scholarly journals Comparative Study of Two Thoracic Radiotherapy Schedules for Palliation of Symptom, Radiological Response and Acute Toxicities in Advanced Non-small Cell Lung Cancer

2021 ◽  
Vol 6 (2) ◽  
pp. 159-165
Author(s):  
Subhash Chand Bairwa ◽  
Ravinder Singh Gothwal ◽  
Badri Ram ◽  
Shivani Gupta ◽  
Chetna Meena
Keyword(s):  
Advanced Nsclc ◽  
Radiation Pneumonitis ◽  
Pulmonary Functions ◽  
Radiological Response ◽  
The Difference ◽  
Symptom Palliation ◽  
Nsclc Patients ◽  
And Control ◽  
Fractionation Schedules

Aim: To compare the effect of two RT schedules for thoracic palliation in advanced NSCLC patients (30 Gy in 10 fractions over two weeks and 27 Gy in 6 fractions over three weeks, 2 fractions per week) on pulmonary symptoms, radiological response of the primary thoracic tumour, pulmonary functions and acute toxicities. Material and method: A hospital based quantitative prospective follow-up study. Total 104 advanced NSCLC patients were randomized into two fractionation arms. Evaluation was done pretreatment and 4 weeks after end of RT. Symptoms palliation and radiological response to RT & radiation pneumonitis were assessed by using RTOG 4-point scale and Revised (RECIST) guideline version 1.1 respectively. Radiotherapy was given by Cobalt-60 teletherapy machine. Results: Total 96 patients were evaluated for symptom palliation, radiological response and acute toxicities. The percentage of patients achieving symptom palliation was slightly higher in the control arm. At 1st month of follow-up, 16.67% & 18.75% patients in Study & control arm showed PR. Post-RT mean FVC and FEV1 showed a tendency for improvement in both mean FVC and FEV1 in compare to baseline. Treatment was well tolerated both arms. Grade I nausea and vomiting developed in 43% and 37.5% patients in Study and Control Arm respectively. 58% & 39% patients developed Grade 1 radiation pneumonitis as cough & dyspnea in study and control arms respectively. Grade 2 radiation pneumonitis was developed in 2 patient of study arm at 3rd week of follow-up but they lost follow up. Around 31% patients developed Grade1 esophagitis as dysphagia in both arms at 1 week of follow-up which was reduced up to 7% by 2nd week. A very few patients developed grade1 skin reaction as dermatitis in 1st week of treatment. The difference in symptom palliation, radiological response, pulmonary functions and acute toxicities in both arms was not statistically significant. Conclusion: The two RT fractionation schedules showed equal efficacy in terms of symptoms palliation, radiological response of the primary thoracic tumor, pulmonary functions and acute toxicities. Thus the 27 Gy/6 fractionation arm appears preferable compared to 30 Gy/10 arm to minimize the patients’ visits and load on the machines.

Correlation of tumor response and survival in advanced NSCLC patients treated with paclitaxel plus carboplatin (PC) versus paclitaxel plus carboplatin plus gemcitabine (PCG)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7650-7650
Author(s):  
A. Paccagnella ◽  
F. Oniga ◽  
A. Bearz ◽  
A. Favaretto ◽  
F. Barbieri ◽  
...  
Keyword(s):  
Median Survival ◽  
Advanced Nsclc ◽  
Tumor Response ◽  
Cox Model ◽  
Early Death ◽  
Survival Difference ◽  
The Difference ◽  
Similar Survival ◽  
Cox Analysis ◽  
Nsclc Patients

7650 Background: We showed that PCG significantly increases both response rate (RR) (43.6% vs 20%) and median survival (10.8 mo vs 8.3 mo) over PC and that at Cox analysis, the only independent prognostic factors were PS and treatment (Paccagnella et al, J Clin Oncol 2006;24: 681–687). According to the Prentice criteria (Stat Med 1989;8: 431–440), to directly relate response and survival it is necessarily that responding patients (and non responding) of both arms have a similar survival and that the survival difference between the two arms disappear when the response factor is included in the multivariate analysis. Methods: Out of 324 pts included in the original analysis, 26 pts were not evaluable for response (early death, toxicity, refusal) before the planned response evaluation at two months and were excluded (15 pts from PC arm and 11 pts from PCG arm). The analysis however was also performed considering the non evaluable patients as non responders. Results: Overall, Responder patients had a median Survival that nearly doubled that of no responders: 14.73 mo vs 7.67 mo (HR: 0.49; CI: 0.31–0.54; P=0.000). No responder pts from PC and PCG arms had a similar survival (median 7.53 mo and 8.07 mo respectively; P= 0.96) as well as responder (CR + PR) patients (median 14.13 mo and 15.40 mo respectively; P=0.38). The principal difference between the two arms was that more than the double of patients in PCG arm responded (43.6% vs 20%) and consequently had a survival advantage of clinical relevance in comparison to patients in PC arm. When tumor response was introduced in the Cox model (as a four level variable), the difference in Overall Survival between PCG and PC changed from a significant level (HR=1.28; CI 1.00–1.63; P=0.049) to a not significant level (HR=0.99; CI: 0.76 - 1.28; P=0.97). Conclusions: To our knowledge this is the first report showing a significant direct correlation between response and survival in advanced NSCLC according to Prentice criteria. No significant financial relationships to disclose.

