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Tanaka I, Hori K, Koyama J, Gen S, Morise M, Kodama Y, Matsui A, Miyazawa A, Hase T, Hibino Y, Yokoyama T, Kimura T, Yoshida N, Sato M, Ishii M. Femoral bone metastasis is a poor prognostic factor in EGFR-TKIs-treated patients with EGFR-mutated non-small-cell lung cancer: a retrospective, multicenter cohort study. Ther Adv Med Oncol 2024; 16:17588359241303090. [PMID: 39712073 PMCID: PMC11662391 DOI: 10.1177/17588359241303090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 11/11/2024] [Indexed: 12/24/2024] Open
Abstract
Background Epidermal growth factor receptor (EGFR)-mutant non-small-cell lung cancers (NSCLCs) have higher frequencies of bone metastases than those of wild type; however, the metastatic pattern and influence on clinical outcome remain unclear. Objectives To analyze the association between bone metastatic sites and the clinical efficacy of the first-, second-, and third-generation EGFR-tyrosine kinase inhibitors (TKI), in these patients. Design Retrospective multicenter cohort study. Methods The clinical data of patients with advanced-NSCLC harboring EGFR mutation, who were treated by EGFR-TKIs as first-line treatment at five medical institutions (N = 411), were retrospectively assessed for bone metastatic sites, overall survival (OS), and progression-free survival (PFS). Results Bone metastases were found in 41.1% of the patients at diagnosis, including 13.1%, 8.0%, and 20.0 for single, double, and multiple lesions (⩾3), respectively. The vertebra (76.3%) and pelvis (60.9%) were the most frequent metastatic sites. Femoral-, sternum-, and scapula-metastases were remarkably increased in the patients with multiple-bone metastases. In the EGFR-mutant NSCLC patient treated with osimertinib, both the OS and the PFS of the patients with femoral bone metastasis were significantly shorter than those of the patients without femoral bone metastasis (OS: not reached vs 12.1 months, p < 0.0001; and PFS: 17.2 vs 9.3 months, p < 0.0018). Furthermore, a multivariable Cox regression analysis, including several poor prognostic factors, such as L858R mutation and liver metastasis, demonstrated that femoral bone metastasis was a statistically independent predictor of OS. Conclusion Femoral bone metastasis is associated with poor survival of EGFR-mutant NSCLC patients who were treated with EGFR-TKIs, including osimertinib, and is an independent prognostic factor of OS.
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Affiliation(s)
- Ichidai Tanaka
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan
| | - Kazumi Hori
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Junji Koyama
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Soei Gen
- Department of Respiratory Medicine, Gifu Prefectural Tajimi Hospital, Tajimi, Japan
| | - Masahiro Morise
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yuta Kodama
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Akira Matsui
- Department of Respiratory Medicine, Kariya Toyota General Hospital, Kariya, Japan
| | - Ayako Miyazawa
- Department of Respiratory Medicine, Konan Kosei Hospital, Konan, Japan
| | - Tetsunari Hase
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshitaka Hibino
- Department of Respiratory Medicine, Konan Kosei Hospital, Konan, Japan
| | - Toshihiko Yokoyama
- Department of Respiratory Medicine, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan
| | - Tomoki Kimura
- Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan
| | - Norio Yoshida
- Department of Respiratory Medicine, Kariya Toyota General Hospital, Kariya, Japan
| | - Mitsuo Sato
- Department of Pathophysiological Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Makoto Ishii
- Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Lin Q, Xie A, Zeng X, Cao Y, Man Z, Hao Y, Liu C, Huang X. Bone metastasis scintigram generation using generative adversarial learning with multi-receptive field learning and two-stage training. Med Phys 2024; 51:8915-8928. [PMID: 39225550 DOI: 10.1002/mp.17368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 08/06/2024] [Accepted: 08/09/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Deep learning is the primary method for conducting automated analysis of SPECT bone scintigrams. The lack of available large-scale data significantly hinders the development of well-performing deep learning models, as the performance of a deep learning model is positively correlated with the size of the dataset used. Therefore, there is an urgent demand for an automated data generation method to enlarge the dataset of SPECT bone scintigrams. PURPOSE We introduce a deep learning-based generation model that can generate realistic but not identical samples from the original SPECT bone scintigrams. METHODS Following the generative adversarial learning architecture, a bone metastasis scintigram generation model christened BMS-Gen is proposed. First, BMS-Gen takes multiple input conditions and employs multi-receptive field learning to ensure that the generated samples are as realistic as possible. Second, BMS-Gen adopts generative adversarial learning to retain the diversity of the generated samples. Last, BMS-Gen uses a two-stage training strategy to improve the quality of the generated samples. RESULTS Experimental evaluation conducted on a set of clinical data of SPECT BM scintigrams has shown the performance of the proposed BMS-Gen, achieving the best overall scores of 1678.0, 69.33, and 19.51 for FID (Fréchet Inception Distance), MSE (Mean Square Error), and PSNR (Peak Signal-to-Noise Ratio) metrics. The introduction of samples generated by BMS-Gen contributes a maximum (minimum) increase of 3.01% (0.15%) on the F-1 score and a maximum (minimum) increase of 6.83% (2.21%) on the DSC score for the image classification and segmentation tasks, respectively. CONCLUSIONS The proposed BMS-Gen model can be used as a promising tool for augmenting the data of bone scintigrams, greatly facilitating the development of deep learning-based automated analysis of SPECT bone scintigrams.
