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1.
Medicine (Baltimore) ; 98(37): e17098, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31517837

RESUMO

Lung cancer has become the leading cause of cancer-related deaths around the world. In addition to genetic risk factors and smoking, the metabolic risk factors remain to be elusive.To evaluate the associations between obesity, nonalcoholic fatty liver disease (NAFLD) and pulmonary adenocarcinoma in patients with lung cancer.Consecutive operation-proven lung cancer patients with assessment of metabolic disorders and liver ultrasound in 2009 and 2013 were retrospectively enrolled. T-test and multivariate logistic regression were applied to evaluate the contribution of individual factors to lung adenocarcinoma, as well as the synergistic effects between these factors.Among 3664 lung cancer patients with ultrasound examination, 2844 cases were enrolled for further analysis. Of them, 1053 (37.0%) were females, 1242 (43.7%) were cigarette smokers, 1658 (58.3%) were diagnosed as lung adenocarcinoma, 744 (26.2%) had obesity, and 614 (21.6%) had NAFLD. Proportion of female gender, nonsmoker, obesity, NAFLD, and serum lipid levels in patients with adenocarcinoma were significantly higher than those in other subtypes of lung cancer, and in 2013 than in 2009 (all P < .01). NAFLD and obesity were shown as independent factors and positively associated with pulmonary adenocarcinoma, along with female gender and nonsmoking, higher serum levels of cholesterol. NAFLD and other contributing factors exhibited no synergistic effects on adenocarcinoma.Obesity and NAFLD might increase the risk for pulmonary adenocarcinoma, especially in nonsmoking females, and underscore the need for further study into carcinogenic mechanisms and preventive interventions.


Assuntos
Adenocarcinoma/etiologia , Neoplasias Pulmonares/classificação , Hepatopatia Gordurosa não Alcoólica/complicações , Obesidade/complicações , Adenocarcinoma/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Feminino , Humanos , Modelos Logísticos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Obesidade/epidemiologia , Estudos Retrospectivos , Fatores de Risco
2.
Pan Afr Med J ; 33: 121, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489099

RESUMO

Gestational trophoblastic disease (GTD) develops from abnormal cellular proliferation of trophoblasts following fertilization. It includes benign trophoblastic disease (hydatidiform moles (HM)) and the malignant trophoblastic diseases or gestational trophoblastic neoplasia (GTN). The frequency of the GTD in Tunisia is one per 918 deliveries. The aim of this study is to analyze the clinical characteristics, treatment and outcomes of GTD at Salah Azaiez Institute (ISA). Medical records of women diagnosed with GTD at ISA from January 1st, 1981 to December 31st, 2012 were retrospectively reviewed. FIGO score was determined retrospectively for patients treated before 2002. One hundred and nine patients with GTN were included. Patients presented with metastases at 43% of cases. The most common metastatic sites were lung (30%) and vagina (13%). Fifty six (56 (51%) patients had low-risk and 21 (19%) cases had high-risk, the FIGO score was not assessed in 32 cases. After a median follow-up of 46 months, 21 patients were lost to follow-up, 12 patients died, 19 progressed and 8 relapsed. At 10 years, the OS rate was 85% and the PFS rate 79%. OS was significantly influenced by the presence of metastases at presentation (M0 100 % vs. Metastatic 62 %; p < 0.0001), FIGO stage (I-II 100% VS 61% and 65% for stage III and IV; p < 0.001), FIGO score (low-risk 99 % vs. high-risk 78 %; p < 0.001). GTN is a significant source of maternal morbidity with increased risk of mortality from complications if not detected early and treated promptly.


