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Pulmonary AND Bronchogenic carcinoma [keywords]
- [Clinical epidemiology and histological characteristics of patients with lung cancer in West China Hospital of Sichuan University]. [English Abstract, Journal Article]
- Sichuan Da Xue Xue Bao Yi Xue Ban 2014 Mar; 45(2):309-15.
To identify changes in patterns of primary bronchogenic carcinoma.We reviewed clinical data of patients with primary bronchogenic carcinoma, who were identified as permanent residents of Sichuan province and were treated in West China Hospital of Sichuan University in 2000 and 2010. The distributions of gender, age, urban/rural residency, smoking history, occupational exposure and histological types of tumor were compared between the 2000 group and 2010 group.A total of 2 167 patients (616 in 2000 and 1551 in 2010) met the inclusion criteria. Compared with the 2000 group, the 2010 group had a lower proportion of male patients (male/female sex ratio dropped from 2.78:1 to 2.13:1, P = 0.013), more patients from medium and small sized cities (patients from large city decreased from 42.1% to 32.0%, P < 0.001, and patients from medium and small sized cities decreased from 39.9% to 31.7%, P < 0.001), more patients from rural areas (patients from townships increased from 5.5% to 8.1%, P = 0.041, and patients from villages increased from 12.5% to 28.2%, P < 0.001). No significant difference in age was found in the two cohorts of patients. The proportion of squamous cell carcinoma dropped from 44.8% in 2000 to 28.7% in 2010 (P < 0.001). The proportion of adenocarcinoma increased from 43.0% in 2000 to 53. 1% in 2010 (P < 0.001). The proportion of small cell lung cancer increased from 3.7% in 2000 to 11.9% in 2010 (P < 0.001). The proportion of squamous cell carcinoma in male patients was higher than that of female patients (60.7% vs. 36.6% in 2000; 75.8% vs. 42.9% in 2010). The proportion of adenocarcinoma was higher in female patients than that of male patients (60.7% vs. 36.6% in 2000; 75.8% vs. 42.9% in 2010). The proportion of squamous cell carcinoma was higher in elderly patients (> or = 60) than that of young patients (< 45) (50.5% vs. 33.8% in 2000; 30.2% vs. 15.6% in 2010). The proportion of adenocarcinoma in young patients was higher than of elderly patients (54.9% vs. 36.9% in 2000; 57.1% vs. 51.8% in 2010). Squamous cell carcinoma was predominate in smoking patients (55.6% in 2000; 40.9% in 2010). Adenocarcinoma was predominate in no-smoking patients (58.4% in 2010; 75.7% in 2010) and the patients exposed to risk occupations (46.2% in 2000; 60.2% in 2010).Over the past decade, the percentages of female patients, adenocarcinoma and small cell lung cancer increased significantly in the patients with lung cancer. Male gender, old age (> or = 60) and smoking are risk factors of squamous cell carcinoma. Female gender, young age (< 45) and occupational exposure are risk factors of adenocarcinoma.
- Empyema thoracis from an inhaled peanut. [Journal Article]
- BMJ Case Rep 2014.
A 77-year-old man with a history of pulmonary sarcoidosis was referred with persistent cough and reduced air entry on auscultation of the right lung base. He was an ex-smoker with a 40-pack-year history and his general practitioner was concerned about the possibility of bronchogenic carcinoma. A chest radiograph showed a right-sided pleural effusion with right mid-zone airspace opacification. Bronchoscopy revealed a peanut covered in mucus lodged in the right lower lobe bronchus. CT of the thorax demonstrated a multiloculated right pleural effusion with associated compressive atelectasis, consistent with chronic empyema. A chest drain was inserted but failed to fully clear the collection and the patient proceeded to a thoracoscopic decortication of a pleural empyema secondary to the right lower lobe obstruction from an inhaled peanut. His postoperative recovery was uncomplicated.
- Overcoming drug resistance in ALK-rearranged lung cancer. [Comment, Editorial]
- N Engl J Med 2014 Mar 27; 370(13):1250-1.
- Ceritinib in ALK-rearranged non-small-cell lung cancer. [Clinical Trial, Phase I, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't]
- N Engl J Med 2014 Mar 27; 370(13):1189-97.
Non-small-cell lung cancer (NSCLC) harboring the anaplastic lymphoma kinase gene (ALK) rearrangement is sensitive to the ALK inhibitor crizotinib, but resistance invariably develops. Ceritinib (LDK378) is a new ALK inhibitor that has shown greater antitumor potency than crizotinib in preclinical studies.In this phase 1 study, we administered oral ceritinib in doses of 50 to 750 mg once daily to patients with advanced cancers harboring genetic alterations in ALK. In an expansion phase of the study, patients received the maximum tolerated dose. Patients were assessed to determine the safety, pharmacokinetic properties, and antitumor activity of ceritinib. Tumor biopsies were performed before ceritinib treatment to identify resistance mutations in ALK in a group of patients with NSCLC who had had disease progression during treatment with crizotinib.A total of 59 patients were enrolled in the dose-escalation phase. The maximum tolerated dose of ceritinib was 750 mg once daily; dose-limiting toxic events included diarrhea, vomiting, dehydration, elevated aminotransferase levels, and hypophosphatemia. This phase was followed by an expansion phase, in which an additional 71 patients were treated, for a total of 130 patients overall. Among 114 patients with NSCLC who received at least 400 mg of ceritinib per day, the overall response rate was 58% (95% confidence interval [CI], 48 to 67). Among 80 patients who had received crizotinib previously, the response rate was 56% (95% CI, 45 to 67). Responses were observed in patients with various resistance mutations in ALK and in patients without detectable mutations. Among patients with NSCLC who received at least 400 mg of ceritinib per day, the median progression-free survival was 7.0 months (95% CI, 5.6 to 9.5).Ceritinib was highly active in patients with advanced, ALK-rearranged NSCLC, including those who had had disease progression during crizotinib treatment, regardless of the presence of resistance mutations in ALK. (Funded by Novartis Pharmaceuticals and others; ClinicalTrials.gov number, NCT01283516.).
