinical Effect ◽  
Survival Rates ◽  
Low Dose Radiotherapy ◽  
Group A ◽  
The Common ◽  
Group B

e16517 Background: To observe the clinical effect and survival period of UMIPIC (ultra-minimum incision personalized intratuoral chemoimmunotherapy) combined with radiotherapy in the treatment of esophageal cancer. Methods: 712 patients with esophageal cancer who received UMIPIC treatment in our hospital from January 2011 to December 2015 were selected for the study subjects, 540 cases were treated by UMIPIC combination with radiotherapy in group A and 172 cases were treated by UMIPIC without radiotherapy in group B. All patients were diagnosed with esophageal cancer, and signed the consent for treatment. The patients were treated according to the UMIPIC treatment guidelines. This study was to observe the adverse reactions, clinical efficacy, survival and survival rate of esophageal cancer patients treated with UMIPIC combined with low-dose radiotherapy. Results: The common adverse reactions in group A were fever (18.06%), pain (8.89%), hemoglobin reduction (5.59%), leucopenia (5.40%), nausea (1.48%) and thrombocytopenia (1.12%);The common adverse reactions in group B were fever (26.16%), hemoglobin reduction (17.16%), pain (16.86%), leucopenia (3.55%), thrombocytopenia (2.35%), nausea (1.74%), liver function damage (2.42%), renal function damage (1.21%) and vomiting (1.16%). The other adverse reactions were all lower than 1.00%; The fever, pain and hemoglobin decrease in group A were significantly lower than those in group B (P < 0.05). There were 522 patients whose clinical efficacy could be evaluated in 712 patients. The benefit rate of group A was 95.28%, higher than that of group B 91.84%.The mean and median survival time of group A was 28.412 and 15.670 months, significantly higher than that of group B at 22.103 and 7.070 months. The 1-year survival rate of group A was significantly higher than that of group B (P < 0.05). The 1-year, 2-year and 5-year survival rates of group A were 60.05%, 35.61% and 28.26% while the 1-year, 2-year and 5-year survival rates of group B were 36.94%, 26.44% and 25.00%. Conclusions: The main adverse reactions of UMIPIC in the treatment of esophageal cancer are fever and pain, and other adverse reactions are relatively low. Combined radiotherapy can improve the clinical benefit rate, prolong the survival time and the clinical treatment effect is good, it is encouraged to treat esophageal cancer using local therapy of UMPIC with radiotherapy at low dose.

Postoperative radiation for lung cancer metastatic to the brain.

1994 ◽  
Vol 12 (11) ◽  
pp. 2340-2344 ◽  
Author(s):  
J G Armstrong ◽  
M Wronski ◽  
J Galicich ◽  
E Arbit ◽  
S A Leibel ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Survival Rates ◽  
Term Survival ◽  
Lung Cancer Patients ◽  
C 23 ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
The Brain

PURPOSE Although resection of single brain metastases and postoperative whole-brain radiation therapy (WBRT) improves survival, compared with treatment using WBRT alone, the value of postoperative WBRT after resection of brain metastases is controversial. We analyzed the largest reported series of lung cancer patients with resected brain metastases to evaluate the impact of postoperative WBRT. MATERIALS AND METHODS Between 1974 and 1989, 185 patients with non-small-cell lung cancer (NSCLC) underwent resection of brain metastases. Patients who had received preoperative WBRT (23%, 42 of 185) were excluded. The remaining patients were divided into group A (no WBRT; n = 32), group B (patients received WBRT and were prognostically matched to group A; n = 32), and group C (all other WBRT patients; n = 79). Most patients received postoperative doses of 30 Gy in 10 fractions. Higher doses were used in 16% of group B and 18% of group C patients. RESULTS Overall 5-year survival rates were as follows: group A, 12%; B, 8%; C, 16%. Overall brain failures occurred in 38% of patients in group A, 47% in group B, and 42% in group C. The use of WBRT (group A v groups B plus C) had no apparent impact on survival or on overall brain failure rates. In particular, no improvement in either of these parameters could be demonstrated when group B was compared with group A. Focal failure (defined as failure within the brain adjacent to the site of the resected brain metastases) occurred as follows: group A, 34% (11 of 32); groups B plus C, 23% (25 of 111) (P = .07). WBRT significantly reduced focal failure for patients with adenocarcinoma (group A, 33% [eight of 24]; groups B plus C, 14% [11 of 79]; P = .05). Nonfocal failure (anatomically distinct from the resected metastasis) occurred in 9% of patients in group A (three of 32), 21% in groups B plus C (23 of 111) (P = .07). CONCLUSION Long-term survival is possible when NSCLC brain metastases are resected. Postoperative WBRT as used in this series only had an impact on the focal control of brain metastases and this effect was of borderline significance. The lack of conclusive benefit supports the need for ongoing randomized trials to test the value of adjuvant postoperative WBRT. Brain failures were relatively common in all three groups of patients, which suggests that doses greater than 30 Gy need to be studied.

