Pulmonary AND Bronchogenic carcinoma [keywords]
- PET/CT fusion in radiotherapy planning for lung cancer--Case reports. [Journal Article]
- Vojnosanit Pregl 2016 Jun; 73(6):599-602.
Application of imaging methods, namely computed tomography (CT), magnetic resonance imaging (MRI) and in recent years positron emission tomography/computed tomography (PET/CT), and the progress of computer technology have allowed the construction of effective computed systems for treatment planning (TPS) and introducing the concept of virtual simulation in 3D conformal radiotherapy planning.We hereby presented two patients with the diagnosis of non-small cell lung cancer who did PET/CT examination. Both patients had surgery earlier and local recidives are diagnosed with PET/CT. PET/CT of the first patient described the focus of intense ¹⁸F-fluorodeoxyglucose (¹⁸FDG) accumulation 2.99 x 2.9 x 2.1 cm in diameter in the projection of soft-tissue volume in the left corner, at operating clips height, corresponding to metabolically active recurrence of the tumor. Mediastinum and right lung parenchyma were without focal accumulation of ¹⁸FDG. Control PET/CT after 3 months was without detectable focus of intense pathological ¹⁸FDG accumulation--good therapeutic response, (metabolic disease remission). On the other hand, in the second case PET/CT showed a focus of intense ¹⁸FDG accumulation screening in the scar tissue of the apical part of the right lung, 20 x 16 mm, corresponding to metabolically active tumor recurrence. In the lung parenchyma on the left and in the mediastinum no visible focus of intense ¹⁸FDG accumulation was descrbed. Radiography included using 3D conformal radiotherapy with fusion PET/CT scan and CT simulations.PET/CT provides important information for planning conformal radiotherapy, especially in dose escalation, sparing of organ at risk and better locoregional control of the disease.
- [Lung cancer screening - risk stratification : Who should undergo screening?] [JOURNAL ARTICLE, ENGLISH ABSTRACT]
- Radiologe 2016 Aug 5.
Lung cancer is one of the leading causes of deaths in Europa and the USA. In approximately 75 % of lung cancer patients, bronchogenic carcinoma is detected at an advanced tumor stage; therefore, therapeutic options which aim at curing the disease in these patients are limited and treatment is mostly palliative. A relatively good prognosis is reserved for the minority of patients where the tumor is detected at an early stage and treatment is potentially curative. For this reason, early diagnosis of lung cancer could save lives. Retrospective analyses of the US national lung screening trial (NLST) showed that especially high-risk populations (e. g. higher age, positive smoking history, overweight and a positive family history for lung cancer) benefit most from lung cancer screening. Thus, the effectiveness of computed tomography (CT) screening can be improved by focusing on high-risk populations. This review article summarizes the risk stratification models of the large European and American screening studies and discusses possible future biomarkers for risk stratification.
- Chinese scientists to pioneer first human CRISPR trial. [News]
- Nature 2016 Jul 28; 535(7613):476-7.
- Management of Resistance to EGFR TKI-Targeted Therapy of Lung Cancer: Lessons in Monitoring Cancer Evolution. [Comment, Journal Article]
- Oncology (Williston Park) 2016 Jul; 30(7):616-8.
- Association between Congenital Lung Malformations and Lung Tumors in Children and Adults. A Systematic Review. [REVIEW, JOURNAL ARTICLE]
- J Thorac Oncol 2016 Jul 15.
