BACKGROUND: Though the surgical treatment of stage IIIB lung cancer is not generalized due to low complete remission rate high morbidity and mortality there are several reports on the improvement of long term survival after preoperative and postoperative adjuvant therapy. In this study we analyzed the prognostic factors affecting long term survival after surgical treatment of stage IIIB lung cancer MATERIAL AND METHOD: We analyzed the long term survival for age pathology invaded mediastinal organ n stage type of operation complete or incomplete resection and adjuvant therapy through a retrospective review of patients underwent surgical treatment. RESULT: From 1990 to 1998 56 patients(51/male 5/female0 with stage IIIB lung cancer were trated surgically. Forty two patients underwent radical resection and morbidity and mortality were 17% 12% respectively. The survival rate for overall patients and the radical resection group were 9% 12% respectively. In the radical resection group excluding explothoracotomy only(n=14) and the surgical mortality patients(n=5) the age the type of operation celly type resectability and N stage had no influence on the long term survival. The survival rate of radical resection group was significantly better than that of the explothoracotomy only group(p=0.04) The long term survival rate of postoperative combination therapy group was significantly better than chemotherapy or radiotherapy alone(p=0.04) CONCLUSION: Age type after surgical treatment of stage IIIB lung cancer. We conclude that combined modality of adjuvant treatment after radical resection of stage IIIB lung cancer seems to offer better long term survival in selective patients. The numbers of patients involved was small. Nevertheless these preliminary findings indicate questions that will need to be experienced further in larger studies.
Drug Therapy ; Humans ; Lung Neoplasms* ; Lung* ; Mortality ; Neoplasm Staging ; Pathology ; Radiotherapy ; Retrospective Studies ; Survival Rate

OBJECTIVEThe aim of this study was to analyze the clinical features and prognostic factors in patients with brain metastasis from colorectal cancer (CRC).

METHODSClinical materials of 45 colorectal cancer patients who developed brain metastasis were collected, and the data and follow-up data of those patients were retrospectively analyzed.

RESULTSMost brain metastases were from rectal cancer (64.4%), and 80.0% of the 45 cases had extracranial metastases. The most common extracranial metastatic site was the lung (57.8%), followed by the liver (35.6%). All the brain metastases in patients with liver metastases were supratentorial, while in contrast, 44.8% of the patients without liver metastasis had subtentorial metastasis, showing a significant difference between them (P<0.05). The interval time from diagnosis of CRC to the development of brain metastases in case of Dukes D stage was 12.0 months, significantly shorter than that in the cases of Dukes A stage (24.0 months), B (36.0 months) and C (29.0 months) (P<0.05). The interval time was also shorter in the patients who developed extracranial metastasis within one year than those more than one year (12.0 months vs. 38.0 months)( P<0.05). The median survival time of patients with brain metastasis from colorectal was 6.0 months, with a 1-year survival rate of 21.1% and 2-year survival rate of 3.3% only. Univariate analysis showed that the median survival of patients with a KPS score of ≥70 was 8.0 months, significantly higher than 2.0 months in those with a KPS score of <70 (P<0.05). The median survival of patients with one or two brain metastases was 8.0 months, significantly higher than 4.0 months of those with >2 brain metastases (P<0.05). The median survival time after diagnosis of brain metastasis was 4.0 months for those who received monotherapy (only steroids, only chemotherapy or only radiotherapy), significantly shorter than 10.0 months of patients who received chemoradiotherapy, and 12.0 months of those who underwent surgery (P<0.05). Comparing each two differently treated groups, the survival time of surgery combined with chemotherapy or radiotherapy group was significantly different from that of all of other groups (P<0.05). The median survival time of chemoradiotherapy group was longer than that of monotherapy, but the difference was not significant (P>0.05). Multivariate analysis showed that brain metastases >2 and treatment modality type are independent prognostic factors for survival.

CONCLUSIONSPatients initially diagnosed with a Dukes D stage primary colorectal tumor and occurrence of extracranial metastasis (especially, pulmonary metastasis) within one year are associated to an increased risk of brain metastases and have a shorter survival time. Most brain metastases in patients with liver metastases are supratentorial, while many patients without liver metastasis have subtentorial metastasis. Brain metastases >2 and the type of treatment modality are independent prognostic factors for survival. The prognosis of patients who received chemoradiotherapy is better than those treated only with chemotherapy or radiotherapy. Some subsets of patients may benefit from surgery plus chemotherapy/radiotherapy.

Brain Neoplasms ; mortality ; secondary ; therapy ; Chemoradiotherapy ; Colorectal Neoplasms ; Humans ; Liver Neoplasms ; secondary ; Lung Neoplasms ; secondary ; Neoplasm Staging ; Prognosis ; Rectal Neoplasms ; pathology ; Retrospective Studies ; Survival Rate ; Time Factors

OBJECTIVETo compare the effectiveness and safety of different treatment modes for limited-stage small cell lung cancer(SCLC).

