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1.
Anticancer Res ; 40(2): 957-964, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32014940

RESUMO

BACKGROUND/AIM: To describe real clinical outcomes when using systemic therapy to treat non-small cell lung cancer (NSCLC) patients who have anaplastic lymphoma kinase (ALK) fusion gene mutation. PATIENTS AND METHODS: We performed a retrospective chart review from April 2008 to March 2019 sourced from 16 medical institutes that cover a population of three million people. RESULTS: There were 129 ALK rearranged NSCLC patients. Among them, 103 patients including 40 recurrent disease cases received ALK-tyrosine kinase inhibitors (TKI) and chemotherapy. Our treatment results were comparable to previously reported clinical trials and clinical practice studies. First-line alectinib, treatment sequence of ALK-TKI followed by another ALK-TKI, and pemetrexed-containing chemotherapy contributed to the outcome of treatment. CONCLUSION: By arrangement of treatment such as treatment sequence of ALK-TKI and chemotherapy regimen, it might be possible to obtain a treatment outcome almost equivalent to those of clinical trials even in real clinical practice.

3.
Anticancer Res ; 40(1): 413-419, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892595

RESUMO

BACKGROUND/AIM: In patients with lung cancer, there has been no study that treated 'distant metastases' as 'metastatic patterns'. This study aimed to evaluate if specific 'metastatic patterns' exist in lung cancer patients. PATIENTS AND METHODS: Data were collected from lung cancer patients between 2009 and 2018. Metastatic patterns were analyzed using cluster analysis in patients with epidermal growth factor receptor (EGFR) mutation-positive lung adenocarcinoma, those with small cell lung cancer (SCLC), and those with squamous cell lung cancer (SqCLC). RESULTS: In 313 patients (127 patients with EGFR mutation, 87 patients with SCLC, and 99 patients with SqCLC), metastatic patterns existed in each of the three subset groups, and metastatic patterns of these groups were statistically different. CONCLUSION: The knowledge of the metastatic patterns might be useful for clinical practice in the foreseeable future, as it enables a more efficient detection of metastatic disease through imaging, and a more effective treatment at predicted metastatic sites.


Assuntos
Neoplasias Pulmonares/patologia , Adenocarcinoma de Pulmão/genética , Idoso , Idoso de 80 Anos ou mais , Análise por Conglomerados , Receptores ErbB/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação/genética , Metástase Neoplásica , Probabilidade
4.
Anticancer Res ; 40(1): 421-426, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31892596

RESUMO

BACKGROUND/AIM: Distant organ metastases do not occur at random in lung cancer. A retrospective study was conducted in order to evaluate 1) what kinds of metastatic patterns exist in three different types of lung cancer, and 2) whether metastatic patterns affected prognosis in the different types of lung cancer. PATIENTS AND METHODS: Data were collected from all consecutive patients with diagnosed lung cancer between April 2009 and October 2018 in our hospitals. Cluster analysis was performed to classify patients. Kaplan-Meier analysis, log-rank test, and Cox proportional hazards model were used. RESULTS: Epidermal growth factor-mutated adenocarcinoma, small cell lung cancer, and squamous cell lung cancer had different 'metastatic patterns', survival, and unfavorable prognostic factors, respectively. CONCLUSION: There might be different metastatic patterns, survival, and unfavorable prognostic factors in each pathological and genetic type of lung cancer. It is worthwhile carrying out diagnostic imaging and treatment considering information on metastatic patterns.


Assuntos
Neoplasias Pulmonares/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Receptores ErbB/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Mutação/genética , Metástase Neoplásica , Prognóstico , Modelos de Riscos Proporcionais , Análise de Sobrevida
5.
Medicine (Baltimore) ; 98(48): e17828, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31770198

RESUMO

RATIONALE: Multicentric carpotarsal osteolysis (MCTO) is a rare hereditary disease caused by mutations in MafB, a negative regulator of osteoclastogenesis. PATIENT CONCERNS: A 20-year-old, Japanese woman with scoliosis visited our institute for treatment. Scoliosis was apparent since she was 12 years old, but she had not sought treatment until the age of 19. Medical examination showed a typical facial appearance associated with a small forehead and hypotelorism; shortening of the fingers of both hands and both upper limbs was observed, in addition to clubfoot. No café au lait spots or mental retardation were observed. On the other hand, the trunk showed evidence of an irregular waistline and a rib hump that obviously suggested scoliosis. Neurological deficit was not observed. Spirometry showed decreased forced vital capacity (FVC). Although proteinuria was observed, renal dysfunction and hypertension were not seen. The major curve of scoliosis was 82° (MC, Th7-L2; Th11 apical vertebra), and the upper curve was 77° (UC, Th1-6; Th3 apical vertebra). In a recumbent-traction position, the major curve was 54° and the upper curve was 56°. The pelvic incidence minus lumbar lordosis (PI-LL) angle was <10° and no mismatch was observed; thoracic kyphosis was decreased to 16°. DIAGNOSIS: The patient was diagnosed with symptomatic scoliosis secondary to MCTO. INTERVENTIONS: We decided to perform a correction and fusion from Th2 to L3 using a posterior spinal instrumentation. OUTCOMES: Postoperative x-ray demonstrated scoliosis angle correction from 77° to 38° at Th1-6 and 82° to 39° at Th7-L2. Postoperative x-ray demonstrated thoracic kyphosis angle correction from 16° to 21°. The patient's height increased from 155 to 161 cm. LESSONS: It has been 24 months since the operation, and no exacerbation has been observed. To the best of our knowledge, this is the first report of surgical treatment of scoliosis secondary to MCTO.