The appropriate management of asymptomatic congenital pulmonary malformations (CPMs) remains controversial. Prophylactic surgery is recommended to avoid the risk for development of pulmonary infections and to prevent the highly debated development of malignancy. However, the true risk for development of malignancy remains unknown. A systematic review analyzed all cases in which lung tumors associated with CPMs in both the pediatric and adult populations were described.A comprehensive literature search was carried out; it included all the cases in which an association between CPMs and malignant pulmonary lesions was reported.In all, 134 publications were eligible for inclusion. In 168 patients CPM was found associated with lung tumor. The diagnosis was made in 76 children at a mean age of 3.68 ± 3.4, whereas in the adult population (n = 92) it was made at a mean age of 44.62 ± 16.09. Cough was the most frequent presenting symptom both in children and in adults. Most of the patients underwent lobectomy. The tumor most often associated with CPM was pleuropulmonary bastoma in children (n = 31) and adenocarcinoma (n = 20) or bronchioloalveolar carcinoma (n = 20) in adults. The CPM most frequenty associated with tumors in children was congenital cystic adenomatoid malformation (n = 37), especially type 1 (n = 21), whereas in adults it was bronchogenic cyst (n = 25), followed by congenital cystic adenomatoid malformation (n = 21).CPMs should be followed up and never underestimated because they may conceal a tumor. Apparently, there is no age limit for malignant progression of CPMs and no limit of the interval between first detection of the CPM and appearance of the associated tumor.
- Superior Vena Cava Syndrome due to Thrombosis: A Rare Paraneoplastic Presentation of Bronchogenic Carcinoma. [Journal Article]
- Iran J Med Sci 2016 Jul; 41(4):354-8.
Superior vena cava (SVC) syndrome is not an uncommon occurrence in patients with malignancy and it is often described as a medical emergency. In majority of the cases, SVC syndrome occurs due to mechanical obstruction of the SVC by extraluminal compression with primary intrathoracic malignancies. However, intraluminal obstruction due to thrombosis can also produce symptoms and signs of SVC syndrome. Clot-related SVC obstruction is mostly associated with indwelling central venous catheter and pacemaker leads, although such thrombosis can occur spontaneously in a background of a hypercoagulable state, e.g., malignancy. Here, an unusual case of sudden onset SVC syndrome has been reported, which on initial radiologic evaluation was found to have a lung nodule without any significant mediastinal mass or adenopathy compressing SVC. Subsequent investigation with Doppler ultrasonography of the neck showed thrombosis in the right internal jugular, right subclavian and right brachiocephalic vein, which was responsible for SVC syndrome. Histopathological evaluation of lung nodule confirmed presence of an adenocarcinoma. Therefore, venous thromboembolism as a paraneoplastic syndrome should be kept in mind while evaluating a case of SVC obstruction in a cancer patient. Management of the underlying disease is of prime importance in such cases and anticoagulation is the mainstay of therapy. Ability to identify paraneoplastic syndrome may have a significant effect on clinical outcome, ranging from early diagnosis to improved quality of life of the patient.
- [Impact on neutrophil-to-lymphocyte ratio and quality of life in the patients of non-small-cell lung cancer treated with grain-size moxibustion: a randomized controlled trial]. [English Abstract, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't]
- Zhongguo Zhen Jiu 2016 Apr; 36(4):342-6.
To explore the impact on neutrophil-to-lymphocyte ratio (NLR) and the quality of life (QOL) in the patients of non-small-cell lung cancer (NSCLC) treated with wheat-size moxibustion therapy.Seventy patients of NSCLC were randomized into an observation group and a control group, 35 cases in each one. Finally, 33 cases were participated in the observation group and 32 cases in the control group for statistical analysis. In the observation group, Zusanli (ST 36) and Feishu (BL 13) were selected for grain-size moxibustion, 9 moxa cones on each acupoint, once a day. There was the follow-up visit without any treatment applied in the control group. The trial lasted for 6 weeks. The changes in NLR and the QOL score before and after treatment were observed in the patients of the two groups and the differences were compared between the two groups.Compared with the condition before treatment, in the observation group, NLR was reduced apparently (P< 0.05), the general health state/life quality field, physical functioning, emotional functioning, cognitive functioning, fatigue, pain, short breath, insomnia and anorexia were improved apparently (all P < 0.05). In the control group, the differences were not significant in NLR, the general health states/life quality field, physical functioning, emotional functioning, cognitive functioning, role functioning, social functioning, fatigue, pain, short breath, insomnia and anorexia before and after treatment (all P > 0.05). In comparison of the two groups, NLR was reduced apparently in the observation group as compared with that in the control group after treatment (P < 0.05). The scores of the general health state/life quality field, physical functioning, emotional functioning and cognitive functioning were increased apparently as compared with those in the control group after treatment (all P < 0.05). The scores of fatigue, pain, short breath, insomnia and anorexia in the observation group were reduced apparently as compared with those in the control group after treatment (all P < 0.05).The wheat-size moxibustion therapy reduces NLR and improves the immune function and quality of life in the patients of NSCLC.