Development of brain metastases in stage III/IV non-small cell lung cancer patients treated with or without erlotinib.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19011-e19011 ◽  
Author(s):  
Jing Liu ◽  
Li Kong ◽  
Xue Meng ◽  
Jinbo Yue ◽  
Xindong Sun ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Brain Metastases ◽  
Small Cell Lung Cancer ◽  
Small Cell ◽  
Stage Iii ◽  
Control Group ◽  
Small Cell Lung ◽  
Nsclc Patients ◽  
And Control

e19011 Background: Non-small cell lung cancer (NSCLC) has a risk of death from brain metastases (BM) that exceeds potential mortality from extracranial disease progression. Erlotinib has been proved to be effective for NSCLC patients. We hold a study to evaluate value of erlotinib in preventing BM in stage III/IV NSCLC patients. Methods: Pathologically confirmed NSCLC stage III/IV patients were included and divided into erlotinib group and control group according to whether erlotinib administration (at least one month) in 1- or 2-line therapy or not. Stage IV patients with BM were excluded. Patients with any EGFR-TKI treatment were excluded from control group. Times of erlotinib administration to BM and to death or last follow-up were recorded for erlotinib group. Times of corresponding 1- or 2-line chemotherapy to BM and to death or last follow-up were recorded for control group correspondingly. Time to BM, 1- and 2-year incidence of BM were end points. Results: 140 patients were included (68 in erlotinib group and 72 in control group) and all clinical characteristics between two groups were balanced. At a median follow-up of 20.0 months, the median time to BM for all patients was 28.0 months (95% CI, 23.795-32.205 months). 1- and 2-year incidence of BM were 17.8% (95% CI, 10.744-24.856%) and 38.8% (95% CI, 27.236-50.364%) respectively. The median time to BM were 42.0 months (95% CI, 15.567-68.433 months) and 19.0 months (95% CI, 11.305-26.695 months) (P=0.028) for erlotinib group and control group. Erilotinib group has a lower BM incidence than control group (1-year: 14.4%, 95% CI: 4.992%-23.808%, vs 21.1%, 95% CI: 10.712%-31.488%, P=0.384; 2-year: 26.2%, 95% CI: 18.712%-33.688%, vs 50.2%, 95% CI: 34.128%-66.272%, P=0.005). Multivariate analysis shows interval to BM were longer for erlotinib group (HR, 2.531; 95% CI, 1.272-5.051; P=0.008) and stage III disease (HR, 2.093; 95% CI, 1.035-4.231; P=0.040). Conclusions: Erlotinib administration improves time to BM and 2-year incidence of BM of stage III/IV NSCLC patients. Erlotinib administration and stage III disease predicts lower incidence of BM in all patients.

Efficacy of EGFR-TKIs monotherapy versus TKI plus chemotherapy as first-line treatment in EGFR mutant lung adenocarcinoma with liver metastases.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e21099-e21099
Author(s):  
Huijuan Wang ◽  
Mengmeng Li ◽  
Mina Zhang ◽  
Zhang guo Wei ◽  
Xiangtao Yan ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Liver Metastases ◽  
Egfr Mutation ◽  
Advanced Nsclc ◽  
Small Cell Lung ◽  
First Line ◽  
Chemotherapy Group ◽  
Nsclc Patients ◽  
Egfr Tkis