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Affiliation(s)
- Qiang Lin
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, China
- Key Laboratory of China's Ethnic Languages and Information Technology of Ministry of Education, Northwest Minzu University, Lanzhou, China
- Key Laboratory of Computational Nuclear Medicine, Northwest Minzu University, Lanzhou, China
| | - An Xie
- Key Laboratory of China's Ethnic Languages and Information Technology of Ministry of Education, Northwest Minzu University, Lanzhou, China
- Key Laboratory of Computational Nuclear Medicine, Northwest Minzu University, Lanzhou, China
| | - Xianwu Zeng
- Department of Nuclear Medicine, Gansu Provincial Cancer Hospital, Lanzhou, China
| | - Yongchun Cao
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, China
- Key Laboratory of China's Ethnic Languages and Information Technology of Ministry of Education, Northwest Minzu University, Lanzhou, China
- Key Laboratory of Computational Nuclear Medicine, Northwest Minzu University, Lanzhou, China
| | - Zhengxing Man
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, China
- Key Laboratory of China's Ethnic Languages and Information Technology of Ministry of Education, Northwest Minzu University, Lanzhou, China
- Key Laboratory of Computational Nuclear Medicine, Northwest Minzu University, Lanzhou, China
| | - Yusheng Hao
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, China
- Key Laboratory of China's Ethnic Languages and Information Technology of Ministry of Education, Northwest Minzu University, Lanzhou, China
- Key Laboratory of Computational Nuclear Medicine, Northwest Minzu University, Lanzhou, China
| | - Caihong Liu
- School of Mathematics and Computer Science, Northwest Minzu University, Lanzhou, China
- Key Laboratory of China's Ethnic Languages and Information Technology of Ministry of Education, Northwest Minzu University, Lanzhou, China
- Key Laboratory of Computational Nuclear Medicine, Northwest Minzu University, Lanzhou, China
| | - Xiaodi Huang
- School of Computing, Mathematics and Engineering, Charles Sturt University, Albury, Australia
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Rui Z, Lu D, Wei L, Shen J. Worldwide research trends on bone metastases of lung cancer: a bibliometric analysis. Front Oncol 2024; 14:1429194. [PMID: 39512767 PMCID: PMC11543356 DOI: 10.3389/fonc.2024.1429194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 09/30/2024] [Indexed: 11/15/2024] Open
Abstract
Background Lung cancer has the highest fatality rate among all malignancies worldwide. Within this disease, bone metastasis (BM) emerges as a particularly deleterious site of metastatic dissemination, marked by a dismal prognosis. The objective of this investigation is to shed light on the current international research efforts and the development trajectory on lung cancer BM through a bibliometric analysis (performance and visualization analysis). Method Data were obtained from the Web of Science Core Collection repository on lung cancer BM from 1 January 2012 to 1 January 2022. Subsequently, the collected data underwent scrutiny using the VOSviewer software to reveal patterns of co-authorship, co-citation, and keyword analysis, while the CiteSpace software facilitated the generation of keyword cluster maps and performed burst analyses. Results The study included 327 papers of 2,154 authors, 587 organizations, and 41 countries, and explored the cooperation between them and the relationships between citations. Over the past decade, published papers showed a steady growth trend. China had the highest production with 189 papers, and USA had the highest collaboration with other countries, with 43 total link strength. Lung Cancer exhibited the highest frequency of co-cited journals, with a co-citation time of 412 and an IF/JCR partition of 6.081/Q1 in 2021. The most frequently co-cited article, authored by Tsuya A and published in Lung Cancer in 2007, amassed 70 co-citations. High-frequency keywords were categorized into four clusters: pathogenesis, treatment and clinical manifestations, prognosis, and diagnosis. In recent years, there has been a significant increase in the strong citation burst strength of keywords such as "predictor," "skeletal-related events," "efficacy," "migration," "docetaxel," and "impact." Lung adenocarcinoma is the most common type of tumor. Conclusion This bibliometric study provides a comprehensive analysis of lung cancer BM in the recent 10 years. The field of early diagnosis, pathogenesis, and new treatments is entering a phase of rapid development and remains valuable for future research.