scholarly journals The Impact of Pain Control on Invasive Clinical Procedure on Children with Leukemia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5827-5827
Author(s):  
Jiayi WANG ◽  
Yingyi He ◽  
Zhimin Liang ◽  
Tiezhen Ye ◽  
Hui Zhang
Keyword(s):  
Local Anesthesia ◽  
Pain Control ◽  
Adverse Reactions ◽  
Low Dose ◽  
Invasive Procedure ◽  
Anesthesia Group ◽  
Group A ◽  
Group B ◽  
The Impact ◽  
Group D

Abstract Background: Palliative care is becoming more and more important for systemic cancer treatment in developed countries, while this remains infamous topic in developing countries, such as in China. Contemporary treatment strategies have greatly contributed to the improved outcome in childhood cancer patients, survivorship comes at the cost of developing some treatment-related health condition, such as pain-related depression, chronic pain etc. Thus, developing a well-tolerated pain control methods is of great importance within the cancer treatment. Objective: To evaluate the impact and outcome of different pain control applications on invasive procedure in children with leukemia, and record the adverse reactions. Methods: The enrollment of childhood leukemia patients in our hospital from November 2011 to November 2016 were divided into four groups, that is successively midazolam + local anesthesia (group A), midazolam + ketamine +local anesthesia (group B), midazolam + fentanyl + local anesthesia (group C), and fentanyl + propofol + local anesthesia (group D). The efficacy and adverse reactions were systemically recorded. The inter-group diffferences were calculated using x2 test. Results: No significancewas observed in age, gender, and disease distribution in these four groups by ANOVA ONEWAY analysis. The sedation outcome is more pronunced in group D than others. Also, the quality of procedural pain control in group D was the best (P<0.01). In terms of the analgesic effect, group B and D were better than that group A and C. There was significant difference in Hallucination was more easily detected in group B and C. Systemic recovery was delayed in group B other than group A, C, and D. Basing on the survey, we did found that the family members were more willing to accept pain control treatment for their sick kids under the safety assurance. The compliance was significantly improved in group D. Conclusion: Upon adequate auxiliary breathing preparation and rigorous monitor, propofol combined with low-dose fentanyl was the best sedative/analgesic option for pain control within leukemia patients receiving invasive procedure.The outcome of propofol combined with low-dose fentanyl wasvery safe, satisfactory and compliable. Up to now, this study is the first pain control study for invasive procedure in China mainland, it deserves being paid attention. Disclosures No relevant conflicts of interest to declare.

The clinical effect of Chitosan nanoparticles against Helicobacter pylori

2020 ◽  
Vol 10 (7) ◽  
pp. 1116-1121
Author(s):  
Jing Wang ◽  
Xinhong Wang ◽  
Min Li ◽  
Suxiang Fan
Keyword(s):  
Triple Therapy ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Chitosan Nanoparticles ◽  
High Dose ◽  
Significant Difference ◽  
Oral Liquid ◽  
Group A ◽  
The Difference ◽  
Group B