METHODSThe clinical data of 171 SCLC patients who had received different therapies were retrospectively analyzed.

RESULTSOf these 171 patients,55 had received concurrent radiochemotherapy,66 received sequential radiochemotherapy,and 50 received chemotherapy alone. For these 171 patients,the overall response rate(ORR)was 73.1%,overall survival(OS)and progression-free survival(PFS)were 23.5 months and 15.2 months,respectively,and the 1-,3-,and 5-year survival rates were 76.2%,30.4%,and 16.3%,respectively. For the concurrent group,sequential group,chemotherapy alone group,the median OS were 30.6,23.1,and 19.1 months,the median PFS were 19.7,13.3,and 11.5 months,and the 5-year survival rate was 28.7%,13.6%,and 9.4%,respectively(all P<0.05). The main toxic effects were myelosuppression,radiation pneumonia,and radiation esophagitis. The incidences of 1-2 grade myelosuppression were 92.7%,89.4%,and 92% in the concurrent group,sequential group,and chemotherapy alone group(P=0.25). For concurrent group and sequential group,the incidence of 1 grade radiation pneumonia were 47.2% and 50%,respectively(P=0.61),whereas the incidence of 1-2 grade radiation esophagitis were 94.5% and 75.8%(P=0.02). Multivariate analysis showed that gender,ECOG score,TNM stage,and thoracic radiation therapy were the independent prognostic factors for SCLC.

CONCLUSIONConcurrent radiochemotherapy is the treatment of choice for SCLC patients because it can improve the survival with tolerable toxicities.

Adult ; Aged ; Chemoradiotherapy ; methods ; Drug Therapy ; methods ; Esophagitis ; epidemiology ; Female ; Humans ; Lung Neoplasms ; mortality ; pathology ; therapy ; Male ; Middle Aged ; Neoplasm Staging ; Radiation Pneumonitis ; epidemiology ; Retrospective Studies ; Small Cell Lung Carcinoma ; mortality ; pathology ; therapy ; Survival Rate

OBJECTIVETo study the therapeutic result of operation combined chemotherapy for stage IIIa non-small cell lung cancer.

METHODSFrom January 2000 to December 2003, the data of 83 cases with stage IIIa non-small cell lung cancer undergoing operation combined chemotherapy and 33 cases with stage IIIa non-small cell lung cancer undergoing non-operative therapy were retrospectively analyzed. The median survival time and the 1-, 2-, 3- year survival rates of the two groups were compared by the Kaplan-Meier method.

RESULTSThe median survival time of the operation group was 20.3 months, and the 1-, 2-, 3- year survival rates were 85%, 70%, and 35% respectively. The median survival time of the non-operation group was 14.5 months and the 1-, 2-, 3- year survival rates were 75%, 33%, and 15% respectively.

CONCLUSIONThe therapeutic result of the operation combined chemotherapy for the stage IIIa non-small cell lung cancer is better than that of the non-operative therapy obviously.

Adult ; Aged ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; pathology ; surgery ; Combined Modality Therapy ; Female ; Humans ; Lung Neoplasms ; drug therapy ; mortality ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Staging ; Pneumonectomy ; methods ; Retrospective Studies ; Survival Rate ; Treatment Outcome

BACKGROUNDPlatinum-based chemotherapy has been proved effective in patients with advanced non-small cell lung cancer (NSCLC). This study evaluated the effectiveness and safety of first-line chemotherapy with gemcitabine plus cisplatin (GEM-Cis) 3-week regimen in routine care of Chinese patients with advanced NSCLC.

METHODSTwo hundred and twenty-one patients with NSCLC stage IIIb or IV were enrolled and 209 were eligible for effectiveness and safety analysis. The median age was 58 (range 29 to 79) years. The percents of cases in stage IV and stage IIIb were 52.2% and 47.8%; of Karnofsky performance score (KPS) less than 80 and 80 - 100 were 37.3% and 62.7% and of adeno-cancer and non-adeno-cancer were 59.8% and 40.2%. The average number of completed chemotherapy cycles was three. Measures of effectiveness included clinical benefit, significant clinical response (SCR) and adverse effects of GEM-Cis in the treatment of NSCLC at stages IIIb/IV.

RESULTSKPS increased from 79 +/- 9 at baseline to 86 +/- 10 after chemotherapy (P < 0.01). Lung cancer symptom scale (LCSS) score of pain, dyspnea and cough increased from 77 +/- 24, 74 +/- 22 and 63 +/- 19 to 92 +/- 15, 90 +/- 14 and 86 +/- 15, respectively (P < 0.01). The clinical benefit rate was 85.2% [95% confidence interval (CI) 80.3% - 90.0%]. The SCR was 89.5% (95% CI 85.3% - 93.7%). Median survival time was 7.8 months (95% CI 7.1 months-9.1 months). Sixty-four patients (30.6%) experienced an adverse effect that was deemed clinically significant. Only one patient (0.5%) was hospitalized due to chemotherapy related adverse effects. Life-threatening toxicity was observed in two patients (1.0%).

