BACKGROUNDTo evaluate the efficacy and toxicity of ITP (ifosfamide + perarubicin + cisplatin) and NP (vinorelbine + cisplatin) regimens in the treatment of advanced non small cell lung cancer (NSCLC).

METHODSOne hundred inoperatable or recurrent patients with stage III and IV NSCLC were randomized into ITP group and NP group treated by the two regimens responsively for 2 or 3 cycles.

RESULTSThe overall response rate was 51.5% for ITP group and 50.9% for the NP group, respectively. There was no statistically significant difference of the overall response rate between the two groups ( P > 0.05). The major side effects were leukopenia and gastrointestinal reaction. The leukopenia incidence was higher in ITP group than that in NC group ( P < 0.05).

CONCLUSIONSBoth ITP and NP regimens are effective for the advanced NSCLC. Compared with ITP regimen, NP regimen has less bone marrow toxicity than ITP regimen.

BACKGROUNDTo compare the efficacy and side effects between cisplatin solution and cisplatin powder combination regimens for lung cancer.

METHODSA total of 223 patients were enrolled into this study. EP protocol was given to patients with small cell lung cancer (SCLC), and NP protocol to non small cell lung cancer (NSCLC). The 223 patients were randomly divided into cisplatin solution group and cisplatin powder group, and the same drugs and dosage were used in the two groups for the same type of lung cancer.

RESULTSResponse rates of the cisplatin solution group and the cisplatin powder group were 84.8% and 82.4% for SCLC ( P > 0.05), and 31.6% and 29.9% for NSCLC ( P > 0.05), respectively. The major side effects were gastrointestinal reactions and myelosuppression. Significantly higher incidence of nausea/vomiting was found in cisplatin solution group than that in cisplatin powder group for either SCLC or NSCLC ( P < 0.05). There was a remarkable difference in cost of hospitalization between the two groups ( P < 0.05).

CONCLUSIONSCisplatin solution is as effective as cisplatin powder in the treatment of lung cancer. However, the more severe nausea/vomiting reactions and higher cost of cisplatin solution should be considered in its clinical application.

BACKGROUNDTracheal adenoid cystic carcinoma (TACC) is a rare, low malignant and primary tracheal carcinoma, which is easily misdiagnosed and missedly diagnosed. The aim of this study is to increase the knowledge about TACC.

METHODSData including clinical manifestations and treatment were retrospectively analyzed for 8 cases of TACC confirmed by pathology and follow-up was carried out.

RESULTSThe main manifestations were cough, stridor, hemoptysis and progressive inspiratory dyspnea. Fiberoptic bronchoscope and computerized tomography were reliable examinations for final diagnosis. Five cases underwent operative treatment, and three cases underwent interventional treatment by fiberoptic bronchoscope in which 1 case accepted a second operation after recurrence and 2 cases accepted chemotherapy after operation. One case was lost, 1 case treated by interventional treatment died after 11 months and other 6 cases were followed-up from 2 months to 34 months who were alive.

CONCLUSIONSTACC is low malignancy and has good prognosis. The best treatment is operation. The better palliative treatment is interventional treatment by fiberoptic bronchoscope which can relieve symptoms and improve the patient's living quality.

BACKGROUNDCisplatin-based chemotherapy is the standard regimens in the treatment of advanced non-small cell lung cancer (NSCLC). The aim of this trial is to evaluate the efficacy and toxicity of paclitaxel or gemcitabine combined with cispltin for patients with advanced NSCLC.

METHODSSeventy-seven advanced NSCLC patients were randomly divided into 2 groups, 39 in TP group and 38 in GP group. TP group: paclitaxel 135 mg/m², on day 1; cisplatin 30 mg/m², on days 1-3. GP group: gemcitabine 1000 mg/m², on days 1, 8; cisplatin 30 mg/m², on days 1-3.

RESULTSPatients' characteristics were similar between the two groups. The overall response rate was 46.2% in the TP group and 42.1% in the GP group. There was no statistically significant difference in response rate between the two groups (P > 0.05). The major cytotoxicity was leukopenia in the TP group and thrombocytopenia in the GP group.