Assuntos
Doença Trofoblástica Gestacional/epidemiologia , Mola Hidatiforme/epidemiologia , Adolescente , Adulto , Feminino , Seguimentos , Doença Trofoblástica Gestacional/patologia , Doença Trofoblástica Gestacional/terapia , Humanos , Mola Hidatiforme/patologia , Mola Hidatiforme/terapia , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/secundário , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Gravidez , Intervalo Livre de Progressão , Estudos Retrospectivos , Taxa de Sobrevida , Tunísia , Neoplasias Vaginais/epidemiologia , Neoplasias Vaginais/secundário , Adulto Jovem
3.
Anticancer Res ; 39(9): 4603-4612, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31519557

RESUMO

BACKGROUND/AIM: Sarcopenia describes the loss of skeletal muscle mass. While this condition is associated with a high mortality in cancer patients, its influence on survival is still underestimated. PATIENTS AND METHODS: A systematic review for articles was performed using the PubMed database, Cochrane Library, Biomed Central, Science Direct and by manual search. We used data of overall survival in sarcopenic patients for assessing the death risk. We extracted hazard ratio estimates from univariate and multivariate Cox proportional hazards models for meta-analysis. RESULTS: A total of 15 studies were eligible for meta-analysis including a total of 2,521 lung cancer patients. Univariate meta-analysis revealed a two-fold increased death risk in sarcopenic patients; multivariate meta-analysis yielded a significant, three-fold elevated risk of death. This higher mortality is independent of tumour stage. CONCLUSION: Muscle loss is an independent risk factor for increased death risk in lung cancer patients independent of cancer stage. This argues for implementing screening for sarcopenia into cancer care.


Assuntos
Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/mortalidade , Sarcopenia/etiologia , Humanos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/epidemiologia , Músculo Esquelético/patologia , Estadiamento de Neoplasias , Tamanho do Órgão , Prognóstico , Modelos de Riscos Proporcionais , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia
4.
Medicine (Baltimore) ; 98(35): e17020, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464961

RESUMO

The aim of this retrospective national cohort study is to assess the association between various radiation heart dosimetric parameters (RHDPs), acute myocardial infarct (AMI) and overall survival (OS) outcomes in non-small cell lung cancer (NSCLC) patients treated with post-operative thoracic radiotherapy (PORT) using contemporary radiation techniques.We identified patients with stage I to III NSCLC treated with PORT at the 2 national cancer institutions from 2007 to 2014. We linked their electronic medical records to the national AMI and death registries. Univariable Cox regression was performed to assess the association between various RHDPs, AMI, and OS.We included 43 eligible patients with median follow-up of 36.6 months. Median age was 64 years. Majority of the patients had pathological stage III disease (72%). Median prescription dose was 60Gy. Median mean heart dose (MHD) was 9.4Gy. There were no AMI events. The 5-year OS was 34%. Univariable Cox regression showed that age was significantly associated with OS (hazard ratio, 1.06; 95% confidence interval, 1.01 to 1.10; P = .008). Radiation heart doses, including MHD, volume of heart receiving at least 5, 25, 30, 40, 50Gy and dose to 30% of heart volume, were not significantly associated with OS.There is insufficient evidence to conclude that RHDPs are associated with OS for patients with NSCLC treated with PORT in this study. Studies with larger sample size and longer term follow-up are needed to assess AMI outcome.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/radioterapia , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/radioterapia , Dosagem Radioterapêutica , Fatores Etários , Idoso , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/epidemiologia , Estadiamento de Neoplasias , Modelos de Riscos Proporcionais , Estudos Retrospectivos
5.
Zhonghua Zhong Liu Za Zhi ; 41(8): 633-637, 2019 Aug 23.
Artigo em Chinês | MEDLINE | ID: mdl-31434457