CONCLUSIONFirst-line chemotherapy with GEM-Cis in the routine care of Chinese patients with advanced NSCLC is effective and safe.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; pathology ; Cisplatin ; administration & dosage ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Humans ; Lung Neoplasms ; drug therapy ; mortality ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prospective Studies

OBJECTIVETo assess the clinical efficacy of global traditional Chinese medicine (TCM) therapy in treating senile advanced non-small cell lung cancer (NSCLC), with the aim of seeking a standardized, rational and economical way to treat advanced NSCLC in old patients.

METHODSA retrospective analysis and comparison was carried out in 86 patients with senile advanced NSCLC, 44 treated by global TCM (TCM group) and 42 by chemotherapy (control group) through dynamical observation on related indexes including tumor size, quality of life and the survival time, as well as on the fee for medical service at various time points in the course of the treatment.

RESULTSThe changes of tumor size, score of clinical main symptoms and behavior condition (by ZPS scoring), as well as survival rates in the two groups at corresponding time points, were not different significantly (P>0.05). The mean survival time in the TCM group was 13.20+/-1.52 months and that in the chemotherapy group was 13.45+/-1.94 months, showing insignificant difference between them. However, the median survival time in the TCM group (12 months) was actually longer than that in the chemotherapy group (9 months, P<0.05). The mean daily expense and the mean expense (RMB yuan) for each patient in the TCM group were significantly lower than that in the control group, which was 180.73+/-93.21 vs 825.84+/-329.63 for the mean daily expense and 34077.21+/-14638.04 vs 58516.59+/-45429.76 for the mean expense for each patient (both P<0.01).

CONCLUSIONTreatment of senile advanced NSCLC with TCM alone has its apparent superiority in stabilizing tumor focus, improving clinical symptoms, elevating quality of life and prolonging the survival time. TCM is also less expensive, making it a good alternative therapeutic approach for this specific group of people.

Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; economics ; mortality ; pathology ; therapy ; Disease Progression ; Female ; Humans ; Lung Neoplasms ; economics ; mortality ; pathology ; therapy ; Male ; Medicine, Chinese Traditional ; economics ; methods ; Middle Aged ; Retrospective Studies ; Survival Analysis ; Time Factors ; Treatment Outcome

BACKGROUND/AIMS: Chemotherapy combined with radiation therapy is the standard treatment for limited stage small cell lung cancer (LS-SCLC). Although numerous studies indicate that the overall duration of chemoradiotherapy is the most relevant predictor of outcome, the optimal chemotherapy and radiation schedule for LS-SCLC remains controversial. Therefore we analyzed the time from the start of any treatment until the end of radiotherapy (SER) in patients with LS-SCLC. METHODS: We retrospectively analyzed 29 patients diagnosed histologically with LS-SCLC and divided them into two groups: a short SER group (< 60 days) and a long SER (> 60 days) group. Patients were treated with irinotecan-based chemotherapy and thoracic radiotherapy. RESULTS: Sixteen patients were in the short SER group and 13 patients were in the long SER group. Short SER significantly prolonged survival rate (p = 0.03) compared with that of long SER. However, no significant differences in side effects were observed. CONCLUSIONS: Short SER should be considered to improve the outcome of concurrent chemoradiotherapy for LS-SCLC.
Aged ; *Chemoradiotherapy ; Chi-Square Distribution ; Female ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms/mortality/pathology/*therapy ; Male ; Middle Aged ; Neoplasm Staging ; Odds Ratio ; Proportional Hazards Models ; Retrospective Studies ; Small Cell Lung Carcinoma/mortality/pathology/*surgery ; Time Factors ; Treatment Outcome

OBJECTIVETo investigate the prognostic factors of small cell lung cancer (SCLC) and establish a reliable model of clinical prognostic index.

METHODSKaplan-Meier and Cox regression were used to analyze the relationship between survival time and prognostic factors in 60 cases of SCLC. The prognostic factors included clinical and laboratory parameters, serum cytokeratin fragment 19 (CYFRA21-1), carcinoembryonic antigen (CEA), neuron-specific enolase (NSE), CA125, interleukin-2 (IL-2) and soluble interleukin-2 receptors (sIL-2R).