CONCLUSIONSBoth TP and GP regimens are effective for advanced NSCLC and have no significant difference. The side effects of the two regimens are different but all adverse reactions are tolerable.

BACKGROUNDSarcomatoid carcinoma (SC) is a rare malignant cancer with mixed tumor and sarcomatoid tissues. The aim of this study is to investigate the clinical manifestations and pathological findings of sarcomatoid carcinoma of the lung.

METHODSData including clinical manifestations, pathological findings, treatment were retrospectively analysed from fourteen patients with lung sarcomatoid carcinoma confirmed by pathology and follow-up was carried out.

RESULTSMean age at onset was 62 years old and gender ratios (M/F) in these patients was 6:1. The clinical manifestations of lung sarcomatoid carcinoma were similar to that of other types of lung cancer while there were characteristic findings on the enhancement CT scan. Bronchofiberscopy was not a reliable examination for final diagnosis. Cells with endothelial phenotype could be detected by immunohistochemical method.

CONCLUSIONSThe final diagnosis of this disease depends on histopathological observation, while the diagnosis may be missed among patients without surgical intervention. Immunohistochemical examination is helpful for diagnosis and differential diagnosis. The therapeutic strategy is coincident with that for non-small cell lung cancer.

BACKGROUNDMalignant pleural effusion is one of the common complications in patients with advanced lung cancer. Intracavitary injection of drug is a usual method, but it also exhibits unstable efficacy and obvious adverse reaction. The aim of this study is to evaluate the efficacy of hyperthermia combined with intracavitary injection of drug for malignant pleural effusion.

METHODSFifty patients with malignant pleural effusion caused by lung cancer were randomized into two groups after puncture or closed drainage. Group A was treated with hyperthermia combined with intrapleural injection of cisplatin and interleukin-2. Group B was treated only with intrapleural injection of cisplatin and interleukin-2.

RESULTSThe response rate of pleural effusion was 88% in group A and 60% in group B (P=0.024). The quality of life in group A was significantly better than that in group B (P=0.013).

CONCLUSIONSHyperthermia combined with intracavitary injection is effective and secure in treatment of malignant pleural effusion.

BACKGROUNDvinorelbine/cisplatin is an important regimen for advanced non-small lung cancer (NSCLC), but the side effect is severe . This study aims to compare the efficacy and toxicity of vinorelbine/cisplatin and vinorelbine/oxaliplatin regimens in the treatment of advanced NSCLC.

METHODSOne hundred and twenty six inoperatable or recurrent patients with stage III and IV NSCLC were randomized into vinorelbine/cisplatin group and vinorelbine/oxaliplatin group. All of them were treated by the two regimens responsively for 2 or 3 cycles.

RESULTSThe overall response rate was 48.4%(30/62) for vinorelbine/cisplatin group and 42.2% (27/64) for vinorelbine/oxaliplatin group, the partial response rate was 45.2% (28/62) and 40.6% (26/64) respectively. There was no statistically significant difference of overall response rate between two groups (P > 0.05). The major side effects were leukopenia and gastrointestinal reaction, 25 patients (40.3%) in vinorelbine/cisplatin group and 10 patients (15.6%) in vinorelbine/oxaliplatin group had grade III+IV leucopenia (P < 0.05). Eleven patients (17.7%) in vinorelbine/cisplatin group and 3 patients (4.7%) in vinorelbine/oxaliplatin group had grade III+IV gastrointestinal reaction (P < 0.05). Seven patients (11.7%) in vinorelbine/cisplatin group and 60 patients (93.8%) in vinorelbine/oxaliplatin group had neurotoxicity (P < 0.05).

CONCLUSIONSBoth vinorelbine/cisplatin and vinorelbine/oxaliplatin regimens are effective for advanced NSCLC. Compared with vinorelbine/cisplatin regimen, vinorelbine/oxaliplatin regimen has less bone marrow toxicity and gastrointestinal toxicity but higher neurotoxicity.