RESUMO

Objective: To investigate whether elevated levels of C-reactive protein (CRP) and neutrophil (NE) in the blood is associated with an increased risk of lung cancer incidence. Methods: From 2006 to 2007, all employees and retirees from Kailuan (Group) Limited liability Corporation were included in this Kailuan Cohort study. The last follow-up date was December 2015. Data on new cases of lung cancer were collected, and multivariable Cox proportional hazards regression models were used to the relationship between baseline CRP and NE at baseline and risk of lung cancer. Results: A total of 92 735 participants were enrolled in this study. During the follow-up, 850 new cases of lung cancer were identified. All subjects were divided into four groups according to the combination level of CRP and NE at baseline: CRP≤3 mg/L and NE≤4×10(9)/L(Group A), CRP≤3 mg/L and NE>4×10(9)/L(Group B), CRP>3 mg/L and NE≤4×10(9)/L(Group C), CRP>3 mg/L and NE>4×10(9)/L(Group D). The cumulative incidence of lung cancer were 950/100 000, 1 030/100 000, 1 081/100 000 and 1 596/100 000 in these four groups, respectively (P<0.001). Multivariate Cox proportional risk model showed that participants from Group D had an significantly increased 72% risks of lung cancer when compared to Group A (95% CI: 1.40~2.12, P<0.001). Stratified analyses gender showed that males in Group D had higher risk of lung cancer when compared with participants in Group A (HR=1.73, 95% CI: 1.40~2.15, P<0.001). Conclusion: Elevated levels of CRP and NE might increase the risk of lung cancer.


Assuntos
Neoplasias Pulmonares/epidemiologia , Proteína C-Reativa/metabolismo , Feminino , Humanos , Contagem de Leucócitos , Neoplasias Pulmonares/sangue , Masculino , Neutrófilos , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco
6.
J Comput Assist Tomogr ; 43(4): 592-598, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31162231

RESUMO

OBJECTIVES: The objective of this study was to determine the effect of a lobectomy to the location and orientation of nonresected lung nodule and its corresponding airway. METHODS: We reviewed preoperative and postoperative computed tomography of patients who underwent lobectomies and have a separate nonresected nodule in the ipsilateral lung. Displacement of the nonresected nodule and angulation of its corresponding segmental bronchus were measured. RESULTS: Fifty nodules from 40 patients (30 females, 10 male; mean ± SD age, 67 ± 7 years) were assessed. Nodules are displaced clockwise after right upper, right middle, and left lower lobectomies and counterclockwise after right lower and left upper lobectomies. Displacement of the remaining nodules was greater in the craniocaudal plane, followed by anteroposterior and transverses planes (mean, 3.7, 2.5, and 1.9 cm, respectively). CONCLUSIONS: Remaining ipsilateral nodules and their associated segmental airways are displaced in a predictable fashion after lobectomy. This may help in the assessment of follow-up imaging.


Assuntos
Neoplasias Pulmonares , Pneumonectomia , Complicações Pós-Operatórias , Tomografia Computadorizada por Raios X , Idoso , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Período Pós-Operatório , Estudos Retrospectivos
7.
J Cancer Res Clin Oncol ; 145(8): 1919-1937, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31236668

RESUMO

PURPOSE: This review is devoted to assessing the prevalence of human papillomavirus (HPV) in lung cancer (LC) in the world. HPV is recognized as the etiological factor of cervical cancer, however, there is widespread evidence that this virus is detected not only in gynecological carcinomas, but also in tumors of other organs, in particular the upper respiratory tract and digestive tract. MATERIALS AND METHODS:  A search was conducted to a depth of 29 years in the PubMed, Web of Science, Scopus, databases. The review includes 95 articles. RESULTS: Of all the analyzed studies (9195 patients), 12 works showed a complete absence of HPV in the biological material in patients with LC. The absence of a virus among lung cancer patients has been established for Canada, the Netherlands and Singapore. The highest average percent of occurrence of this virus is shown for such countries as: Brazil, Korea, Greece and Taiwan (more than 40%). But the highest percentage of HPV occurrence by region is observed in Latin America (33.5%), followed by the Asian countries (31%), in European countries the frequency is 18%. Interestingly, the highest occurrence of high oncogenic types (16 and 18) is observed in Asia (40.3%), then in Latin America (33.6%), Europe (25.6%) and North America (15.4%). Low-oncogenic types (6 and 11) are also predominantly observed in Asia (39.9%), while in Europe and North America 30% and 12.8%, respectively. A meta-analysis of the prevalence of HPV was conducted using Comprehensive Meta-Analysis 3.0. Program, which included 26 studies, the results of which revealed: the prevalence of HPV infection in tumor lung tissue was compared with normal lung tissue OR (95% CI) = 5.38 (3.21-9.00) p < 0.0001, significance was also found for Chinese studies OR = 6.3, 95% CI 3.42-11.53, p < 0.0001, I2 = 71.8% and for nine studies in Europe OR = 6.3, 95% CI 1.8-22.18, p = 0.004, I2 = 51.0%. However, given the fact that the frequency of occurrence of HPV in lung tumor tissue varies greatly, a question may arise about the real role of HPV in LC carcinogenesis, which makes further research relevant and promising.