e21099 Background: Liver metastasis is one of the most reasons for the poor prognosis of patients with advanced lung cancer. Seeking for active and effective treatment measures is very important for these patients. At present, the first-line standard treatment of the advanced NSCLC with EGFR mutation is EGFR-TKIs monotherapy. However, its efficacy is poor in the advanced non-small cell lung cancer with EGFR mutation and liver metastases. The objective of this study is to evaluate the efficacy of EGFR-TKIs plus chemotherapy in patients with EGFR mutation of advanced non-small cell lung cancer with liver metastases. Methods: The clinical data of a total of 384 advanced NSCLC patients with EGFR mutation positive who were admitted to The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital from February 2017 to June 2020 were retrospectively analyzed. There were 75 patients with liver metastases. Patients were divided into two groups, and accepted EGFR-TKIs monotherapy or EGFR-TKIs plus chemotherapy, respectively. All patients treatment response were evaluated by the RECIST1.1 Response evaluation criteria in solid tumors.Progression free-survival (PFS) were also analyzed. Results: In the study, 75 patients were finally screened. There were 37 patients in the EGFR-TKIs monotherapy group and 38 patients in the TKI plus chemotherapy group. The median follow-up time was 23.0 months. At the latest follow-up date (2021-01-01), 57 patients had disease progression and 35 patients had died. Comparing with EGFR-TKIs monotherapy,the first-line PFS of EGFR-TKI plus chemotherapy group was longer, and the median PFS was 12.7 months VS 7.4 months (P = 0.018).The ORR of primary lung lesions was no significant difference between these two groups（65.8%VS 51.4% P = 0.204), and DCR (97.4% VS 94.6% P = 0.981) also had no difference between two groups（P > 0.05）. ORR of liver metastases in the EGFR-TKIs plus chemotherapy group was significantly higher than EGFR-TKIs monotherapy group ORR (65.8%VS 40.5%，P = 0.028). Conclusions: In advanced NSCLC patients with EGFR mutation and liver metastases, comparing with EGFR-TKIs monotherapy, taking EGFR-TKIs plus chemotherapy as first-line treatment had longer PFS, and better efficacy on liver lesions.

BCG VACCINATION AGAINST TUBERCULOSIS IN CHICAGO

PEDIATRICS ◽  
1961 ◽  
Vol 28 (4) ◽  
pp. 622-641
Author(s):  
Sol Roy Rosenthal ◽  
Erhard Loewinsohn ◽  
Mary L. Graham ◽  
Dorothy Liveright ◽  
Margaret G. Thorne ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Miliary Tuberculosis ◽  
Cook County ◽  
Cook County Hospital ◽  
Follow Up Care ◽  
Single Vaccination ◽  
Medical Importance ◽  
The Difference ◽  
And Control

A series of 1,716 BCG-vaccinated and 1,665 nonvaccinated infants, all born at the Cook County Hospital in Chicago between February, 1937, and February, 1948, were followed until February, 1960 (23 years). Among the vaccinated there was a total of 17 cases of tuberculosis (0.43/1,000/yr) and 65 cases in the nonvaccinated 1.7/1,000/yr), a reduction of 75%, statistically highly significant (p 0.001). The morbidity was 0.41/1,000/yr (16 cases in 1,716) in the vaccinated subjects and 1.5/1000/yr (59 cases in 1,665) in the controls, or a reduction of 74% (p 0.001). There was one death from tuberculosis in the vaccinated subjects and six in the controls, or a reduction of 83%. The number of deaths is too small for meaningful statistical analysis. Comparisons of the control and vaccinated groups were made for subsequent contact to tuberculosis in the home and environment, sex, race, birth weight, observation years, follow-up care, general health and reasons for loss from study. The over-all comparability of the two groups was adequate in most respects. Statistically significant differences were assessed for medical importance. In 639 families in which there were both vaccinated and control siblings, 8 of the 790 vaccinated subjects developed tuberculosis as compared with 30 of the 845 control individuals. The difference is highly significant (p 0.001). Thirteen cases of nonfatal tuberculosis developed in the controls 2 years of age and under and none in the vaccinated. There were three deaths from tuberculosis in the controls under 2½ years of age (miliary tuberculosis plus meningitis in all) and one death in the vaccinated group (meningitis). The latter was an infant who had not converted at 6 months of age and was not revaccinated. Following vaccination, 99.3% became tuberculin positive and 82.4% were still positive, after 8 years, to a single vaccination.

scholarly journals Pembrolizumab Alone or Combined With Chemotherapy in Advanced NSCLC With PD-L1 ≥50%: Results of a Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Ya Chen ◽  
Yanan Wang ◽  
Zhengyu Yang ◽  
Minjuan Hu ◽  
Yanwei Zhang ◽  
...  
Keyword(s):  
Overall Survival ◽  
Advanced Nsclc ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Standard Of Care ◽  
Programmed Death ◽  
Platinum Based Chemotherapy ◽  
Prospective Trials ◽  
Nsclc Patients