The objective of this study was to observe the clinical effect of Chitosan nanoparticles therapy on Helicobacter pylori (HP) infection. Three treatment groups (A, B, and control group C) were randomly assigned with 60 cases of HP each, making 180 cases. Group C received standard triple therapy (omeprazole + amoxicillin + clarithromycin), group A got a routine dose of Chitosan nanoparticles plus triple therapy, and group B got a high dose of Chitosan nanoparticles plus triple therapy. The course of treatment in each group was 7 days. The eradication rate, clinical efficacy and adverse reactions were observed. Up to 172 patients finished the experiment, with 59 patients in Group A, 57 in Group B and 56 in Group C. In a total analysis set (FAS), the eradication rates of HP in Group A, Group B and Group C were 80.00%, 80.70%, and 71.67%, respectively. There was no significant difference between the two groups (P > 0.05). In accordance with the PPS, the HP eradication rates of group A, B, and C were 81.36%, 80.70% and 76.79%, respectively, and there was no significant difference between the two groups (P > 0.05). The clinical efficacy of group A, B, and C were 91.67%, 91.23%, and 70.00%, respectively. The differences among the three groups were statistically significant (P < 0.05). In accordance with the PPS, the clinical efficacy of group A, B and C was 93.22%, 91.23%, and 75.00%, respectively. With a P-value of less than 0.05, the results indicated that the difference between the two groups was statistically significant. There were 21 adverse reactions in the experiment, including 3 in group A, 6 in group B, and 12 in group C. The difference was statistically significant (P < 0.05) between group A and B compared with group C, the difference was statistically significant (P < 0.05); the difference between group A and group B was statistically significant (P < 0.05). In conclusion the therapeutic effect of Chitosan nanoparticles and oral liquid, combined with triple therapy on HP infection is satisfactory, with less adverse reactions are. However, the findings suggest that it is not desirable to use a high dose Chitosan nanoparticles and oral liquid.

scholarly journals Low-Dose Chemotherapy with Insulin (Insulin Potentiation Therapy) in Combination with Hormone Therapy for Treatment of Castration-Resistant Prostate Cancer

ISRN Urology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Christo Damyanov ◽  
Desislava Gerasimova ◽  
Ivan Maslev ◽  
Veselin Gavrilov
Keyword(s):  
Hormone Therapy ◽  
Low Dose ◽  
Lhrh Agonist ◽  
Castration Resistant Prostate Cancer ◽  
Prostate Tumors ◽  
Castration Resistant ◽  
Group A ◽  
Previously Treated ◽  
Group B ◽  
Low Dose Chemotherapy

Purpose. To evaluate the results and quality of life of patients with resistant of castration-resistant tumors previously treated with Insulin-potentiation therapy (IPT) combined with hormone therapy. Materials and methods. Sixteen patients with metastasis prostate tumors after bilateral castration, androgenic blockade, and progression of the disease were observed during the study. The patients were divided into two groups: group A consisting of 8 patients treated with low-dose chemotherapy Epirubicin, Vinblastine, and Cyclophosphamide combined with LHRH agonist and group B consisting of another 8 patients treated with low-dose chemotherapy Docetaxel combined with LHRH agonist. Results. The overall (groups A and B) results concerning PSA after the sixth IPT show partial effect in 8 out of 16 (50%) patients, stabilization in 4 out of 16 (25%), and progression in 4 out of 16 (25%). The median survival for all treated patients is 11,7 months (range 3–30 months). During the treatment no significant side effects were observed, and no lethal cases occurred. Conclusion. In spite of the small number of the treated patients with castration-resistant prostate tumors, the preliminary results are promising and this gives us hope and expectations for future serious multicenter research over the possibilities for routine implementation of IPTLD.

scholarly journals Sequential Treatment of Afatinib and Osimertinib in Patients with Advanced Non-small Cell Lung Cancer Harboring EGFR Mutations: Results from a Real-world Study in South Korea

2021 ◽  
Author(s):  
Taeyun Kim ◽  
Tae Won Jang ◽  
Chang Min Choi ◽  
Mi-Hyun Kim ◽  
Sung Yong Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
South Korea ◽  
Small Cell Lung Cancer ◽  
Survival Rates ◽  
Small Cell ◽  
Egfr Mutations ◽  
Small Cell Lung ◽  
Group A ◽  
Group B ◽  
Egfr Mutated

