Objective The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer.
Brain metastasis is a major cause of poor prognosis and high mortality for non-small cell lung cancer patients. The prognosis of non-small-cell lung cancer(NSCLC) patients with brain metastasis is generally poor and m...Brain metastasis is a major cause of poor prognosis and high mortality for non-small cell lung cancer patients. The prognosis of non-small-cell lung cancer(NSCLC) patients with brain metastasis is generally poor and more effective treatment is required to improve their prognosis. Whole-brain radiotherapy, surgery, stereotactic radiosurgery, chemotherapy and targeted therapy are the main treatment for brain metastasis. This review focuses on the five therapeutic strategy and in particular, on targeted therapy.展开更多
Brain(leptomeningeal) metastasis is one of the most common and severe complications of lung cancer. This article interprets expert consensus on the treatment advice for brain(leptomeningeal) metastasis of lung cancer,...Brain(leptomeningeal) metastasis is one of the most common and severe complications of lung cancer. This article interprets expert consensus on the treatment advice for brain(leptomeningeal) metastasis of lung cancer, expounding on its epidemiology, diagnostic standards, efficacy assessment, treatment advice, and other aspects.展开更多
BACKGROUND Small cell lung cancer(SCLC)is a common and aggressive subtype of lung cancer.It is characterized by rapid growth and a high mortality rate.Approximately 10%of patients with SCLC present with brain metastas...BACKGROUND Small cell lung cancer(SCLC)is a common and aggressive subtype of lung cancer.It is characterized by rapid growth and a high mortality rate.Approximately 10%of patients with SCLC present with brain metastases at the time of diagnosis,which is associated with a median survival of 5 mo.This study aimed to summarize the effect of bevacizumab on the progression-free survival(PFS)and overall survival of patients with brain metastasis of SCLC.CASE SUMMARY A 62-year-old man was referred to our hospital in February 2023 because of dizziness and numbness of the right lower extremity without headache or fever for more than four weeks.The patient was diagnosed with limited-stage SCLC.He received 8 cycles of chemotherapy combined with maintenance bevacizumab therapy and achieved a PFS of over 7 mo.CONCLUSION The combination of bevacizumab and irinotecan effectively alleviated brain metastasis in SCLC and prolonged PFS.展开更多
Objective:To evaluate the outcomes and explore the risk factors for survival of lung cancer patients with brain metastases(BMs)who were treated with whole brain radiotherapy(WBRT)and to identify the significance of th...Objective:To evaluate the outcomes and explore the risk factors for survival of lung cancer patients with brain metastases(BMs)who were treated with whole brain radiotherapy(WBRT)and to identify the significance of the risk factors.Methods:A retrospective analysis was carried out for lung cancer patients with BMs who were treated with WBRT in the Second Affiliated Hospital of Soochow University from January 2014 to December 2017.Their survival time was calculated using the Kaplan-Meier method.Meanwhile,the neutrophil-lymphocyte ratio(NLR)cutoff values were defined using the receiver operating characteristic(ROC)curve analysis,and the characteristics of different NLR groups were compared using the Wilcoxon Rank Sum Test.Results:A total of 179 patients were assessed.Their median overall survival(OS)was 9.9(95%CI 7.08–12.72)months.As shown by univariate analyses,their OS was significantly affected by histology(P<0.001),number of BMs(P=0.009),local treatment of BMs(P=0.019),Karnofsky Performance Status score(P=0.001),Graded Prognostic Assessment(GPA)score(P<0.001),hemoglobin level(P=0.002),lymphocyte count(P=0.006),albumin level(P=0.001),and NLR(P<0.001).Meanwhile,according to multivariate analyses,independent risk factors for OS included non-adenocarcinoma(ADCA)histology(P<0.001)and high NLR(P=0.006).Moreover,the optimal NLR cutoff value was determined to be 7.0.The patients in this study were divided into three categories based on their total score determined by assigning each risk factor of histology and NLR one point.The median survival in the patients with scores of 0,1,and 2 was 19.6 months,8.5 months,and 2.2 months,respectively(P=0.001).The survival time and prognostic factors of different pathological types of patients were further analyzed.As a result,the median OS of patients with small-cell lung cancer(SCLC),ADCA patients receiving targeted therapy,and ADCA patients not receiving targeted therapy was 10.9 months,13.2 months,and 9.5 months,respectively.The results of multivariate analyses all showed that NLR was an independent risk factor for OS of these three pathological types of patients.Conclusions:Non-ADCA histology and high NLR serve as independent prognostic factors for survival of lung cancer patients with BMs who have been treated with WBRT.A prognostic model comprising histological type and NLR can be used to evaluate the survival.展开更多
文摘Objective The aim of this study was to define the maximum-tolerated dose (MTD) and observe the toxicity of escalating topotecan combined whole brain radiotherapy for brain metastasis in lung cancer.