Assuntos
Osteólise/complicações , Escoliose/genética , Feminino , Humanos , Fator de Transcrição MafB/metabolismo , Osteólise/genética , Escoliose/cirurgia , Fusão Vertebral/métodos , Adulto Jovem
6.
Tuberk Toraks ; 67(2): 142-145, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31414646

RESUMO

The adrenal gland is a common site for metastasis from non-small-cell lung cancer (NSCLC). Adrenal metastases are usually solitary, asymptomatic and diagnosed incidentally during staging of patients with lung adenocarcinoma. Huge but sole adrenal gland metastasis with rapid growth and local invasion is extremely rare and those occurring in the setting of NSCLC have not been reported previously. Herein we describe a 66 year old male patient with NSCLC who had huge but sole adrenal gland metastasis with rapid growth and local invasion and extension into stomach, pancreas and left kidney. Interestingly there was no increase in the primary lesion of NSCLC. These findings were confirmed by autopsy. Despite the occurrence of an adrenal gland metastasis with considerable size being rare, it should be considered in the differential diagnosis, even if there is no involvement of the other organ and the primary lesion is of a small size.


Assuntos
Adenocarcinoma/patologia , Neoplasias das Glândulas Suprarrenais/secundário , Carcinoma Pulmonar de Células não Pequenas/secundário , Neoplasias Pulmonares/patologia , Adenocarcinoma/diagnóstico por imagem , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/patologia , Idoso , Autopsia , Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma Pulmonar de Células não Pequenas/patologia , Diagnóstico Diferencial , Evolução Fatal , Humanos , Achados Incidentais , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Radiografia , Tomografia Computadorizada por Raios X
9.
In Vivo ; 33(4): 1369-1372, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31280232

RESUMO

BACKGROUND/AIM: The aim of this retrospective study was to identify, using logistic analysis, the factors associated with distant metastasis in non-small cell lung cancer patients carrying mutations in epidermal growth factor receptor. PATIENTS AND METHODS: Patients who were diagnosed with distant metastasis at the time of diagnosis up to their death and during the period from April 2009 to March 2019, were included in this study. Clinical charts and imaging studies were reviewed. RESULTS: A total of 64 patients during the research period. The factors associated with pleural metastasis were "female" and "no bone metastasis". The factor associated with brain metastasis was "lung metastasis". The factors associated with liver metastasis were "age under 70" and "Exon 19 deletion". CONCLUSION: Knowing the factors associated with distant metastasis will provide useful information to conduct targeted and efficient imaging studies.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/genética , Carcinoma Pulmonar de Células não Pequenas/patologia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Mutação , Idoso , Idoso de 80 Anos ou mais , Receptores ErbB/genética , Éxons , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias
10.
J Gen Fam Med ; 20(3): 101-106, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31065474

RESUMO

Background: In patients with bronchial asthma and those with chronic obstructive pulmonary disease (COPD), inhalation therapy and rinsing of the mouth and the oropharynx by gargling ("RMOG") after inhalation are recommended. We performed a cross-sectional audit aimed at investigating (a) the proportion of patients performing "RMOG" after inhalation and (b) storage place of patients' inhaler. Methods: Patients with bronchial asthma and those with COPD were asked by medical aids at outpatient visits whether they did "RMOG every time," "RMOG sometimes," or "no RMOG" after inhalation, and where they stored their inhaler. Results: During a six month study period up to September 2017, 330 consecutive patients with asthma and those with COPD were included in the study. Two hundred and thirty-two (70.3%) of the 330 patients answered "RMOG every time" and 98 (29.7%) of them did "RMOG sometimes" and did "no RMOG." There was a difference in the proportion of patients performing RMOG after inhalation with patient age. With regard to the storage location of inhaler, we found the proportion of patients performing RMOG was higher in those who stored inhalers in a room with running water than in those who stored inhalers at other places. This difference was found in patients with both bronchial asthma and those with COPD. Conclusions: Further implementation of "patient education" on performing RMOG after inhalation for patients receiving inhaled medication is still necessary. Our results suggest that it is better to store inhalers in places where there is easy access to tap water used for RMOG.