Abstract The optimal sequence for administration of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) for treating non-small cell lung cancer (NSCLC) is still unclear. This study aimed to evaluate the efficacy of sequential afatinib and osimertinib treatment in patients with NSCLC harboring EGFR mutations. Electronic records of patients with EGFR-mutated NSCLC, who were administered afatinib and osimertinib (group A) or other chemotherapy (group B) between October 2014 and October 2019, across 16 hospitals in South Korea were reviewed. The primary outcome, time on treatment (TOT), secondary outcome, and overall survival (OS) were estimated using the Kaplan-Meier method and log-rank test. Multivariate analyses were performed using the Cox proportional hazards model. Of the 737 patients who received frontline afatinib treatment, 360 with complete records were selected (group A:154, group B: 206). The median TOT was 33.9 months (95% confidence interval [CI]: 24.5−43.3) in group A and 21.3 months (95% CI: 19.4−23.1) in group B. The median TOT with afatinib was 12.9 months (95% CI: 11.8−14.0) overall, and 15.2 months (95% CI: 13.2−17.1) in group A. The 2- and 3-year survival rates were 86.0% and 69.3% in group A and 75.9% and 55.3% in group B, respectively. Sequential afatinib and osimertinib treatment resulted in better survival rates than treatment with afatinib followed by other chemotherapies. Therefore, this sequential treatment strategy may offer clinical benefits to patients with EGFR-mutated NSCLC.

scholarly journals Radio-frequency thermal ablation of lung cancer under epidural anaesthesia: comparison of the effectiveness of blocks between higher and mid-thoracic level

2009 ◽  
pp. 36-38
Author(s):  
MR Khandoker ◽  
H Razwanul ◽  
H Rashadul ◽  
AM Sarwar ◽  
UH Shahera Khatun
Keyword(s):  
Lung Cancer ◽  
Thermal Ablation ◽  
Heat Rate ◽  
Epidural Block ◽  
Epidural Needle ◽  
Epidural Group ◽  
Lung Cancer Patients ◽  
Thoracic Epidural ◽  
Group A ◽  
Group B

Purpose of the investigation is to evaluate the effectiveness of high thoracic epidural block in comparison to mid-thoracic epidural during Radiofrequency ablation for lung cancer. 60 patients (38 male) were selected for epidural segmental block who were proposed for radiofrequency thermal ablation for lung cancer. Patients were randomly divided in 2 groups: Group-A, higher thoracic epidural group & Group-B, mid-thoracic epidural group. Under all aseptic preparation 18 G Epidural catheter was inserted through 18 G epidural needle and 4-6 ml of 0.5% bupivacaine was used during anaesthesia. Extend of block was demarcated by pain prick. RFT probe was allowed to insert 30 minutes after anaesthesia. The heat rate, blood pressure, respiration, Sp02 and temperature were monitored continuously during the procedure. Excellent block was found in 21 cases of Group-A and 15 cases of Group-B. Anaesthesia was inadequate in two cases of Group-A, and in 5 cases of Group-B, So, Higher thoracic epidural technique is better than mid thoracic epidural.DOI: http://dx.doi.org/10.3329/jbsa.v17i1.4050 Journal of BSA, Vol. 17, No. 1 & 2, 2004 p.36-38

The Effects of Serum hs-CRP on the Incidence of Lung Cancer in Male Patients with Pulmonary Tuberculosis

2020 ◽  
Author(s):  
Youhua JIANG ◽  
Kewei NI ◽  
Meiyu FANG ◽  
Junling LIU
Keyword(s):  
Lung Cancer ◽  
Pulmonary Tuberculosis ◽  
Cancer Patients ◽  
Serum Levels ◽  
Incidence Rates ◽  
Lung Cancer Patients ◽  
Group A ◽  
Male Patients ◽  
Hs Crp ◽  
Group B

Background: This study intended to investigate the effects of serum high-sensitivity C-reactive protein (hs-CRP) on the incidence of lung cancer in male patients with pulmonary tuberculosis. Methods: A total of 1091 male patients with pulmonary tuberculosis in Zhejiang Cancer Hospital, Hangzhou, China from Jan 2009 to Jan 2012 were selected as the research objects. All patients were followed up from the beginning of hospitalization. According to serum hs-CRP level, patients were divided into two groups: group A (hs-CRP < 1 mg/L) and group B (hs-CRP > 3 mg/L). The relationship between baseline hs-CRP and the risk of lung cancer in patients with pulmonary tuberculosis was analyzed by multivariate Cox proportional risk regression model, and the serum levels of hs-CRP between lung cancer patients in all groups and other non-lung cancer patients were compared. Results: There were differences in age, drinking, smoking, diabetes history, body mass index (BMI), thyroglobulin (TG), history of hypertension and hyperglycemia among the three groups (P=0.036, 0.018, 0.040, 0.029, 0.006, 0.034, 0.020, 0.010). The serum levels of hs-CRP in patients with squamous carcinoma, adenocarcinoma and small cell carcinoma were significantly higher than those in non-lung cancer patients (P=0.022, 0.043, 0.011). The incidence rates of lung cancer in patients in group B and C were 1.37 and 1.69 times higher than that in group A, respectively. Conclusion: The increased serum level of hs-CRP will increase the incidence rate of lung cancer in male patients with pulmonary tuberculosis.