Assuntos
Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/virologia , Papillomaviridae/fisiologia , Infecções por Papillomavirus/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Carcinoma de Células Escamosas/virologia , Feminino , Neoplasias Gastrointestinais/epidemiologia , Neoplasias Gastrointestinais/virologia , Geografia , Humanos , Infecções por Papillomavirus/complicações , Prevalência , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/virologia
9.
Medicine (Baltimore) ; 98(24): e16037, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31192962

RESUMO

BACKGROUND: The association between Methylenetetrahydrofolate Reductase (MTHFR) polymorphisms and lung cancer risk in Chinese people has been widely explored; however, the results remain controversial. Thus, we conducted a meta-analysis to investigate the association between MTHFR gene polymorphisms and susceptibility to lung cancer in Chinese people. OBJECTIVE: We performed an updated meta-analysis to investigate the association between MTHFR gene polymorphisms and susceptibility to lung cancer in Chinese people. METHODS: PubMed, EMBASE, WANFANG database, and CNKI were searched to collect eligible articles. The associations of MTHFR gene polymorphism with lung cancer risk were evaluated by calculating the pooled odds ratios (ORs) and the 95% confidence interval (CI). The dominant, recessive, heterozygous, homozygous, and allelic genetic models were used to calculate the combined ORs. RESULTS: A total of 16 eligible studies were identified in the present meta-analysis. Evidence from the pooled results indicated a significant association between the MTHFR C677T polymorphism and lung cancer susceptibility in Chinese people under the dominant, recessive, homozygous and allelic genetic models (T vs C: OR = 1.252, 95% CI, 1.090-1.437; TT vs CC: OR = 1.741, 95% CI, 1.252-2.420. (TT + CT) vs CC: OR = 1.227, 95% CI, 1.030-1.426. TT vs (CT + CC): OR = 1.606, 95% CI, 1.207-2.137). CONCLUSION: The present updated meta-analysis demonstrated that the MTHFR C677T polymorphism was significantly associated with susceptibility to lung cancer in Chinese people. Additional case-control studies with large sample sizes are needed to validate our findings.


Assuntos
Predisposição Genética para Doença , Neoplasias Pulmonares/genética , Metilenotetra-Hidrofolato Redutase (NADPH2)/genética , Polimorfismo de Nucleotídeo Único , Grupo com Ancestrais do Continente Asiático/genética , China , Humanos , Neoplasias Pulmonares/epidemiologia
10.
Medicine (Baltimore) ; 98(20): e15642, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31096483