文摘Brain metastasis is a major cause of poor prognosis and high mortality for non-small cell lung cancer patients. The prognosis of non-small-cell lung cancer(NSCLC) patients with brain metastasis is generally poor and more effective treatment is required to improve their prognosis. Whole-brain radiotherapy, surgery, stereotactic radiosurgery, chemotherapy and targeted therapy are the main treatment for brain metastasis. This review focuses on the five therapeutic strategy and in particular, on targeted therapy.
文摘Brain(leptomeningeal) metastasis is one of the most common and severe complications of lung cancer. This article interprets expert consensus on the treatment advice for brain(leptomeningeal) metastasis of lung cancer, expounding on its epidemiology, diagnostic standards, efficacy assessment, treatment advice, and other aspects.
基金Yu-Qing Xia Famous Old Chinese Medicine Heritage Workshop of“3+3”Project of Traditional Chinese Medicine Heritage in Beijing,Jing Zhong Yi Ke Zi(2021),No.73National Natural Science Foundation of China,No.81973640+1 种基金Nursery Program of Wangjing Hospital,Chinese Academy of Traditional Chinese Medicine,No.WJYY-YJKT-2022-05China Academy of Traditional Chinese Medicine Wangjing Hospital High-Level Chinese Medicine Hospital Construction Project Chinese Medicine Clinical Evidence-Based Research:The Evidence-Based Research of Electrothermal Acupuncture for Relieving Cancer-Related Fatigue in Patients With Malignant Tumor,No.WYYY-XZKT-2023-20.
文摘BACKGROUND Small cell lung cancer(SCLC)is a common and aggressive subtype of lung cancer.It is characterized by rapid growth and a high mortality rate.Approximately 10%of patients with SCLC present with brain metastases at the time of diagnosis,which is associated with a median survival of 5 mo.This study aimed to summarize the effect of bevacizumab on the progression-free survival(PFS)and overall survival of patients with brain metastasis of SCLC.CASE SUMMARY A 62-year-old man was referred to our hospital in February 2023 because of dizziness and numbness of the right lower extremity without headache or fever for more than four weeks.The patient was diagnosed with limited-stage SCLC.He received 8 cycles of chemotherapy combined with maintenance bevacizumab therapy and achieved a PFS of over 7 mo.CONCLUSION The combination of bevacizumab and irinotecan effectively alleviated brain metastasis in SCLC and prolonged PFS.
文摘Objective:To evaluate the outcomes and explore the risk factors for survival of lung cancer patients with brain metastases(BMs)who were treated with whole brain radiotherapy(WBRT)and to identify the significance of the risk factors.Methods:A retrospective analysis was carried out for lung cancer patients with BMs who were treated with WBRT in the Second Affiliated Hospital of Soochow University from January 2014 to December 2017.Their survival time was calculated using the Kaplan-Meier method.Meanwhile,the neutrophil-lymphocyte ratio(NLR)cutoff values were defined using the receiver operating characteristic(ROC)curve analysis,and the characteristics of different NLR groups were compared using the Wilcoxon Rank Sum Test.Results:A total of 179 patients were assessed.Their median overall survival(OS)was 9.9(95%CI 7.08–12.72)months.As shown by univariate analyses,their OS was significantly affected by histology(P<0.001),number of BMs(P=0.009),local treatment of BMs(P=0.019),Karnofsky Performance Status score(P=0.001),Graded Prognostic Assessment(GPA)score(P<0.001),hemoglobin level(P=0.002),lymphocyte count(P=0.006),albumin level(P=0.001),and NLR(P<0.001).Meanwhile,according to multivariate analyses,independent risk factors for OS included non-adenocarcinoma(ADCA)histology(P<0.001)and high NLR(P=0.006).Moreover,the optimal NLR cutoff value was determined to be 7.0.The patients in this study were divided into three categories based on their total score determined by assigning each risk factor of histology and NLR one point.The median survival in the patients with scores of 0,1,and 2 was 19.6 months,8.5 months,and 2.2 months,respectively(P=0.001).The survival time and prognostic factors of different pathological types of patients were further analyzed.As a result,the median OS of patients with small-cell lung cancer(SCLC),ADCA patients receiving targeted therapy,and ADCA patients not receiving targeted therapy was 10.9 months,13.2 months,and 9.5 months,respectively.The results of multivariate analyses all showed that NLR was an independent risk factor for OS of these three pathological types of patients.Conclusions:Non-ADCA histology and high NLR serve as independent prognostic factors for survival of lung cancer patients with BMs who have been treated with WBRT.A prognostic model comprising histological type and NLR can be used to evaluate the survival.
