ABSTRACT
PURPOSE: In patients with nonsmall cell lung cancer (NSCLC), the effect of age on adjuvant chemotherapy (CT) after primary surgical treatment is controversial. The aim of this study was to investigate the effect of age and other clinical variables on survival in NSCLC patients who received adjuvant CT. MATERIALS AND METHODS: NSCLC patients who underwent primary resection and received adjuvant CT between January 2012 and January 2016 were included in the study. The patients were divided into two age groups: (1) patients >65 years old (older patient group) and (2) patients ≤ 65 years old (young patient group). The effects of clinical variables such as age, histology, pT stage, pN stage, pTNM stage, adjuvant thoracic radiotherapy, and recurrence status on survival were assessed using the log-rank test and multivariable Cox regression analysis. RESULTS: A total of 91 NSCLC patients who received adjuvant CT after complete resection were included in the study. The median age of the patients was 60 (36–73) years. Eighty-six percent of the patients were male. 49.4% had squamous NSCLC and 50.6% had nonsquamous NSCLC. 59% had stage I and II disease and 41% had stage III disease. The mean overall survival was 61.9 months [95% confidence interval (CI) 51.28–72.69] in the young patient group and 73.1 months (95% CI 60.24–85.94) in the older patient group . The mean disease-free survival was 47.0 months (95% CI 37.81–56.23) in the young patient group and 51.1 months (95% CI 40.68–57.17) in the older patient group (P = 0.119 and P = 0.407, respectively). Pathological stage III [heart rate (HR): 2.615, P = 0.014] and presence of recurrence (HR: 2.496, P = 0.019) were found to be independent risk factors. However, age did not show statistical significance (HR: 0.428, 95% CI 0.128–1.427, P = 0.167). CONCLUSION: In NSCLC patients who underwent complete resection and received adjuvant CT, advanced age had no prognostic effect on survival.
ABSTRACT
To report a case of Churg-Strauss syndrome who had asthma and allergic rhinitis treated with montelukast. A nonsmoking 59-year-old woman presented with fever, hemoptysis and dyspnea. Past medical history included allergic rhinitis and asthma which were diagnosed 18 years ago. The asthma was treated successfully with inhaled salmeterol and beclamethasone. She also received montelukast [10 mg/day] for 3 years. Although her chest X-ray was normal a week earlier, she had widespread bilateral pulmonary infiltrates on admission. She had leukocytosis [12.5 x 109/l] with eosinophilia [15.6%]. Her total IgE count was 550 U/ml. Testing for protoplasmic-staining antineutrophil cytoplasmic antibodies was positive. Bronchoalveolar lavage could not be performed due to bronchospasm and severe hypoxemia; however, mucosal biopsies were obtained, which revealed eosinophil leukocytes in the lumen and walls of small vessels. She was diagnosed to have Churg-Strauss syndrome and had remarkable clinical improvement on day 5 with high-dose of oral prednisolone [50 mg/day]. Radiological improvement was detected at the end of the second week. This case shows the importance of being aware that leukotriene receptor antagonists could cause Churg-Strauss syndrome, in spite of the uncertainty about its mechanism