RESUMO

The aim of this study was to investigate the clinical factors affecting the survival prognosis of lung adenocarcinoma, and to establish a predictive model of survival prognosis of lung adenocarcinoma by artificial neural network.Download the cancer genome atlas (TCGA) database for lung adenocarcinoma research data, perform cox regression analysis and descriptive statistics on the obtained clinical data, draw the survival curve by Kaplan-Meier method, select the independent variables that are statistically significant for constructing the artificial neural networks (ANN) model, and establish artificial neural network model.The number of valid cases included in the study was 524, including 280 men and 244 women, with an age range of 33 to 88 years, mean age 66.87 years, and median progression-free survival (PFS) was 37.7 months. The median overall survival time (OS) was 41.1 months. Cox multivariate analysis showed that smoking history, tumor stage, and surgical margin resection status were independently associated with PFS, and tumor stage and surgical margin resection status were independently associated with OS. The accuracy of the established ANN model itself was predicted to be 65.8%. The accuracy of correctly predicting the prognosis of the predicted samples was 75.0%, and the area under the receiver operating characteristic curve was 0.712.The clinical prognostic factors of lung adenocarcinoma include: smoking history, tumor stage, and surgical margin resection status. The established ANN model can be used to predict the prognosis of lung adenocarcinoma.


Assuntos
Adenocarcinoma de Pulmão/mortalidade , Adenocarcinoma de Pulmão/patologia , Biblioteca Genômica , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Redes Neurais (Computação) , Adenocarcinoma de Pulmão/epidemiologia , Adenocarcinoma de Pulmão/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Fumar Cigarros/epidemiologia , Feminino , Humanos , Estimativa de Kaplan-Meier , Modelos Logísticos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/genética , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Prognóstico , Curva ROC , Análise de Regressão , Fatores de Risco
11.
Sci Total Environ ; 683: 267-274, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31132706

RESUMO

Mesothelioma is a tumor of the serosal membranes described both in human and veterinary medicine. While in humans the relationship between mesothelioma and exposure to asbestos and some other asbestiform minerals is well known, in animals it is still difficult to establish. In this paper a case of malignant peritoneal mesothelioma probably related to asbestos exposure in a wild boar is described. At post-mortem evaluation the peritoneum, diaphragm and serosal surface of liver and kidneys showed isolated to coalescent multiple nodular lesions. Samples from diaphragm, liver and lung were collected to perform microbiological and histological investigations. To assess the presence of asbestos and/or other asbestiform minerals, SEM-EDS investigations were performed on organs and soil samples collected from the area where the wild boar lived. Microbiological investigations were negative for Mycobacterium species. Gross and histological examination were compatible with a biphasic mesothelioma, with nodules composed of epithelioid and sarcomatoid elements with high pleomorphism. Immunohistochemistry revealed only multifocal scattered positivity for WT-1 and D2-40. Asbestos fibres were detected in all samples (organs and soil) by SEM-EDS, demonstrating a potential relationship between the neoplasia and the exposure to naturally occurring asbestos (NOA). In conclusion, the results of the present study are further confirmation that wild animals, such as the boar, are suitable sentinels to indicate the risk of environmental exposure to asbestos for human populations.


Assuntos
Exposição Ambiental/estatística & dados numéricos , Monitoramento Ambiental/métodos , Neoplasias Pulmonares/veterinária , Mesotelioma/veterinária , Animais , Asbestos/análise , Asbestose/epidemiologia , Asbestose/veterinária , Poluentes Ambientais/análise , Humanos , Itália , Neoplasias Pulmonares/epidemiologia , Mesotelioma/epidemiologia , Suínos
12.
Int J Mol Sci ; 20(9)2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31067796