- Superior vena cava obstruction (SCVO). [Case Reports, Journal Article]
- Ir Med J 2014 Feb; 107(2):51-2.
- Radiation enhanced efficiency of combined electromagnetic hyperthermia and chemotherapy of lung carcinoma using cisplatin functionalized magnetic nanoparticles. [Journal Article, Research Support, Non-U.S. Gov't]
- Pharmazie 2014 Feb; 69(2):128-31.
The effect of trimodality treatment consisting of hyperthermia, cisplatin and radiation was investigated in two non-small lung carcinoma cell lines with different sensitivities to cisplatin. Hyperthermia treatment was performed using heat released via Neél and Brown relaxation of magnetic nanoparticles in an alternating magnetic field. Radiation with dose 1.5 Gy was performed after 15 min electromagnetic hyperthermia and cisplatin treatment. Electromagnetic hyperthermia enhanced cisplatin-induced radiosensitization in both the cisplatin-sensitive H460 (viability 11.2 +/- 1.8 %) and cisplatin-resistant A549 (viability 14.5 +/- 2.3 %) lung carcinoma cell line. Proposed nanotechnology based trimodality cancer treatment may have therefore important clinical applications.
- Tumor, node and metastasis classification of lung cancer - M1a versus M1b - Analysis of M descriptors and other prognostic factors. [JOURNAL ARTICLE]
- Lung Cancer 2014 Feb 23.
The current edition of the tumor, node and metastasis (TNM) classification of lung cancer (LC) divides the presence of metastasis (M1) into two categories: M1a and M1b, depending on its anatomical location. To assess this new classification, the survival and the M descriptors of LC patients with metastatic disease registered by the Bronchogenic Carcinoma Cooperative Group of the Spanish Society of Pneumology and Thoracic Surgery II (GCCB-S-II), were analyzed.Non-small cell lung cancer (NSCLC) patients, with M1a or M1b disease, included in the GCCB-S-II, from April 2009 to December 2010, staged in accordance with the prospective staging project protocol of the International Association for the Study of Lung Cancer (IASLC), and with complete TNM staging and follow-up data, were studied. The overall survival associated with each M1 category and each M descriptor, besides other prognostic factors (sex, age, performance status [PS] and others) were analyzed by univariate and multivariate models.640 NSCLC patients (195 M1a and 445 M1b) were included. M1b tumors had significantly worse survival than M1a tumors (p<0.001). The prognostic value of M1 category was independent from other prognostic variables such as PS, weight loss, and others. The number of metastatic sites (isolated versus multiple) and the number of lesions (single versus multiple) in patients with isolated metastasis showed prognostic value, especially in those with brain metastasis.The current division of the M1 category into two subsets (M1a and M1b) is warranted by their prognostic significance. The number of metastatic sites and the number of lesions in patients with isolated metastasis should be taken into account, because they also have prognostic relevance.
- Pulmonary lymphangitic carcinomatosis from head and neck squamous cell carcinoma. [JOURNAL ARTICLE]
- Int J Oral Maxillofac Surg 2014 Mar 4.
Pulmonary lymphangitic carcinomatosis (PLC) secondary to mucosal head and neck squamous cell carcinoma (HNSCC) is extremely rare, difficult to diagnose in the pre-symptomatic phase, and is rapidly fatal. We describe two cases of fatal PLC secondary to squamous cell carcinoma in whom a review of pre-treatment imaging (computed tomography of the chest) changes reported as unspecific were retrospectively felt to be consistent with pre-symptomatic PLC. Case 1, a 73-year-old male with T2N2bMx poorly differentiated squamous cell carcinoma of the right tonsil, died 6 weeks after chemoradiotherapy with curative intent. Case 2, a 65-year-old female with T4aN2bMx of the right body of the mandible, died within 6 weeks of radical surgery including free tissue transfer. A review of the literature showed that PLC secondary to HNSCC occurs in an older cohort of patients: mean age 69 years vs. other tumour groups 50 years. PLC secondary to HNSCC can behave in distinctly different ways, demonstrating similarity to either gastric adenocarcinoma or bronchogenic squamous cell carcinomas.
- [Thoracoscopic surgery of lung cancer]. [English Abstract, Journal Article, Review]
- Duodecim 2014; 130(2):145-51.
Surgery alone or in combination with adjuvant therapies provides the best possibility for cure for non-small cell lung cancer patients with local disease. The most common surgical resection is lobectomy. In addition, the local and mediastinal lymph nodes are removed for disease staging and adjuvant therapy evaluation. Thoracoscopic surgery is performed through small incisions. The surgical and oncological principles are identical but the benefits of the thoracoscopic approach include faster recovery and extension of curative resection to patients not tolerating thoracotomy. Thoracoscopic lobectomy seems to be comparable to open surgery with respect to the local cancer recurrence and long term survival.
- [What we can learn from a case of medical malpractice--physician's violation of duty of care and error in clinical judgment regarding study eligibility denied as the cause of patient's death one month following study drug administration]. [Case Reports, Journal Article]
- Nihon Geka Gakkai Zasshi 2014 Jan; 115(1):39-40.