scholarly journals Effects of Arteriovenous Thrombolysis Combined with Mechanical Thrombectomy on Efficacy and Neurological Function of Acute Cerebral Infarct Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Tao Ding ◽  
Liwen Tang ◽  
Bohong Hu ◽  
Junxin Yuan ◽  
Xiangdong Li ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Clinical Efficacy ◽  
Adverse Reactions ◽  
Mechanical Thrombectomy ◽  
Length Of Hospital Stay ◽  
Neurological Function ◽  
Nihss Score ◽  
Group A ◽  
Group B ◽  
Acute Cerebral Infarct

Objective. To investigate the effects of arteriovenous thrombolysis combined with mechanical thrombectomy on clinical efficacy, neurological function, and the changes of nerve injury markers of acute cerebral infarct (ACI) patients. Methods. A total of 143 cases with ACI admitted to our hospital from June 2017 to June 2019 were elected as research subjects. Among them, 69 cases of patients who received treatment of arteriovenous thrombolysis were considered as group A, and 74 cases of patients who received treatment of arteriovenous thrombolysis combined with mechanical thrombectomy were considered as group B. NIHSS score, clinical efficacy, vascular recanalization, adverse reactions, hemodynamics, neurological injury indexes, duration of coma, length of hospital stay, and prognosis of patients in the two groups were compared. Results. After treatment, the NIHSS score of group A was higher than that of group B (P<0.05), the clinical efficacy of group B was better than that of group A, and the incidence of adverse reactions was lower than that of group A (P<0.05). There was no difference in vascular recanalization rate, duration of coma, and prognosis between the two groups (P>0.05). Length of hospital stay, maximum peak velocity after treatment (Vs), and mean flow rate (Vm) of group A were lower than those of group B, while vascular resistance index (RI), pulsatility index (PI), serum glutamic acid (Glu), neuron-specific enolase (NES), and S100β protein detected by enzyme-linked immunosorbent assay (ELISA) of group A were higher than those of group B (P<0.05). Conclusion. Arteriovenous thrombolysis combined with mechanical thrombectomy has a significant effect on ACI, with high safety and quick effect. In addition, it has a stronger effect on improving and protecting the neurological function of patients, which is worth promoting in clinical practice.

scholarly journals Effect of Eye Movement Training on Sleep Quality of Patients with Advanced Lung Cancer Based on Pittsburgh Sleep Quality Index

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Haiping Hu ◽  
Wenying Yang ◽  
Zhimin Liu ◽  
Xiaona Zhang ◽  
Junmei Shi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Sleep Quality ◽  
Eye Movement ◽  
Negative Emotion ◽  
Advanced Lung Cancer ◽  
Lung Cancer Patients ◽  
Movement Training ◽  
Pain Scores ◽  
Group A ◽  
Group B

Objective. To explore the effect of eye movement training on sleep quality of patients with advanced lung cancer based on the Pittsburgh Sleep Quality Index (PSQI). Methods. 120 advanced lung cancer patients admitted to our hospital from January 2019 to January 2020 were selected as the research object and divided into group A (PSQI scores ≥ 10 points, n = 60) and group B (PSQI < 10 points, n = 60). Routine nursing was performed to both groups, and patients in group A received the eye movement training additionally, so as to compare their PSQI scores, negative emotion scores, adverse reaction rate (ARR), Cancer Coping Modes Questionnaire (CCMQ) scores, and pain scores. Results. After training, group A obtained significantly better sleep quality ( P < 0.05 ), lower negative emotion scores ( P < 0.001 ), lower ARR ( P < 0.05 ), better CCMQ scores ( P < 0.05 ), and lower pain scores ( P < 0.001 ) than group B. Conclusion. Eye movement training should be promoted in practice because it can reduce negative emotions, alleviate pain sensation, improve sleep quality and body condition, and lower the ARR for advanced lung cancer patients.

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