ObjectivesPembrolizumab plus platinum-based chemotherapy and pembrolizumab monotherapy (PM) both become standard of care in patients with advanced non-small-cell lung cancer (NSCLC) and a programmed death ligand 1 (PD-L1) tumor proportion score (TPS) greater than 50%. This study aimed to figure out the better treatment choice.MethodIn this retrospective analysis, we compared the clinical efficacy of PM and PC as first-line treatment in NSCLC patients with a PD-L1 ≥50% and negative for genomic alterations in the EGFR and ALK genes.ResultAmong the population, 115 patients received PC, and 91 patients received PM. Up to Dec 30, 2020, median follow-up was 17.13 months. The median progression-free survival (PFS) rates of PC and PM were 12.37 and 9.60 months (HR: 0.44, p < 0.001), respectively. The median overall survival (OS) rates were NE and 28.91 months (HR: 0.40, p = 0.005), respectively. Subgroup analysis found that the PFS benefit of PC was evident in most subgroups excepting patients with brain metastasis. The 1-year overall survival rates of PC and PM were 89.3% and 76.1%, respectively. The ORR was 61.7 and 46.9% (p = 0.004), respectively.ConclusionIn patients with previously untreated, PD-L1 ≥50%, advanced NSCLC without EGFR or ALK mutations, the addition of pembrolizumab to standard platinum-based chemotherapy seems to be the preferred treatment, which needs to be validated by further prospective trials.

scholarly journals The Effect of Psychodrama Integrated Psycho-Education Program on Resilience and Divorce Adjustment of Children of Divorced Families

2020 ◽  
Vol 10 (1) ◽  
pp. 56
Author(s):  
Uğur Gürgan
Keyword(s):  
Data Collection ◽  
Education Program ◽  
Personal Information ◽  
Control Groups ◽  
Divorced Families ◽  
Divorce Adjustment ◽  
Post Test ◽  
The Difference ◽  
And Control

The aim of this study is to determine the effect of Psycho-drama Integrated Psycho-Education Program (PIPP) on divorce adaptation and resilience scores of children of divorced families. In this study, a 2x3 design with experimental and control groups and having pre-test, post-test and follow-up measurements was used. Nonparametric statistics were used in the analysis of the obtained data. Mann Whitney U test was adopted to determine the significance of the difference between the groups and Wilcoxon Signed-Ranks Test was utilized to find the significance of the difference between the measurements. The Child’s Divorce Adjustment Inventory, Child and Youth Resilience Measure and Personal Information Form were used as data collection tools. Based on the results, it was seen that the PIPP had a highly significant effect on the increase in adaptation and resilience scores of children of divorced families and this effect was long-lasting.

scholarly journals Hematocrit levels and thrombotic events in patients with polycythemia vera: an analysis of Veterans Health Administration data

2019 ◽  
Vol 98 (11) ◽  
pp. 2533-2539
Author(s):  
Shreekant Parasuraman ◽  
Jingbo Yu ◽  
Dilan Paranagama ◽  
Sulena Shrestha ◽  
Li Wang ◽  
...  
Keyword(s):  
Polycythemia Vera ◽  
Cox Regression ◽  
Veterans Health Administration ◽  
Veterans Health ◽  
Health Administration ◽  
Monitoring And Control ◽  
The Difference ◽  
And Control ◽  
The Relationship

Abstract Patients with polycythemia vera (PV) have a high incidence of thrombotic events (TEs), contributing to a greater mortality risk than the general population. The relationship between hematocrit (HCT) levels and TE occurrence among patients with PV from the Veterans Health Administration (VHA) was evaluated to replicate findings of the CYTO-PV trial with a real-world patient population. This retrospective study used VHA medical record and claims data from the first claim with a PV diagnosis (index) until death, disenrollment, or end of study, collected between October 1, 2005, and September 30, 2012. Patients were aged ≥ 18 years at index, had ≥ 2 claims for PV (ICD-9-CM code, 238.4) ≥ 30 days apart during the identification period, continuous health plan enrollment from 12 months pre-index until end of study, and ≥ 3 HCT measurements per year during follow-up. This analysis focused on patients with no pre-index TE, and with all HCT values either < 45% or ≥ 45% during the follow-up period. The difference in TE risk between HCT groups was assessed using unadjusted Cox regression models based on time to first TE. Patients (N = 213) were mean (SD) age 68.9 (11.5) years, 98.6% male, and 61.5% white. TE rates for patients with HCT values < 45% versus ≥ 45% were 40.3% and 54.2%, respectively. Among patients with ≥ 1 HCT before TE, TE risk hazard ratio was 1.61 (95% CI, 1.03–2.51; P = 0.036). This analysis of the VHA population further supports effective monitoring and control of HCT levels < 45% to reduce TE risk in patients with PV.

