Purpose： A number of different clinical characteristics have been reported to singly correlate with therapeutic activity of epidermal growth factor receptor （EGFR） tyrosine kinase inhibitors （TKIs） in advanced no...Purpose： A number of different clinical characteristics have been reported to singly correlate with therapeutic activity of epidermal growth factor receptor （EGFR） tyrosine kinase inhibitors （TKIs） in advanced non-small-cell lung cancer （NSCLC）. This study aimed to identify predictive factors associated with prognostic benefits of gefitinib. Patients and methods： EGFR gene typing in 33 advanced NSCLC patients received gefitinib （250 mg/day） were analyzed with mutant-enriched PCR assay. Gefitinib response was evaluated with potential predictive factors retrospectively. Results： The overall objective response rate （ORR） and median progression-flee survival （PFS） in the 33 patients treated by gefitinib were 45.5% and 3.0 （2.0-4.0） months. The ORR and median PFS in EGFR gene mutation patients were significantly higher/longer than those in EGFR gene wild-type patients （P〈0.01）. Similarly, the ORR and median PFS in non-smoker patients were significantly higher/longer than those in smoker patients （P〈0.05, P〈0.01, respectively）. However, no difference for ORR and median PFS occurred between male and female patients. Logistic multivariate analysis showed that only EGFR mutated gene was significantly associated with the ORR （P〈0.01）. Both EGFR mutated gene and non-smoker were the major factors that contributed to PFS （P〈0.05）. Conclusions： EGFR mutated gene and non-smoker status are potential predictors for gefitinib response in NSCLC patients.展开更多
目的系统评价单纯三维适形放射治疗(放疗)与同步化学治疗(化疗)在局部晚期非小细胞肺癌治疗中的疗效与安全性。方法计算机检索Cochrane Database of Systematic Reviews、Medline、EMbase、OpenSIGLE、National Technical Information S...目的系统评价单纯三维适形放射治疗(放疗)与同步化学治疗(化疗)在局部晚期非小细胞肺癌治疗中的疗效与安全性。方法计算机检索Cochrane Database of Systematic Reviews、Medline、EMbase、OpenSIGLE、National Technical Information Service(NTIS)、中国知网(CNKI)、维普数据库(VIP)、万方数据库和CBM中关于三维适形放疗联合化疗治疗局部晚期非小细胞肺癌疗效评估的随机对照试验(RCT),同时追索纳入文献的参考文献。检索时限均从建库至2011年10月。由两名研究者对纳入研究的质量进行严格评价和资料提取,对符合质量标准的RCT进行Meta分析。统计学分析采用RevMan5.0.25软件。结果共纳入12个RCT,Meta分析5个主要结局指标的结果显示:单纯三维适形放疗与同步化疗比较,有效率和局部症状改善差异有统计学意义[分别为OR=2.52,95%CI(1.41,4.52)和OR=3.22,95%CI(1.32,7.83)],放射性食管炎、放射性肺炎和骨髓抑制程度差异无统计学意义。结论现有研究表明,三维适形放疗联合化疗可明显改善患者局部症状,提高治疗有效率,且大部分患者可耐受毒副作用,临床医师可将联合化疗作为强推荐。但鉴于纳入研究较少,样本量小,质量不高,仍需开展大样本、多中心、方法科学和规范的高质量RCT,以进一步验证二者的联合治疗效果。展开更多
应用流式细胞仪检测92例非小细胞肺癌的 DNA 含量,异倍体检出率53.3%,平均DNA 指数1.53。经各种指标对比分析发现:肺癌细胞 DNA 倍体与肺癌的病理类型之间无明显关系,但与肺癌细胞的分化程度、癌灶的大小,临床分期及五年生存率之间均有...应用流式细胞仪检测92例非小细胞肺癌的 DNA 含量,异倍体检出率53.3%,平均DNA 指数1.53。经各种指标对比分析发现:肺癌细胞 DNA 倍体与肺癌的病理类型之间无明显关系,但与肺癌细胞的分化程度、癌灶的大小,临床分期及五年生存率之间均有密切关系。结果提示:肺癌细胞的 DNA 倍体是反映病理学上恶性程度和评价预后的重要参数。展开更多
