ABSTRACT
Lung cancer is the leading cause of cancer death worldwide as well as in China. For many years, conventional oncologic treatments such as surgery, chemotherapy, and radiotherapy (RT) have dominated the field of non-small cell lung cancer (NSCLC). The recent introduction of immunotherapy in clinical practice, led to a paradigm shift in lung cancer as in many other solid tumors. Recent pre-clinical and clinical data have shown RT may also modify antitumor immune responses through induction of immunogenic cell death and reprogramming of the tumor microenvironment. This has led many to reexamine RT as a partner therapy to immuno-oncology treatments and investigate their potential synergy in an exponentially growing number of clinical trials. Clinical trials combining radiotherapy and immunotherapy are attracting major attention, experts were invited to discuss frontier and controversial academic topics: (1) Recent developments of clinical synergy between radiation and immune checkpoint inhibitors (ICIs) in the treatment of NSCLC; (2) Will immunotherapy and radiotherapy increase the toxicity risk for cancer patients; (3) How to cope the mixed responses/disassociated responses phenomenon in checkpoint inhibition therapy to NSCLC with local ablative therapy; (4) Combining radiotherapy and immunotherapy in the treatment of NSCLC brain metastases.
ABSTRACT
Objective To explore the prognostic factor by analyzing clinical characters, pathologic features and treatment methods of thymic carcinoma. Methods From January 2000 to Deceber 2011, 71 patients received re-section of thymic carcinoma. They were analyzed retrospectively based on Masaoka stage(stageII 7,stageIII 33, stageIV 31). The clinical factors included histological classification, Masaoka stage, treatment and prognosis. Sur-vival rate was calculated and the survival curve was plotted by Kaplan-Meimer and Log-Rank method, Multi-analy-sis was carried out by COX regression. Results For these patients, the median survival time was 57. 2 months, the 5-year survival rate was 47. 9%. 25 patients received complete resection with 5-years survival rate 68%, 46 patients received partial resection with 5-years survival rate 36. 9%. 41 patients whose lump size was greater than or equal to 8 cm with 5-years survival rate 53. 6%, 40% with lower than 8 cm. Histology Masaoka staging with 5-years survival rate was stage II(57. 1%) , stage III(69. 7%) and stage IV(29. 0%) , respectively. Defferent his-tological type with 5-years survival rate squamous carcinoma(55. 1%) , adenocarcinoma (14. 3%) ,small cell car-cinoma ( 28. 6%) , adenosquamous carcinoma ( 33. 3%) , and carcinoid ( 100%) , respectively. The operation method, the maximum diameter, mass Masaoka stage and different pathology types for survival were statistically dif-ferent (P<0. 05). Preoperative treatment, postoperative radiotherapy and differentiation degree of survival had no statistical difference. Conclusion Surgical method, lump size, masaoka stage and histological type are the impor-tant factors affecting prognosis. Adjuvant radiotherapy maybe is not the poor prognosis factor of thymic tumors. Sur-gical method and lump size are the significant independent prognostic factors in patients with thymic tumors.
ABSTRACT
The results of chemotherapy in the treatment of advanced non-small-cell lung cancer (NSCLC)had reached a plateau.Targeted therapy is the key to improving efficacy.In the last 5 years the epidermal growth factor receptor(EGFR)has emerged as one of the most important targets for drug development in oncology.Small molecules that inhibit the tyrosine kinase(TK)domain of EGFR have become new critical weapons in the treatment of NSCLC.Monoclonal antibodies targeting the external domain of EGFR have been shown to have clinical benefit when combined with chemotherapy.Recent data suggest that multitargeted inhibitors might have greater activity owing to their ability to simultaneously block key signaling pathways.Preliminary results of such agents in clinical trials shows that they have a well-tolerated toxicity profile,and might have a promising value in the treatment of advanced non-small-cell lung cancer.
ABSTRACT
Purpose:To investigate the characteristic findi ngs for HPO in bone scintigraphy and evaluate the clinical significance of HPO i n lung diseases. Methods:~99mTc-MDP bone scintigram of 11 025 patients in Shanghai Chest Hospital were reviewed. Among them 75 HPO cases were confirmed by ~99mTc-MDP bone scan. The scintigrams and clinical evidences of these pat ients were retrospectively analyzed. Results:①In our study, bone scan disclosed two patterns: doubl e-stripe sign and symmetrically increased uptake in juxta-articular bone. The incidence were 96% and 2.6% respectively. Increased uptake along the cortical ma rgins of the long bone were more obvious in the lower than upper extremities.②H PO occurred principally in man more than 45 years old with smoking history excee ding 400 pack years. ③Digital clubbing and arthralgia were presented in 25(33.3 %) of the 75 patients with HPO. They may be the first sign of the intrathoracic tumors especially of bronchogenic carcinoma. ④We observed 72 HPO cases(96%) sec ondary to intrathoracic tumors including solitary pleural tumor, pulmonary metas tatic tumor, thymic carcinoma and bronchogenic carcinoma. The most common diseas e associated with HPO was bronchogenic carcinoma, which occurred in 90.7% of pat ients. The inflammatory pulmonary disease associated with HPO was unusual(4%), i ncluding bacterial pneumonia and tubclosis. ⑤The incidence of HPO in patients w ith bronchogenic carcinoma was 2.3%. The tumor was predominantly located in the periphery. HPO was more common in patients with adenocarcinoma(51.4%) and almost occurred in middle or low differentiated lung cancer(91.2%). There was no relat ionship between HPO and staging of tumor. Conclusions:Double-stripe sign was a main characteristic findi ng for HPO. The presence of HPO may predict the involvement of lung disease. HPO was mainly associated with intrathoracic tumors especially with lung cancer. Th e physicians should pay much attention to the syndrome.