scholarly journals Usefulness of Two Independent DNA and RNA Tissue-Based Multiplex Assays for the Routine Care of Advanced NSCLC Patients

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1124 ◽  
Author(s):  
Elba Marin ◽  
Cristina Teixido ◽  
Elena Carmona-Rocha ◽  
Roxana Reyes ◽  
Ainara Arcocha ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Median Overall Survival ◽  
Advanced Nsclc ◽  
Gene Mutations ◽  
Routine Care ◽  
Molecular Testing ◽  
Cancer Management ◽  
Dna And Rna ◽  
Nsclc Patients

Personalized medicine is nowadays a paradigm in lung cancer management, offering important benefits to patients. This study aimed to test the feasibility and utility of embedding two multiplexed genomic platforms as the routine workup of advanced non-squamous non-small cell lung cancer (NSCLC) patients. Two parallel multiplexed approaches were performed based on DNA sequencing and direct digital detection of RNA with nCounter® technology to evaluate gene mutations and fusions. The results were used to guide genotype-directed therapies and patient outcomes were collected. A total of 224 advanced non-squamous NSCLC patients were prospectively included in the study. Overall, 85% of samples were successfully characterized at DNA and RNA levels and oncogenic drivers were found in 68% of patients, with KRAS, EGFR, METΔex14, BRAF, and ALK being the most frequent (31%, 19%, 5%, 4%, and 4%, respectively). Among all patients with complete genotyping results and follow-up data (n = 156), the median overall survival (OS) was 1.90 years (confidence interval (CI) 95% 1.69–2.10) for individuals harbouring an actionable driver treated with a matched therapy, compared with 0.59 years (CI 95% 0.39–0.79) in those not eligible for any targeted therapy and 0.61 years (CI 95% 0.12–1.10) in patients with no drivers identified (p < 0.001). Integrating DNA and RNA multiplexing technologies into the routine molecular testing of advanced NSCLC patients is feasible and useful and highlights the necessity of widespread integrating comprehensive molecular diagnosis into lung cancer care.

scholarly journals Using Montelukast as an Add-on Treatment in Nephrotic Syndrome Pediatrics: A Randomized Clinical Trial Study

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Fatemeh Javidi ◽  
Parsa Yousefichaijan ◽  
Fatemeh Dorreh ◽  
Ali Arjmand ◽  
Masoud Rezagholizamenjany
Keyword(s):  
Clinical Trial ◽  
Nephrotic Syndrome ◽  
Intervention Group ◽  
Control Group ◽  
Final Report ◽  
Before And After ◽  
Spss Software ◽  
The Difference ◽  
And Control

Background: Montelukast, as a non-steroidal anti-inflammatory drug, could reduce inflammation in nephrotic syndrome (NS). This study aimed to evaluate the therapeutic effect of montelukast as adjunctive therapy in pediatric NS. Methods: This clinical trial study was conducted on patients with NS. The patients were assigned into two equal groups (N = 25 in each) of intervention (steroid + montelukast) and control and treated for one month. One month later, in the follow-up stage, their proteinuria was measured. The results before and after treatment were statistically analyzed by SPSS software version 21, and the final report of the project was presented. Results: The age of participants in the intervention and control groups was 7.26 ± 4.23 and 6.79 ± 3.91 years, respectively (P = 0.68), and there were 10 female participants in both groups (P = 1.0). Albumin levels in 96% of the control group and 76% of the intervention group were 1.5 - 2.5 μg/dL (P = 0.037). Also, 48% of participants in the control group were corticosteroid dependent, and 60% of participants in the intervention group responded to corticosteroids (P = 0.194). The severity of nephrotic syndrome was moderate in 60% of participants in the control group and mild in 60% of participants in the intervention group (P = 0.138). Conclusions: The results of this study showed that recovery rate was higher in the intervention group, but the difference was not statistically significant.

Sign in / Sign up

Export Citation Format

Share Document