文摘Purpose： A number of different clinical characteristics have been reported to singly correlate with therapeutic activity of epidermal growth factor receptor （EGFR） tyrosine kinase inhibitors （TKIs） in advanced non-small-cell lung cancer （NSCLC）. This study aimed to identify predictive factors associated with prognostic benefits of gefitinib. Patients and methods： EGFR gene typing in 33 advanced NSCLC patients received gefitinib （250 mg/day） were analyzed with mutant-enriched PCR assay. Gefitinib response was evaluated with potential predictive factors retrospectively. Results： The overall objective response rate （ORR） and median progression-flee survival （PFS） in the 33 patients treated by gefitinib were 45.5% and 3.0 （2.0-4.0） months. The ORR and median PFS in EGFR gene mutation patients were significantly higher/longer than those in EGFR gene wild-type patients （P〈0.01）. Similarly, the ORR and median PFS in non-smoker patients were significantly higher/longer than those in smoker patients （P〈0.05, P〈0.01, respectively）. However, no difference for ORR and median PFS occurred between male and female patients. Logistic multivariate analysis showed that only EGFR mutated gene was significantly associated with the ORR （P〈0.01）. Both EGFR mutated gene and non-smoker were the major factors that contributed to PFS （P〈0.05）. Conclusions： EGFR mutated gene and non-smoker status are potential predictors for gefitinib response in NSCLC patients.
文摘目的系统评价单纯三维适形放射治疗(放疗)与同步化学治疗(化疗)在局部晚期非小细胞肺癌治疗中的疗效与安全性。方法计算机检索Cochrane Database of Systematic Reviews、Medline、EMbase、OpenSIGLE、National Technical Information Service(NTIS)、中国知网(CNKI)、维普数据库(VIP)、万方数据库和CBM中关于三维适形放疗联合化疗治疗局部晚期非小细胞肺癌疗效评估的随机对照试验(RCT),同时追索纳入文献的参考文献。检索时限均从建库至2011年10月。由两名研究者对纳入研究的质量进行严格评价和资料提取,对符合质量标准的RCT进行Meta分析。统计学分析采用RevMan5.0.25软件。结果共纳入12个RCT,Meta分析5个主要结局指标的结果显示:单纯三维适形放疗与同步化疗比较,有效率和局部症状改善差异有统计学意义[分别为OR=2.52,95%CI(1.41,4.52)和OR=3.22,95%CI(1.32,7.83)],放射性食管炎、放射性肺炎和骨髓抑制程度差异无统计学意义。结论现有研究表明,三维适形放疗联合化疗可明显改善患者局部症状,提高治疗有效率,且大部分患者可耐受毒副作用,临床医师可将联合化疗作为强推荐。但鉴于纳入研究较少,样本量小,质量不高,仍需开展大样本、多中心、方法科学和规范的高质量RCT,以进一步验证二者的联合治疗效果。
文摘应用流式细胞仪检测92例非小细胞肺癌的 DNA 含量,异倍体检出率53.3%,平均DNA 指数1.53。经各种指标对比分析发现:肺癌细胞 DNA 倍体与肺癌的病理类型之间无明显关系,但与肺癌细胞的分化程度、癌灶的大小,临床分期及五年生存率之间均有密切关系。结果提示:肺癌细胞的 DNA 倍体是反映病理学上恶性程度和评价预后的重要参数。
文摘免疫治疗是目前除手术、化疗、放疗及靶向治疗外,另一种能够有效改善肺癌预后的治疗方法。在各种免疫治疗方法中,免疫检查点抑制剂(immune checkpoint inhibitors,ICI)在近年来发展迅速,已成为肿瘤治疗领域的新兴疗法及研究热点。其中,程序性死亡受体1(programmed death receptor-1,PD-1)及其配体程序性死亡配体-1(programmed death receptor-ligand1,PD-L1)的抑制剂在多种恶性肿瘤的治疗中均取得了显著疗效,部分药物已被美国FDA批准应用于临床。该文对PD-1/PD-L1抑制剂在晚期非小细胞肺癌(non-small-cell lung cancer,NSCLC)患者治疗中的临床研究现状进行综述,探讨其在晚期NSCLC治疗中的临床应用价值、前景及面临的问题与挑战。