RESUMO

The therapeutic scenario for elderly patients with advanced NSCLC has been limited to radiotherapy and chemotherapy. Recently, a novel therapeutic approach based on targeting the immune-checkpoints has showed noteworthy results in advanced NSCLC. PD1/PD-L1 pathway is co-opted by tumor cells through the expression of PD-L1 on the tumor cell surface and on cells within the microenvironment, leading to suppression of anti-tumor cytolytic T-cell activity by the tumor. The success of immune-checkpoints inhibitors in clinical trials led to rapid approval by the FDA and EMA. Currently, data regarding efficacy and safety of ICIs in older subjects is limited by the poor number of elderly recruited in clinical trials. Careful assessment and management of comorbidities is essential to achieve better outcomes and limit the immune related adverse events in elderly NSCLC patients.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/terapia , Imunoterapia/métodos , Neoplasias Pulmonares/terapia , Receptor de Morte Celular Programada 1/imunologia , Fatores Etários , Idoso , Anticorpos Monoclonais/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/epidemiologia , Ensaios Clínicos como Assunto , Humanos , Imunoterapia/efeitos adversos , Neoplasias Pulmonares/epidemiologia
13.
Crit Rev Oncol Hematol ; 138: 87-103, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31092389

RESUMO

Lung cancer (LC) is the leading cause of cancer-related death worldwide, despite a decreasing incidence rate in recent years, especially in men. Most risk factors for LC could be linked to an individual's reproductive system and secondary sex characteristics ('sex-related') and/or to some physical, behavioral and personality traits ('gender-related') peculiar to males rather than females or vice versa. An imbalance of these etiologic factors could explain why some LC features may differ between sexes. For this review, an extended literature data collection was performed, using keywords to identify 'sex/gender' and 'LC'. Differences between genders in LC epidemiology, pathological and molecular characteristics, loco-regional and/or systemic treatments outcome and prognosis were systematically analyzed. The possible predictive role of physio-pathological factors in males and females paves the way for a personalized therapeutic approach, emphasizing the need to include gender as a stratification factor in future clinical trials design.


Assuntos
Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Fatores Sexuais , Feminino , Humanos , Masculino , Prognóstico , Fatores de Risco , Resultado do Tratamento
14.
Artigo em Inglês | MEDLINE | ID: mdl-31022924

RESUMO

Urban planning has been proven and is expected to promote public health by improving the built environment. With a focus on respiratory health, this paper explores the impact of the built environment on the incidence of lung cancer and its planning implications. While the occurrence of lung cancer is a complicated and cumulative process, it would be valuable to discover the potential risks of the built environment. Based on the data of 52,009 lung cancer cases in Shanghai, China from 2009 to 2013, this paper adopts spatial analytical methods to unravel the spatial distribution of lung cancer cases. With the assistance of geographic information system and Geo-Detector, this paper identifies certain built environments that are correlated with the distribution pattern of lung cancer cases in Shanghai, including the percentage of industrial land (which explains 28% of the cases), location factors (11%), and the percentages of cultivated land and green space (6% and 5%, respectively). Based on the quantitative study, this paper facilitates additional consideration and planning intervention measures for respiratory health such as green buffering. It is an ecological study to illustrate correlation that provides approaches for further study to unravel the causality of disease incidence and the built environment.


Assuntos
Ambiente Construído , Planejamento de Cidades , Neoplasias Pulmonares/epidemiologia , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Cidades/epidemiologia , Feminino , Sistemas de Informação Geográfica , Humanos , Indústrias , Masculino , Pessoa de Meia-Idade
15.
Ann Ist Super Sanita ; 55(1): 80-89, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30968842

RESUMO

Here are reviewed the studies conducted on asbestos-amosite pollution and its effects on the health of workers exposed from 1928 to 1973 at the Collotta-Cis factory of Ledro, Italy. The methods adopted to conduct the initial research, involving the population itself and the local administrations are described. The data summarized include: epidemiological studies of mortality carried out in 1977-85 and updated in 2009; results of the investigations carried out throughout the 1980s on the health consequences on workers, their families and residents near the factory; process of environmental cleanup from asbestos of the industrial area, completed in 1989, and the pollution risk assessment in the whole Ledro Valley. Although this was a small community of about 400 workers, these studies show that exposure to asbestos is responsible for the death of 81 people (22 mesotheliomas, 21 asbestosis, 38 malignant tumors of the lung, digestive system, ovary), for 1400 years of life lost, and for about 100 invalidity pensions, as recognized to former workers by INAIL.


