scholarly journals Palliative Treatment of Locally Advanced Non Metastatic Lung Cancer

2021 ◽  
Vol 12 (02) ◽  
pp. 71-77
Author(s):  
Gael Kietga ◽  
Wilfried Mosse ◽  
Patricia Agbanglanon ◽  
Bertrand Compaore ◽  
Davy Nchepo ◽  
...  
Author(s):  
Rana Fessi ◽  
Besma Ourari ◽  
Jihen B. Amar ◽  
Heifa Zaibi ◽  
Saloua Azzabi ◽  
...  

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3466-3466
Author(s):  
Kyaw Zin Thein ◽  
Lukman Tijani ◽  
Thein H. Oo

Introduction: LC is the leading cause of cancer mortality in USA. PATP was provided in experimental trials to decrease the venous thromboembolism (VTE) rates and to provide anti-tumor effect with ultimate aim to improve survival in patients with solid cancers as VTE is the second leading cause of death in cancer patients. We undertook a systematic review and meta- analysis of randomized controlled trials (RCTs) to determine the impact of PATP with LMWHs on overall survival (OS) in patients with locally advanced or metastatic LC. Methods: We performed a comprehensive literature search using MEDLINE and EMBASE databases through July 26, 2019. The references of all potential studies were also reviewed for any additional relevant studies. RCTs utilizing PATP with LMWHs in patients with locally advanced or metastatic lung cancer were incorporated in the analysis. A generic inverse variance method was used to calculate the estimated pooled hazard ratio (HR) for progression or metastasis free survival and OS with 95% confidence interval (CI). Heterogeneity was assessed with Cochran's Q -statistic. Random effects model was applied. Results: A total of 3,452 patients with lung cancer from six RCTs were included in our meta-analysis. The prophylactic doses of bemiparin, dalteparin, tinzaparin, nadroparin and intermediate dose of enoxaparin were used in the studies. The duration of LMWH ranged from 3 to 6 months. The randomization ratio was 1 to 1 in all studies. The I2statistic for heterogeneity was 64, suggesting moderate heterogeneity among RCTs. The pooled HR for OS was not statistically significant at 1.02 (95% CI: 0.83-1.26; P = 0.83). In a subset of small cell lung cancer (SCLC) patients, the pooled HR for OS was 1.03 (95% CI: 0.72-1.48; P = 0.85). The HR for OS was noted at 1.70 (95% CI: 0.70-4.15; P = 0.24) in patients with limited stage SCLC. In a subset of non-small cell lung cancer, the pooled HR of OS was 1.00 (95% CI: 0.79-1.26; P = 0.98). The pooled HR for progression or metastasis free survivalwas 1.03 (95% CI: 0.86-1.24; P = 0.74) according to an analysis of 5 RCTs. Conclusions: Our meta- analysis demonstrated that no survival advantage was noted with the addition of PATP with LMWHs to routine standard chemotherapy in patients with locally advanced or metastatic LC, regardless of histology types as well as stages of SCLC. Disclosures Oo: Medical Education Speakers Network: Honoraria; Janssen and Janssen: Other: Research: site co-investigator .


Author(s):  
M. Kaous ◽  
D.D. Balachandran ◽  
G. Pacheco ◽  
S.A. Mahoney ◽  
J.N.T. Po ◽  
...  

2021 ◽  
pp. 0272989X2199895
Author(s):  
Adinda Mieras ◽  
Annemarie Becker-Commissaris ◽  
Hanna T. Klop ◽  
H. Roeline W. Pasman ◽  
Denise de Jong ◽  
...  

Background Previous studies have investigated patients’ treatment goals before starting a treatment for metastatic lung cancer. Data on the evaluation of treatment goals are lacking. Aim To determine if patients with metastatic lung cancer and their oncologists perceive the treatment goals they defined at the start of systemic treatment as achieved after treatment and if in hindsight they believe it was the right decision to start systemic therapy. Design and Participants A prospective multicenter study in 6 hospitals across the Netherlands between 2016 and 2018. Following systemic treatment, 146 patients with metastatic lung cancer and 23 oncologists completed a questionnaire on the achievement of their treatment goals and whether they made the right treatment decision. Additional interviews with 15 patients and 5 oncologists were conducted. Results According to patients and oncologists, treatment goals were achieved in 30% and 37% for ‘quality of life,’ 49% and 41% for ‘life prolongation,’ 26% and 44% for ‘decrease in tumor size,’ and 44% for ‘cure’, respectively. Most patients and oncologists, in hindsight, felt they had made the right decision to start treatment and also if they had not achieved their goals (72% and 93%). This was related to the feeling that they had to do ‘something.’ Conclusions Before deciding on treatment, the treatment options, including their benefits and side effects, and the goals patients have should be discussed. It is key that these discussions include not only systemic treatment but also palliative care as effective options for doing ‘something.’


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