Objective: Investigated the status quo of quality control of cancer chemotherapy in hospitals in Beijing to discover the main problems and provide the improvement measures. Methods: One medical record of cancer chemotherapy was taken every month for examination of quality control, and a total of 10 medical records in each hospital were examined. A total of 756 medical records from 76 hospitals were examined. Results: The results of analysis showed that the overall standardization and quality control of cancer chemotherapy was positively correlated with the grade of hospital. Only 36.8% of the hospitals were equipped with Pharmacy Intravenous Admixture Services (PIVAS). In terms of quality control of chemotherapy and medicine, the department of oncology had better performance than other departments (P<0.01). The scores of quality control of chemotherapy and medicine in the hospitals with clinical specialist pharmacists were 50.6 and 14.5, significantly higher than 47.2 and 12.7 of those without clinical specialist pharmacists (P<0.05). Conclusion We should focus on the quality control of cancer chemotherapy in secondary hospitals, reinforce the training of oncology specialists, establish the admission system of oncologists, enhance the training of oncology clinical pharmacists and promote the standardization of cancer chemotherapy.

Objective: The aim of this retrospective study was to evaluate the prognostic significance of pretreatment Neutrophil-to-Lymphocyte Ratio(NLR) in locally advanced non-small cell lung cancer(NSCLC) patients treated with thoracic radiotherapy. Methods: We retrospectively analyze 420 patients who received thoracic radiotherapy alone, sequential chemoraiotherapy or concurrent chemoradiotherapy for locally advanced stage NSCLC from January 2007 to December 2010 of our hospital. The patients were divided into two groups (high NLR group and low NLR group) with appropriate cutoff point using the receiver operating characteristic (ROC) curve method. The survival curve was established by Kaplan-Meier method. The Log-rank test was used to compare the survival of the two NLR groups and the multivariate analysis was carried out by Cox regression model. Results: Among the 420 patients, 99 received radiotherapy alone, 139 received sequential chemoradiotherapy and 182 received concurrent chemoradiotherapy. 345 patients died and 75 were still alive. The median follow-up time was 5.2 years and the median overall survival was 22 months. The cut-off value of pretreatment NLR was 2.1. The 5-year PFS and OS rates in high NLR group and low NLR group were 10.6% vs 15.7% (P=0.033) and 15.5% vs 22.7% (P=0.012). Multivariate analysis confirmed that pretreatment NLR (hazard ratio 1.06, P=0.041) was independent prognostic factor of OS. Conclusions Our study revealed that the pretreatment NLR is the independent prognostic factor of OS in patients with locally advanced stage NSCLC treated with thoracic radiotherapy. However, NLR is still greatly influenced by patient′s condition and treatment which needs further research.

Objective This study aimed to evaluate the impact of technical advancement of radiation therapy in patients with LA?NSCLC receiving definitive radiotherapy (RT). Methods Patients treated with definitive RT (≥50 Gy) between 2000 and 2010 were retrospectively reviewed. Overall survival ( OS) , cancer specific survival ( CSS) , locoregional progression?free survival ( LRPFS) , distant metastasis?free survival (DMFS) and progression?free survival (PFS) were calculated and compared among patients irradiated with different techniques. Radiation?induced lung injury ( RILI) and esophageal injury ( RIEI) were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events 3.0 ( NCI?CTCAE 3.0) . Results A total of 946 patients were eligible for analysis, including 288 treated with two?dimensional radiotherapy ( 2D?RT) , 209 with three?dimensional conformal radiation therapy ( 3D?CRT) and 449 with intensity?modulated radiation therapy ( IMRT) respectively. The median follow?up time for the whole population was 84.1 months. The median OS of 2D?RT, 3D?CRT and IMRT groups were 15.8, 19.7 and 23.3 months, respectively, with the corresponding 5?year survival rate of 8. 7%, 13. 0% and 18. 8%, respectively ( P<0.001) . The univariate analysis demonstrated significantly inferior OS, LRPFS, DMFS and PFS of 2D?RT than those provided by 3D?CRT or IMRT. The univariate analysis also revealed that the IMRT group had significantly loger LRPFS and a trend toward better OS and DMFS compared with 3D?CRT. Multivariate analysis showed that TNM stage, RT technique and KPS were independent factors correlated with all survival indexes. Compared with 2D?RT, the utilization of IMRT was associated with significantly improved OS, LRPFS, DMFS as well as PFS. Compared with 3D?CRT, IMRT provided superior DMFS ( P=0.035), a trend approaching significance with regard to LRPFS (P=0.073) but no statistically significant improvement on OS, CSS and PFS in multivariate analysis. The incidence rates of RILI were significantly decreased in the IMRT group (29.3% vs. 26.6% vs.14.0%, P<0.001) whereas that of RIET rates were similar (34.7% vs. 29.7% vs. 35.3%, P=0.342) among the three groups. Conclusions Radiation therapy technique is a factor affecting prognosis of LA?NSCLC patients. Advanced radiation therapy technique is associated with improved tumor control and survival, and decreased radiation?induced lung toxicity.