11.
Conf Proc IEEE Eng Med Biol Soc ; 2019: 1471-1475, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31946171

RESUMO

Gait is one of the important features to assess physical or mental conditions of the elderly which is directly related to their health status. The changes or abnormalities in gait may reflect health risks. Screening tests like TUG (Timed Up and Go) and POMA (Performance Oriented Mobility Assessment) include gait assessment. However, analyzing gait is a complex process usually handled by professionals at clinical facilities. With the development of IoT (Internet of Things) sensors and computer vision technologies, more automatic and accurate approaches are demanded to measure gait at nursing facilities or at-home in the daily environment. In this paper, we propose an automatic and privacy-considered way to analyze gait using a non-contact sensor, a stereo camera. This approach applies a cutting-edge deep learning technology to detect a human subject in 2D images and then combining 3D sensing data to measure gait features, such as step length and walking speed. Compared to Kinect or a single 2D camera, our approach is not only accurate for various walking patterns but also robust to camera setting environment. Experiments at a daycare facility in Tianjin, China showed that our approach is suitable for assessing TUG or POMA tests in the daily environment.

14.
Anticancer Res ; 38(9): 5409-5415, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30194196

RESUMO

BACKGROUND/AIM: To describe real clinical outcomes when using afatinib therapy to treat non-small cell lung cancer patients who have an acquired EGFR T790M mutation. MATERIALS AND METHODS: A retrospective chart review was conducted from January 2013 to November 2017 sourced from 15 medical institutes that cover a population of three million people. RESULTS: There were 74 patients who met the above-mentioned criteria. Treatment outcomes with afatinib, in patients with or without tyrosine kinase inhibitor (TKI) therapy prior to afatinib, were similar to previously reported clinical trials. Stratification of patients by the presence or absence of TKI pretreatment before afatinib, and the presence or absence of an acquired T790M mutation found no statistical difference in overall survival. CONCLUSION: This population-based study found that the disadvantages of pretreatment before afatinib, and absence of an acquired T790M EGFR mutation, could be overcome by an appropriate treatment strategy in clinical practice.


Assuntos
Biomarcadores Tumorais/genética , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Receptores ErbB/antagonistas & inibidores , Receptores ErbB/genética , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Mutação , Inibidores de Proteínas Quinases/uso terapêutico , Quinazolinas/uso terapêutico , Adulto , Afatinib , Idoso , Idoso de 80 Anos ou mais , Carcinoma Pulmonar de Células não Pequenas/enzimologia , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Bases de Dados Factuais , Feminino , Humanos , Japão , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/enzimologia , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Inibidores de Proteínas Quinases/efeitos adversos , Quinazolinas/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
18.
Mol Clin Oncol ; 8(1): 137-140, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29387406

RESUMO

Lung and colon cancers are two of the most common malignancies, which, in some cases, may develop synchronously. In the present study, the treatment and outcome of patients with synchronous lung and colon cancers were reviewed. During a 76-month study period, from April 2009 up to July 2016, 17 (0.54%) of 3,102 patients with lung cancer were diagnosed with colon cancer within 1 month. Heavy smoking and obesity were not specific factors in these patients. A total of 9 patients succumbed to lung cancer during the study period. Survival in asymptomatic patients was longer compared with that in symptomatic patients (median survival, 80 vs. 23.2 months, respectively; P=0.007). Although the incidence of synchronous occurrence of these two cancers may be low, particularly in patients diagnosed incidentally, such patients should be treated accordingly. Future genetic and epidemiological studies are required to elucidate the potential connection between lung and colon cancer.

20.
Mol Clin Oncol ; 8(1): 175-177, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29285395

RESUMO

A 'paradoxical response' to cancer treatment is a term used to describe the emergence of unexpected new lesions and the progression of existing lesions, despite appropriate and effective therapy. 'Pseudo-progression' is a phenomenon in which lymphocytes activated by an immune checkpoint inhibitor accumulate in a tumor and expand its shadow, mimicking enlargement of the primary lesion or development of a new metastatic lesion. Patients receiving cancer chemotherapy may respond differently to treatment, by exhibiting a response, deterioration, or the simultaneous occurrence of both. These variations may be attributed to the heterogeneity of the cancer. However, differences in the temporary response to epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment are rarely observed. If such a phenomenon is observed, it should not affect the evaluation of the therapeutic effect or be considered as an indication for the discontinuation of treatment. We herein report a rare case of a transient increase in carcinomatous pleural fluid as a paradoxical response to osimertinib treatment in a patient with T790M-mutated lung adenocarcinoma. The primary lesion and pulmonary metastases responded well to therapy. Although this paradoxical response is very rare, of non-malignant nature, and does not usually require treatment modification of, physicians must acknowledge that it is not a clinically discouraging characteristic when using EGFR-TKI to treat T790M-mutated lung adenocarcinoma.

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