RESULTSKaplan-Meier analysis showed that poor prognosis was in patients with KPS < 80 or extensive disease and unrelated to other clinical parameters such as age, sex and smoking index, and in patients with serum NSE > 30 micro g/L, CEA > 5.0 micro g/L, CA125 > 37 KU/L and sIL-2R > 500 KU/L. Serum IL-2 and CYFRA21-1 were also elevated, but had no significant prognostic value. Multivariate analysis indicated that serum NSE, stage and treatment of disease were independent prognostic factors. The three prognostic factors enabled establishment of a prognostic index (PI) based on a simple algorithm: PI = NSE (0 if < or = 30 micro g/L, 1 if > 30 microg/L) + stage (0 = LD, 1 = ED) + CEA (0 if < or = 5.0 microg/L, 1 if > 5.0 microg/L).

CONCLUSIONThe stage of disease, systemic treatment and the level of serum NSE are independent prognostic factors. Without considering the influence of treatment-related factors on survival, the levels of serum CEA, NSE and stage of disease before treatment are significant independent prognostic factors. PI calculated on the basis of CEA, NSE and stage is recommended to predict the survival of SCLC.

Adult ; Aged ; Biomarkers, Tumor ; blood ; Brain Neoplasms ; secondary ; Carcinoma, Small Cell ; mortality ; secondary ; therapy ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; secondary ; Lung Neoplasms ; mortality ; pathology ; therapy ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Proportional Hazards Models ; Survival Rate

OBJECTIVETo analyze the clinical characteristics, survival and prognosis of breast cancer patients under 30 years of age.

METHODS129 breast cancer patients under 30 years treated from Jan 1980 to May 2000 were retrospectively reviewed. Clinical features, survival and prognostic factors were analyzed by SPSS 10.0 statistic software.

RESULTSBreast cancer patients under 30 years accounted for 2.6% of all breast cancers in our hospital. The overall 5- and 10-year survival rates were 61.5% and 46.7%, respectively. For patients with tumor < or = 3 cm or > 3 cm, the 10-year survival rates were 65.5% and 27.4% (P < 0.01). For those with number of positive axillary lymph nodes 0, 1-3, or > or = 4, the 10-year survival rates were 79.5%, 40.9% or 31.4% (P < 0.01). For patients who had been treated with or without tamoxifen, the 10-year survival rates were 63.7% and 45% (P < 0.01). For those complicated with pregnancy and lactation which was found in 24.8% of such patients, the 10-year survival rate was 44.3%. In the multivariate analysis, independent prognostic factors that might improve the overall survival were tumor size, axillary metastatic status and tamoxifen treatment.

CONCLUSIONBreast cancer patients aged 30 years and younger may have good prognosis if multimodality treatment is given. Tumor size, axillary metastatic status and tamoxifen treatment are independent prognostic factors. Prognosis of patients, either complicated with pregnancy and lactation or not, is quite similar if the clinical stage is the same and if being treated by the combined therapy.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bone Neoplasms ; secondary ; Breast Neoplasms ; mortality ; pathology ; therapy ; Carcinoma, Ductal, Breast ; mortality ; secondary ; therapy ; Carcinoma, Medullary ; mortality ; secondary ; therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Lactation ; Lung Neoplasms ; secondary ; Mastectomy ; methods ; Pregnancy ; Pregnancy Complications, Neoplastic ; pathology ; therapy ; Prognosis ; Retrospective Studies ; Survival Rate ; Tamoxifen ; administration & dosage

OBJECTIVETo estimate the effect of 10-hydroxycamptothecin (HCPT) to the melanoma lung metastasis mice models and the feasibility of aerosol delivery treatment for lung cancer therapy.

METHODB16F10 melanoma lung metastasis mice models were made, and nodules number, inhibition rate, tumor area, mean nodules diameter and so on were investigated after the aerosol delivery treatment. Spleen index and thymus index were calculated at the end of the experiments. The change of body weight, physiological state and the lung tumor tissue in pathological histology were inspeated.

RESULTThe total number of tumor lesions, weight of lungs and the area of lung metastasis of aerosol treatment group had significant difference comparing with normal group and control group. Mean nodules diameter had no significant difference comparing with control group. The spleen index of aerosol treatment group was decreased and thymus index was significantly decreased comparing with normal group and control group. During the treatment there are no obvious changes in physiological state. The lung cancer tissue of aerosol delivery treatment group was recovered in pathological histology.

CONCLUSIONThe results suggested that aerosol delivery of HCPT demonstrated powerful antitumor activity and was useful for melanoma lung metastasis by aerosol delivery treatment.

Administration, Inhalation ; Animals ; Antineoplastic Agents ; administration & dosage ; Camptothecin ; administration & dosage ; Female ; Lung Neoplasms ; drug therapy ; mortality ; pathology ; Melanoma, Experimental ; drug therapy ; mortality ; pathology ; secondary ; Mice ; Mice, Inbred C57BL ; Weight Loss