Esophageal cancer is one of the most common cancers in China. More than 80% of esophageal cancer patients are diagnosed at a late stage and are not eligible for surgery. Radiotherapy is one of the most important modalities in esophageal cancer treatment. Here we reviewed the advances in esophageal cancer radiotherapy and radiotherapy?based combined?modality therapy, such as optimization of radiation dose and target volume, application of precise radiotherapy technique and the integration of radiotherapy with chemotherapy and targeted therapy.

Objective To analyze the outcome and prognostic factors of IMRT?based preoperative neoadjuvant chemoradiotherapy in patients with thoracic esophageal squamous cell carcinoma ( ESCC ) . Methods Clinical data of 62 patients with thoracic ESCC who received IMRT?based neoajuvant chemoradiotherapy from January 2009 to January 2015 were retrospectively analyzed. The radiation therapy was given 1.8?2 Gy/fraction per day over 5 days per week with 6 MV X?rays, and then all patients underwent esophagectomy and lymphadenectomy. Results Among the 62 patients, the R0 resection rate was 96.8%. Twenty ( 32. 3%) patients achieved pCR and 56 ( 90. 3%) cases got down?staging. Grade Ⅲ marrow suppression and esophagitis were seen in 8 (12.9%) and 2 (3.2%) patients, respectively. Eleven (17.7%) patients experienced postoperative complications and three died. The median follow?up was 27 months. The 1?, 3?and 5?year overall survival rates were 88.0%, 63.3% and 44.2%, respectively, with a corresponding disease?free survival rate of 68. 1%, 54. 8%, and 43. 9%, respectively. The univariate analysis showed that pre?treatment stage Ⅱ, down?staging, T/N pCR, good tumor response to neoadjuvant chemoradiotherapy, pN0 and R0 resection were favorable prognostic factors (P<0.05). The multivariate analyses indicated that pre?treatment stage was an independent prognostic factor. Conclusions For patients with thoracic ESCC, IMRT?based neoadjuvant chemoradiotherapy followed by surgery can achieve a higher R0 resection rate, down?staging rate, higher pCR rate, and a better tolerance. The incidence of postoperative complications is low. Pre?treatment stage, down?staging, pathological tumor response, lymph node status and R0 resection results are prognostic factors, and the pre?treatment stage is an independent prognostic factor.