- [Programs for Continuing Medical Education; B session; 5. The recent progress of lung cancer chemotherapy]. [Journal Article]
- Nihon Naika Gakkai Zasshi 2016 Mar 10; 105(3):493-7.
- [Association between Efficacy of Pemetrexed and EGFR Mutation Status for EGFR Mutated Lung Carcinoma]. [English Abstract, Journal Article]
- Gan To Kagaku Ryoho 2016 Jun; 43(6):733-5.
Subgroup analysis of Japanese patients in a LUX-Lung 3 trial showed different progression-free survival(PFS) after cisplatin (CDDP) plus pemetrexed (PEM) treatment between patients in the exon 21 L858R (L858R) group (8.3 months) and the exon 19 deletion (19 del) group (3.1 months). PEM may have different efficacies in patients with L858R or 19 del.Consecutive patients with advanced/recurrent non-small cell lung cancer (NSCLC)harboring activating EGFR mutations were treated with platinum combined with PEM at our institute. The primary endpoint was to compare PFS of L858R patients to that of 19 del patients, among all patients with EGFR-mutated NSCLC.Thirty-two patients treated between 2009 and 2013 were included. The median age was 67 years (range: 40-78 years). Thirteen patients (41%) had L858R and 19 patients (59%) had 19 del. Patients were treated with CDDP(n=5)or carboplatin (n=27) combined with PEM. Compared with the 19 del group, the L858R group included more female patients(64% versus 47%, p=0.002), fewer patients treated with CDDP (8%versus 21%, p=0.018), and more patients with PEM maintenance therapy (50%versus 29%, p=0.003). The median number of cycles of platinum combined with PEM was 4(range: 1-6), and 13 patients received maintenance therapy. The response rate(RR)was 33.3% among L858R and 22.2% among 19 del (p=0.651). The median PFS was 5.13 months for L858R and 5.40 months for 19 del (p=0.824, HR=1.098, 95% CI: 0.48-2.50). The median overall survival (OS) was 29.17 months for L858R and 32.60 months for 19 del (p=0.232, HR=1.75, 95%CI: 0.69-4.45).This study did not show that PFS after platinum combined with PEM of L858R was superior to that of 19 del. RR and OS were consistent with PFS. A prospective trial is warranted to confirm the results of this study.
- [Evaluation of the Efficacy and Safety of Platinum Doublet Re-Challenge Chemotherapy in Patients with Recurrent Advanced Non-Small Cell Lung Cancer]. [English Abstract, Journal Article]
- Gan To Kagaku Ryoho 2016 Jun; 43(6):723-6.
Docetaxel or pemetrexed is the standard treatment for recurrent advanced non-small cell lung cancer (NSCLC). Until now, combination chemotherapy has failed to demonstrate superiority in patients with recurrent advanced NSCLC, compared to single-agent chemotherapy. The aim of the present study was to assess the efficacy and safety of platinum doublet re-challenge chemotherapy in patients with recurrent advanced NSCLC.Fifty-eight patients with recurrent advanced NSCLC who underwent platinum doublet re-challenge chemotherapy were retrospectively analyzed.The response rate was 6.9%(95%CI: 1.9-16.7%), the disease control rate was 70.7% (95%CI: 57.3-81.9%), the median progression-free survival (PFS) was 123 days, and the median survival time (MST) after re-challenge chemotherapy was 470 days. The disease control rate and the PFS were significantly better in patients who achieved a partial response to first-line chemotherapy than in patients who had stable or progressive disease. In addition, the PFS and MST were significantly longer in patients whose treatment-free interval was more than 90 days. Toxicities were tolerable in most patients, except for 1 patient who showed drug-induced pneumonia.Platinum doublet re-challenge chemotherapy is a treatment option for patients with advanced NSCLC who achieved a partial response to first-line chemotherapy or for patients whose treatment-free interval lasted longer than 90 days.