Assuntos
Amianto Amosita/efeitos adversos , Asbestose/epidemiologia , Recuperação e Remediação Ambiental/métodos , Neoplasias/epidemiologia , Adolescente , Adulto , Idoso , Asbestos , Asbestose/mortalidade , Criança , Surtos de Doenças , Feminino , Humanos , Itália/epidemiologia , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Neoplasias Pulmonares/mortalidade , Masculino , Mesotelioma/epidemiologia , Mesotelioma/etiologia , Mesotelioma/mortalidade , Pessoa de Meia-Idade , Neoplasias/induzido quimicamente , Neoplasias/mortalidade , Exposição Ocupacional/estatística & dados numéricos , Adulto Jovem
16.
BMC Cancer ; 19(1): 383, 2019 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-31023248

RESUMO

BACKGROUND: Malignant pleural mesothelioma (MPM) is a fatal and rare disease that is caused by the inhalation of asbestos. Treatment and care requests made by MPM patients to their physicians were collected and analyzed. METHODS: This cross-sectional survey was part of a larger study (N = 133) regarding the quality of life of MPM patients. Specific responses to two open-ended questions related to patients' requests regarding treatment and care were quantified, analyzed and divided into categories based on content. RESULTS: Responses (N = 217) from MPM patients (N = 73) were categorized into 24 subcategories and then abstracted into 6 categories. The majority of requests were related to patient-physician communication. Patients wanted clear and understandable explanations about MPM and wanted their physician to deliver treatment based on the patient's perspective by accepting and empathizing with their anxiety and pain. Patients expected physicians to be dedicated to their care and establish an improved medical support system for MPM patients. CONCLUSION: Patients with MPM had a variety of unmet needs from their physicians. Physicians who provide care to MPM patients should receive training in both communication skills and stress management. A multidisciplinary care system that includes respiratory and palliative care for MPM patients should be established.


Assuntos
Asbestos/toxicidade , Neoplasias Pulmonares/epidemiologia , Mesotelioma/epidemiologia , Neoplasias Pleurais/epidemiologia , Adulto , Idoso , Exposição Ambiental , Feminino , Humanos , Japão/epidemiologia , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/patologia , Masculino , Mesotelioma/induzido quimicamente , Mesotelioma/patologia , Pessoa de Meia-Idade , Cuidados Paliativos , Médicos , Neoplasias Pleurais/induzido quimicamente , Neoplasias Pleurais/patologia , Qualidade de Vida
17.
Med Clin North Am ; 103(3): 463-473, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30955514

RESUMO

Lung cancer is the world's leading cause of cancer death. Screening for lung cancer by low-dose computed tomography improves mortality. Various modalities exist for diagnosis and staging. Treatment is determined by subtype and stage of cancer; there are several personalized therapies that did not exist just a few years ago. Caring for the patient with lung cancer is a complex task. This review provides a broad outline of this disease, helping clinicians identify such patients and familiarizing them with lung cancer care options, so they are better equipped to guide their patients along this challenging journey.


Assuntos
Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Fumar/efeitos adversos , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/etiologia , Programas de Rastreamento , Estadiamento de Neoplasias , Prognóstico , Fatores de Risco , Tomografia Computadorizada por Raios X/métodos
19.
Phys Med ; 60: 44-49, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31000085