Objective This study aimed to evaluate the impact of technical advancement of radiation therapy in patients with LA?NSCLC receiving definitive radiotherapy (RT). Methods Patients treated with definitive RT (≥50 Gy) between 2000 and 2010 were retrospectively reviewed. Overall survival ( OS) , cancer specific survival ( CSS) , locoregional progression?free survival ( LRPFS) , distant metastasis?free survival (DMFS) and progression?free survival (PFS) were calculated and compared among patients irradiated with different techniques. Radiation?induced lung injury ( RILI) and esophageal injury ( RIEI) were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events 3.0 ( NCI?CTCAE 3.0) . Results A total of 946 patients were eligible for analysis, including 288 treated with two?dimensional radiotherapy ( 2D?RT) , 209 with three?dimensional conformal radiation therapy ( 3D?CRT) and 449 with intensity?modulated radiation therapy ( IMRT) respectively. The median follow?up time for the whole population was 84.1 months. The median OS of 2D?RT, 3D?CRT and IMRT groups were 15.8, 19.7 and 23.3 months, respectively, with the corresponding 5?year survival rate of 8. 7%, 13. 0% and 18. 8%, respectively ( P<0.001) . The univariate analysis demonstrated significantly inferior OS, LRPFS, DMFS and PFS of 2D?RT than those provided by 3D?CRT or IMRT. The univariate analysis also revealed that the IMRT group had significantly loger LRPFS and a trend toward better OS and DMFS compared with 3D?CRT. Multivariate analysis showed that TNM stage, RT technique and KPS were independent factors correlated with all survival indexes. Compared with 2D?RT, the utilization of IMRT was associated with significantly improved OS, LRPFS, DMFS as well as PFS. Compared with 3D?CRT, IMRT provided superior DMFS ( P=0.035), a trend approaching significance with regard to LRPFS (P=0.073) but no statistically significant improvement on OS, CSS and PFS in multivariate analysis. The incidence rates of RILI were significantly decreased in the IMRT group (29.3% vs. 26.6% vs.14.0%, P<0.001) whereas that of RIET rates were similar (34.7% vs. 29.7% vs. 35.3%, P=0.342) among the three groups. Conclusions Radiation therapy technique is a factor affecting prognosis of LA?NSCLC patients. Advanced radiation therapy technique is associated with improved tumor control and survival, and decreased radiation?induced lung toxicity.

Esophageal cancer is one of the most common cancers in China. More than 80% of esophageal cancer patients are diagnosed at a late stage and are not eligible for surgery. Radiotherapy is one of the most important modalities in esophageal cancer treatment. Here we reviewed the advances in esophageal cancer radiotherapy and radiotherapy?based combined?modality therapy, such as optimization of radiation dose and target volume, application of precise radiotherapy technique and the integration of radiotherapy with chemotherapy and targeted therapy.

Objective To analyze the outcome and prognostic factors of IMRT?based preoperative neoadjuvant chemoradiotherapy in patients with thoracic esophageal squamous cell carcinoma ( ESCC ) . Methods Clinical data of 62 patients with thoracic ESCC who received IMRT?based neoajuvant chemoradiotherapy from January 2009 to January 2015 were retrospectively analyzed. The radiation therapy was given 1.8?2 Gy/fraction per day over 5 days per week with 6 MV X?rays, and then all patients underwent esophagectomy and lymphadenectomy. Results Among the 62 patients, the R0 resection rate was 96.8%. Twenty ( 32. 3%) patients achieved pCR and 56 ( 90. 3%) cases got down?staging. Grade Ⅲ marrow suppression and esophagitis were seen in 8 (12.9%) and 2 (3.2%) patients, respectively. Eleven (17.7%) patients experienced postoperative complications and three died. The median follow?up was 27 months. The 1?, 3?and 5?year overall survival rates were 88.0%, 63.3% and 44.2%, respectively, with a corresponding disease?free survival rate of 68. 1%, 54. 8%, and 43. 9%, respectively. The univariate analysis showed that pre?treatment stage Ⅱ, down?staging, T/N pCR, good tumor response to neoadjuvant chemoradiotherapy, pN0 and R0 resection were favorable prognostic factors (P<0.05). The multivariate analyses indicated that pre?treatment stage was an independent prognostic factor. Conclusions For patients with thoracic ESCC, IMRT?based neoadjuvant chemoradiotherapy followed by surgery can achieve a higher R0 resection rate, down?staging rate, higher pCR rate, and a better tolerance. The incidence of postoperative complications is low. Pre?treatment stage, down?staging, pathological tumor response, lymph node status and R0 resection results are prognostic factors, and the pre?treatment stage is an independent prognostic factor.

OBJECTIVETo explore the impact of AJCC TNM Staging 7th edition on survival outcome of limited stage small cell lung cancer (SCLC).

METHODSFour hundred and thirty-seven SCLC patients with completed diagnosis and treatment data treated in our department between January 1996 and December 2006 were reclassified according to the AJCC TNM Staging 7th edition. The patients of stages IA, IB, IIA, IIB, IIIA, IIIB were 8, 44, 7, 64, 192 cases, respectively. Kaplan-Meier method was used for survival analysis and log-rank test was used to identify the prognostic factors. The survival rate was determined using chi-square test.