BACKGROUNDCisplatin plus navelbine (NO) is a standard combination chemotherapy regimen for non-small cell lung cancer (NSCLC), but severe toxicities due to cisplatin often influence the quality of life in the patients, such as nausea and vomiting. The aims of this study are to evaluate the efficacy and toxicity of combined chemotherapy of oxaliplatin and cisplatin plus navelbine in treatment of advanced NSCLC.

METHODSA total of 168 patients were randomly divided into NO group (n=83) and NP group (n=85).

RESULTSThe overall response rate was 38.6% in NO group and 40.0% in NP group respectively. 1-year survival rate was 33.7% in NO group and 31.8% in NP group. There was no significant difference in response rate and 1-year survival between the two groups (P > 0.05). The major side effects were myelosuppression, nausea/vomiting and neurotoxicity in the two groups. Incidences of leukopenia and nausea/vomiting were significantly lower in NO group than those in NP group (P < 0.05), but neurotoxicity in NO group was more obvious than that in NP group (P < 0.001).

CONCLUSIONSThe efficacy and 1-year survival of combined chemotherapy of oxaliplatin and cisplatin plus navelbine are similar in the treatment of advanced NSCLC. However, the side effects of oxaliplatin plus navelbine are lower except for neurotoxicity.

BACKGROUNDMalignant pleural effusions commonly occur in patients with advanced cancer. Treatment is often palliative, such as pleural aspiration or tube thoracostomy with large bore chest tube. Tube thoracostomy with large bore chest tube can cause significant discomfort of patients. The aim of this study is to evaluate the efficacy of small bore catheter for drainage and administration of sclerosing agent in the treatment of malignant pleural effusions.

METHODSSixty patients with malignant pleural effusions were randomly assigned to small bore catheter thoracostomy closed drainage group or conventional pleural aspiration group. Cisplatin and interleukin-2 were infused into the thoracic cavity in eligible patients after drainage. Responses were evaluated 30 days later.

RESULTSOverall response rate (complete response plus partial response) was 80.00% in small bore catheter thoracostomy closed drainage group and 36.67% in conventional pleural aspiration group respectively (P < 0.01). And the side effects in small bore catheter thoracostomy closed drainage group were obviously less than that in conventional pleural aspiration group.

CONCLUSIONSSmall bore intercostal catheter for drainage and administration of sclerosing agent is a valid and safe option for malignant pleural effusions.

Purpose: Patients with advanced biliary tract cancer (BTC) have a poor survival. We aim to evaluate the efficacy and safety of nab-paclitaxel plus gemcitabine and cisplatin regimen in Chinese advanced BTC patients. Materials and Methods: Eligible patients with locally advanced or metastatic BTC administrated intravenous 100 mg/m2 nab-paclitaxel, 800 mg/m2 gemcitabine, and 25 mg/m2 cisplatin every 3 weeks. The primary endpoint was progression-free survival (PFS). The secondary endpoints included overall survival (OS) and adverse events, while exploratory endpoint was the association of biomarkers with efficacy. Results: After the median follow-up of 25.0 months, the median PFS and OS of 34 enrolled patients were 7.1 months (95% confidence interval [CI], 5.4 to 13.7) and 16.4 months (95% CI, 10.9 to 23.6), respectively. The most common treatment-related adverse events at ≥ 3 grade were neutropenia (26.5%) and leukopenia (26.5%). Survival analyses demonstrated that carcinoembryonic antigen (CEA) levels could monitor patients’ survival outcomes. A significant increase in the number of infiltrating CD4+ cells (p=0.008) and a decrease in programmed death-1–positive (PD-1+) cells (p=0.032) were observed in the response patients. Conclusion In advanced BTC patients, nab-paclitaxel plus gemcitabine and cisplatin regimen showed therapeutic potential. Potential prognostic factors of CEA levels, number of CD4+ cells and PD-1+ cells may help us maximize the efficacy benefit.