RESUMO

PURPOSE: To assess the risk of contralateral breast and ipsilateral lung cancer induction from forward-planned IMRT for breast carcinoma. METHODS: The study group included 13 females irradiated for breast cancer with 6 MV photons. The plans were initially generated by using standard fractionated (SF) forward-planned IMRT (50 Gy at 2 Gy/fraction). Hypofractionated (HF) IMRT (42.56 Gy at 2.66 Gy/fraction) was also employed for plan creation. Differential DVHs derived from the treatment plans were used to estimate the patient-specific organ equivalent dose (OED) to the contralateral breast and ipsilateral lung and the relevant lifetime attributable risks of cancer development. These estimates were made with a non-linear mechanistic model. The radiotherapy-induced cancer risks were combined with the lifetime intrinsic risk (LIR) values for unexposed people to determine the patient- and organ-specific relative risk (RR) for second cancer induction. RESULTS: The OED of the contralateral breast from SF and HF forward-planned IMRT was up to 0.99 and 0.86 Gy, respectively. The corresponding values for the ipislateral lung were 4.15 and 3.66 Gy. The patient-specific RR range for the contralateral breast and ipislateral lung cancer induction following SF forward-planned IMRT was 1.04-1.10 and 1.60-1.81, respectively. The corresponding RRs from hypofractionated treatment were 1.03-1.09 and 1.53-1.73. CONCLUSIONS: The treatment of primary breast carcinoma with the use of SF or HF forward-planned IMRT results in increased probabilities for developing secondary malignancies in the healthy contralateral breast or ipsilateral lung compared to the respective LIRs for an unexposed population.


Assuntos
Neoplasias da Mama/radioterapia , Carcinoma/radioterapia , Neoplasias Pulmonares/epidemiologia , Neoplasias Induzidas por Radiação/epidemiologia , Segunda Neoplasia Primária/epidemiologia , Radioterapia de Intensidade Modulada/efeitos adversos , Adulto , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/etiologia , Carcinoma/epidemiologia , Fracionamento da Dose de Radiação , Feminino , Humanos , Neoplasias Pulmonares/etiologia , Pessoa de Meia-Idade , Segunda Neoplasia Primária/etiologia , Dinâmica não Linear , Órgãos em Risco , Modelagem Computacional Específica para o Paciente , Fótons/uso terapêutico , Planejamento da Radioterapia Assistida por Computador , Radioterapia de Intensidade Modulada/métodos , Risco
20.
Tumori ; 105(3): 216-224, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30905312

RESUMO

BACKGROUND: This study aimed to estimate therapeutic effects of first-generation epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in real-world practice, by analyzing survival outcomes in an unselected, Korean female population with advanced lung cancer based on the National Health Insurance Service database. METHODS: We identified women with newly diagnosed advanced lung cancer from January 2004 to December 2013. For progression-free survival (PFS) and overall survival (OS) analyses, patients were defined into the following subgroups: group A, treated with first-generation EGFR-TKI ⩾6 months; group B, treated with EGFR-TKIs <6 months but at least >1 month; and group C, treated with cytotoxic chemotherapy as follows: monotherapy or combination therapy with gemcitabine or pemetrexed; or monotherapy with docetaxel, paclitaxel, or vinorelbine. RESULTS: Among 11,045 enrolled patients, 6170 (55.8%) were treated with first-generation EGFR-TKIs for at least 1 month. The median OS for patients treated with EGFR-TKIs was significantly longer than that of EGFR-TKI-naive patients (19.1 months [95% confidence interval (CI) 18.5-19.7] vs 9.5 months [95% CI 9.1-9.8], P<0.001). In subgroup analysis, group A had a significantly longer median OS compared with group B (30.3 months [95% CI 29.5-31.2] vs 12.3 months [95% CI 11.9-12.7], P<0.001). The median PFS of group A was significantly longer than that of group B (15.8 vs 3.7 months, P<0.001). CONCLUSIONS: Our analysis demonstrates that EGFR-TKIs confer significant PFS and OS benefits in the real-world practice for Korean female with advanced lung cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Neoplasias Pulmonares/tratamento farmacológico , Inibidores de Proteínas Quinases/administração & dosagem , Idoso , Carcinoma Pulmonar de Células não Pequenas , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Receptores ErbB/genética , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Pessoa de Meia-Idade , Mutação , Estadiamento de Neoplasias , Pemetrexede/administração & dosagem , Intervalo Livre de Progressão
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