RESULTSThe median follow-up time was 64 months. The median survival time was 26.2 months and median progression free survival time was 13.7 months. The 1-, 2- and 5-year overall survival rates were 86.0%, 52.7%, and 29.7%, respectively. The log-rank test showed that TNM stage is a statistically significant prognostic factor for OS in LS-SCLC (P<0.001). TNM staging system generally allowed a good separation in pairwise comparison for OS between successive stages except there was no significant difference between stages I and II (P=0.061). The 5-year progression free survival rates of patients of stage I, II, IIIA and IIIB were 53.2%, 43.2%, 16.8%, and 10.9%, respectively. TNM stage also was a statistically significant prognostic factor for PFS in LS-SCLC (P<0.001), but there was no significant difference between successive stages (P>0.05 for all). The T staging confirmed significant influence on OS (P<0.001) with no significant difference between successive stages (P>0.05 for all), while T stage was not a significant prognostic factor for PFS in the LS-SCLC patients (P=0.194). N stage also had a significant influence on OS (P<0.001), but with no significant differences between successive stages except N1 and N2 (P=0.001). N staging also showed significant influence on PFS (P=0.001), but with no significant difference between successive stages (P>0.05) except that between the 5-year survival rates of N2 and N3 cases (P=0.013). The cumulative brain metastasis rates of stages I, II, IIIA, and stage IIIB were 17.3%, 28.6%, 33.3%, and 35.8%, respectively(P=0.072), and were 12.8% and 30.8% for pathological stage I and clinical stage I (P=0.203).

CONCLUSIONAJCC TNM Staging 7th edition criteria for LS-SCLC patients have a high prognostic impact and therefore are preferable in clinical practice and future therapeutic trials.

Disease Progression ; Disease-Free Survival ; Humans ; Kaplan-Meier Estimate ; Lung Neoplasms ; mortality ; pathology ; Neoplasm Staging ; methods ; Prognosis ; Retrospective Studies ; Small Cell Lung Carcinoma ; mortality ; pathology ; Survival Analysis ; Survival Rate ; Time Factors

OBJECTIVETo evaluate the effect of comprehensive treatment and examine the impact of clinical factors on the survival outcome of limited-stage small cell lung cancer.

METHODSThe clinical records of 335 patients with limited-stage small cell lung cancer treated in the Cancer Hospital of Chinese Academy of Medical Sciences between January 1996 and December 2006 were analyzed retrospectively in this study. Kaplan-Meier method was used for survival analysis, and log-rank test and Cox regression were used for univariate and multivariate analyses of prognostic factors.

RESULTSThe median follow-up time was 54 months for all patients, the median survival time was 23.8 months, and progression-free survival was 12.5 months. The 2-, 3-, and 5-year overall survival rates were 47.3%, 32.9%, and 22.9%, respectively. The acute toxicity during comprehensive treatment was tolerable. The incidence of ≥grade 3 hematological toxicity, ≥grade 3 gastrointestinal toxicity, ≥grade 2 radiation pneumonitis and ≥grade 2 acute esophagitis were 37.0%, 14.9%, 11.0%, and 38.8%, respectively. The univariate analysis showed that KPS<80, smoking and high LDH level significantly reduced the overall survival time in patients with limited-stage SCLC. The multivariate analysis showed that KPS and weight loss were independent factors affecting the prognosis for the limited stage SCLC patients (P<0.05 for all).

CONCLUSIONSSequential chemoradiotherapy can be safely and effectively performed in limited-stage small cell lung cancer. Krnofsky performance status and weight loss are independent prognostic factors for the overall survival of LS-SCLC.

Chemoradiotherapy ; Disease-Free Survival ; Esophagitis ; Humans ; Lung Neoplasms ; diagnosis ; epidemiology ; pathology ; Multivariate Analysis ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Small Cell Lung Carcinoma ; diagnosis ; epidemiology ; pathology ; Survival Analysis ; Survival Rate