1.Analysis of non-tumor diseases affecting the diagnosis and treatment of cancer patients
Sen HAN ; Wei LI ; Jian FANG ; Jun NIE ; Ling DAI ; Weiheng HU ; Xiaoling CHEN ; Jie ZHANG ; Xiangjuan MA ; Guangmin TIAN ; Di WU ; Jieran LONG ; Jindi HAN ; Yang WANG ; Ziran ZHANG ; Weiping LIU ; Jun ZHU
Chinese Journal of Clinical Oncology 2018;45(10):517-520
Objective:To investigate the types of non-tumor diseases in patients with cancer, and to explore the effects of those dis-eases on the diagnosis and treatment of cancer patients. Methods:We collected the medical records of cancer patients from January 2013 to December 2017 in Peking University Cancer Hospital, and screened for non-tumor diseases. The clinical records of the patients in this group were analyzed retrospectively, and the effects of those diseases on the diagnosis and treatment of tumors were dis-cussed. Results:Of the 1,323 cases of inter-hospital consultation, 1,153 cases of non-tumor disease (87.2%) were selected. There were 773 men (67.0%) and 380 women (33.0%) included. The median age was 62 (14-90) years. The primary tumor types included lung can-cer, gastric cancer, lymphoma, colorectal cancer, esophageal cancer, breast cancer, malignant melanoma, liver cancer, cholangiocarci-noma/gallbladder cancer, pancreatic cancer, and other tumors. Non-neoplastic diseases included cardiovascular disease in 356 cases (30.9%), respiratory system disease (17.0%) in 196 cases, digestive system disease in 107 cases (9.3%), skin and venereal diseases in 81 cases (7.0%), nervous system lesions (6.4%) in 74 cases, urinary system disease in 72 cases (6.2%), blood disease in 70 cases (6.1%), en-docrine and metabolic diseases in 47 cases (4.1%), autoimmune disease in 23 cases (2.0%), and other diseases (11.0%) in 127 cases. Impact on tumor diagnosis and treatment was as follows:direct, 771 cases (66.9%);no influence, 313 cases (27.1%);and uncertain, 69 cases (6.0%). Conclusions:Cardiovascular disease is a major non-tumor disease associated with cancer. Non-neoplastic diseases are important factors affecting the diagnosis and treatment plans of cancer.
2.Multivariate Analysis of Prognostic Factors in the Eldly Patients with Small Cell Lung Cancer:A Study of 160 Patients
CHEN XIAOLING ; FANG JIAN ; NIE JUN ; DAI LING ; ZHANG JIE ; HU WEIHENG ; HAN JINDI ; MA XIANGJUAN ; TIAN GUANGMING ; HAN SEN ; WU DI ; LONG JIERAN ; WANG YANG
Chinese Journal of Lung Cancer 2014;(1):15-23
Background and objective Lung cancer is currently the leading cause of cancer death, two thirds of patients are over the age of 65. Small cell lung cancer (SCLC) accounts for about15%-20%of all lung cancer. hTe objective of this study is to evaluate the survival of patients older than 65 with SCLC and analyze the independent prognostic factors in this group of patients. Methods A retrospective study has enrolled160 cases of lung cancer aged over 65. hTe prognostic factors were analyzed by Kaplan-Meier and Cox multivariate proportional hazards model. Results ①hTe median follow-up time was12 (2-109) months.1-, 3-, and 5-year survival rate was 47.1%,13.0%, 9.6%respectively, and 74.4%, 25.0%,19.7%for limited-stage (LD), and 36.8%, 8.7%, 5.8%for extensive-stage (ED). Median survival time (MST) of all the patients was12 months, 24 months for LD and11months for ED, respectively.②Multivariate analysis suggested that performance status (PS) pre-treatment, the change of PS atfer treatment, stage, liver metastases and thoracic radiotherapy were the independent prognostic factors in all patients.③For LD-SCLC patients, PS pre-treatment, thoracic radiotherapy were the independent prognostic fac-tors. hTe model of thoracic radiotherapy (concurrent chemoradiation vs sequential chemoradiation, early concurrent chemo-radiation vs late concurrent chemoradiation) and prophylactic cranial irradiation (PCI) did not show signiifcant difference.④For ED-SCLC patients, sex, the change of PS atfer treatment, chemotherapy, liver metastases, thoracic radiotherapy, PCI were the independent prognostic factors. Conclusion hTe survival time is related to PS and thoracic radiotherapy in eldly patients. Besides, it is also related to sex, chemotherapy, liver metastases and PCI for ED-SCLC.
3.Timing of Brain Radiation Therapy Impacts Outcomes in Patients with Non-small Cell Lung Cancer Who Develop Brain Metastases
WANG YANG ; FANG JIAN ; NIE JUN ; DAI LING ; HU WEIHENG ; ZHANG JIE ; MA XIANGJUAN ; HAN JINDI ; CHEN XIAOLING ; TIAN GUANGMING ; WU DI ; HAN SEN ; LONG JIERAN
Chinese Journal of Lung Cancer 2016;19(8):508-514
Background and objective Radiotherapy combined with chemotherapy or molecular targeted therapy remains the standard of treatment for brain metastases from non-small cell lung cancer (NSCLC). hTe aim of this study is to determine if the deferral of brain radiotherapy impacts patient outcomes.Methods Between May 2003 and December 2015, a total of 198 patients with brain metastases from NSCLC who received both brain radiotherapy and systemic therapy (chemo-therapy or targeted therapy) were identiifed. hTe rate of grade 3-4 adverse reactions related to chemotherapy and radiotherapy had no signiifcant difference between two groups. 127 patients received concurrent brain radiotherapy and systemic therapy, and 71 patients received deferred brain radiotherapy after at least two cycles of chemotherapy or targeted therapy. Disease speciifc-graded prognostic assessment was similar in early radiotherapy group and deferred radiotherapy group.Results Me-dian overall survival (OS) was longer in early radiotherapy group compared to deferred radiotherapy group (17.9 monthsvs 12.6 months;P=0.038). Progression free survival (PFS) was also improved in patients receiving early radiotherapy compared to those receiving deferred radiotherapy (4.0 monthsvs 3.0 months;P<0.01). Receiving tyrosine kinase inhibitor (TKI) therapy atfer the diagnosis of brain metastases as any line therapy improved the OS (20.0 monthsvs 10.7 months;P<0.01), whereas receiving TKI as ifrst line therapy did not (17.9 monthsvs 15.2 months;P=0.289).Conclusion Our study suggests that the use of deferred brain radiotherapy may resulted in inferior OS in patients with NSCLC who develop brain metastases. A prospec-tive multi-central randomized study is imminently needed.