Objective： The aim of this study was to investigate the efficacy and toxicity of single agent topotecan(second line) or topotecan＋ cisplatin (first line) in the treatment of the patients with small cell lung cancer (SCLC). Methods： Ninety-seven patients were evaluated efficacy and toxicity in 100 eligible patients in a multiple center clinical trail. Topotecan was administrated as a second line single agent in 38 relapse SCLC patients and the dose of topotecan was 1.25 mg· （ m2· d） -1 for 5 days and repeat every 3 weeks. Topotecan＋ cisplatin regimen was used in the chemonaive SCLC patients and the dose of topotecan was reduced to 1 mg· （ m2· d） -1 for 5 days and the cisplatin was 80 mg· （ m2· d） -1 for one dose. Results： The response rate was 37.5％ as second line chemotherapy in relapse SCLC, including complete response of 3.1％ and the partial response 34.4. The response rate was 79.6％ (complete response,22.4％ and partial response,57.1％ ) when cisplatin was combined with topotecan in the chemonaive SCLC patients. Bone marrow suppression was the main toxicity of topotecan and Grade Ⅲ -Ⅳ neutropenia and thrombopenia was observed in 39.9％ and 31.6％ respectively in single agent regimen and 61.0％ and 39.9％ in combined regimen respectively. The non-hemotological toxicity was mineral. Conclusion： Topotecan may be an effective drugs for the patients with SCLC when used as the first or the second line regimen, and more efficacy when combine with cisplatin. The main toxicity of topotecan is hemotological toxicity.

OBJECTIVEThe goals of this work was to analyse the cost of Shenqi Fuzheng injection-an extraction of a Chinese traditional herbs on reducing adverse effects in lung cancer patients during chemotherapy.

METHODSIn a randomized cross-over trial, each patient completed two identical cisplatin-based chemotherapy cycles, one with Shenqi Fuzheng injection, another without Shenqi Fuzheng injection. Adverse effects and change scores of quality of life (QOL) during chemotherapy were compared in tow cycles. The direct cost dealing with adverse effect and cost-effectiveness analysis were taken.

RESULTSOne hundred and thirty were enrolled with 123 of whom were evaluable. The patient characteristics were well balanced between the two groups. The chemotherapy cycles with Shenqi Fuzheng injection spent 220.5 more Chinese yuan, but the adverse effect of leukopenia, thrombocytopenia and vomiting were slight different and the change of score of several QOL domains showed significant better as compared to those in another cycle.

CONCLUSIONShenqi Fuzheng injection could reduce the severity of toxicity related to chemotherapy and improve the QOL of patients and had some benefits in terms of cost-effectiveness.

Aged ; Antineoplastic Agents ; adverse effects ; Cost-Benefit Analysis ; Costs and Cost Analysis ; Cross-Over Studies ; Drugs, Chinese Herbal ; economics ; therapeutic use ; Female ; Humans ; Injections ; Lung Neoplasms ; drug therapy ; Male ; Middle Aged

BACKGROUNDChronic obstructive pulmonary disease (COPD) has a variable natural history and not all individuals follow the same course. This study aimed to identify the prevalence and characteristics of asymptomatic COPD patients from a population-based survey in China.

METHODSA multistage cluster sampling strategy was used in a population from seven different provinces/cities. All residents (over 40 years old) were interviewed with a standardized questionnaire and spirometry. Post-bronchodilator forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) of less than 70% was defined as the diagnostic criterion of COPD. All COPD patients screened were divided into symptomatic group and asymptomatic group according to the presence or absence of chronic respiratory symptoms. Socio-demographic, personal and exposure variables were collected and analyzed.

RESULTSAmong the 1668 patients who were diagnosed with COPD from the 25 627 sampling subjects, 589 (35.3%) were asymptomatic. The age, sex, body mass index (BMI), rural and urban distributions, smoking habit and education levels were similar in the two groups. A total of 64.7% of the asymptomatic patients had no comorbidities. Cardiovascular diseases and lung cancer were more common among symptomatic COPD patients than asymptomatic group. Asymptomatic COPD group were less likely to present with poor ventilation in the kitchen, a family history of respiratory disease and recurrent childhood cough. Asymptomatic COPD patients had significantly higher FEV(1) (73.1% vs. 61.0%), FVC (91.9% vs. 82.0%), and a higher ratio of FEV(1)/FVC (62.9% vs. 58.7%) (all P < 0.001) than symptomatic group. More asymptomatic patients were underdiagnosed (91.9% vs. 54.3%, P < 0.001) than symptomatic patients.

CONCLUSIONSThis large population-based survey confirmed a high prevalence of asymptomatic COPD patients in China. More use of spirometry screening test may be important to the early detection of COPD.

Adult ; Aged ; Aged, 80 and over ; China ; epidemiology ; Educational Status ; Female ; Humans ; Male ; Middle Aged ; Pulmonary Disease, Chronic Obstructive ; diagnosis ; epidemiology ; Risk Factors ; Smoking ; Spirometry ; Surveys and Questionnaires