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Affiliation(s)
| | | | | | - Jie Shen
- Department of Nuclear Medicine, Tianjin First Central Hospital, Tianjin, China
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Zhao K, Dai P, Xiao P, Pan Y, Liao L, Liu J, Yang X, Li Z, Ma Y, Liu J, Zhang Z, Li S, Zhang H, Chen S, Cai F, Tan Z. Automated segmentation and source prediction of bone tumors using ConvNeXtv2 Fusion based Mask R-CNN to identify lung cancer metastasis. J Bone Oncol 2024; 48:100637. [PMID: 39430914 PMCID: PMC11488409 DOI: 10.1016/j.jbo.2024.100637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2024] [Revised: 09/13/2024] [Accepted: 09/21/2024] [Indexed: 10/22/2024] Open
Abstract
Lung cancer, which is a leading cause of cancer-related deaths worldwide, frequently metastasizes to the bones, significantly diminishing patients' quality of life and complicating treatment strategies. This study aims to develop an advanced 3D Mask R-CNN model, enhanced with the ConvNeXt-V2 backbone, for the automatic segmentation of bone tumors and identification of lung cancer metastasis to support personalized treatment planning. Data were collected from two hospitals: Center A (106 patients) and Center B (265 patients). The data from Center B were used for training, while Center A's dataset served as an independent external validation set. High-resolution CT scans with 1 mm slice thickness and no inter-slice gaps were utilized, and the regions of interest (ROIs) were manually segmented and validated by two experienced radiologists. The 3D Mask R-CNN model achieved a Dice Similarity Coefficient (DSC) of 0.856, a sensitivity of 0.921, and a specificity of 0.961 on the training set. On the test set, it achieved a DSC of 0.849, a sensitivity of 0.911, and a specificity of 0.931. For the classification task, the model attained an AUC of 0.865, an accuracy of 0.866, a sensitivity of 0.875, and a specificity of 0.835 on the training set, while achieving an AUC of 0.842, an accuracy of 0.836, a sensitivity of 0.847, and a specificity of 0.819 on the test set. These results highlight the model's potential in improving the accuracy of bone tumor segmentation and lung cancer metastasis detection, paving the way for enhanced diagnostic workflows and personalized treatment strategies in clinical oncology.
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Affiliation(s)
- Ketong Zhao
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
- Health Management Center, West China Lecheng Hospital of Sichuan University, Qionghai City 571400, Hainan Province, China
| | - Ping Dai
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Ping Xiao
- Department of Otorhinolaryngology, Shenzhen Children’s Hospital, Shenzhen 518055, Guangdong Province, China
| | - Yuhang Pan
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Litao Liao
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Junru Liu
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Xuemei Yang
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Zhenxing Li
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Yanjun Ma
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Jianxi Liu
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Zhengbo Zhang
- Wuxi Hospital of Traditional Chinese Medicine, Wuxi 214071, Jiangsu Province, China
| | - Shupeng Li
- State Key Laboratory of Oncogenomics, School of Chemical Biology and Biotechnology, Peking University, Shenzhen 518055, Guangdong Province, China
| | - Hailong Zhang
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Sheng Chen
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Feiyue Cai
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
| | - Zhen Tan
- Health Management Center, Shenzhen University General Hospital, Shenzhen University, Shenzhen 518055, Guangdong Province, China
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Makita K, Hamamoto Y, Kanzaki H, Nagasaki K, Kochi Y, Kido T. Prognostic assessment of patients with bone metastatic renal cell cancer treated with palliative radiotherapy. Oncol Lett 2024; 28:482. [PMID: 39161334 PMCID: PMC11332580 DOI: 10.3892/ol.2024.14615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 07/23/2024] [Indexed: 08/21/2024] Open
Abstract
The present study investigated the prognosis of patients who received palliative radiotherapy (RT) for bone metastases (BMs) from renal cell cancer (RCC), and assessed the prognostic factors specific to BMs from RCC. A total of 109 patients with RCC and BMs who underwent RT for the first time were included in the study. Prognostic factors were evaluated using multivariate analysis and a scoring system based on regression coefficients was devised. The median follow-up time was 9 months, and the 0.5-year overall survival (OS) rate was 73.0%. In the multivariate analysis, the significant prognostic factors were higher performance status (≥2), no control of the primary site, disseminated metastasis, lymph node metastasis and multiple BMs. A score of 1 point was assigned to each risk factor. The median OS times were 19.0 and 5.0 months in patients with a total score of ≤1 (n=49) and >1 (n=60), respectively (P<0.01). In conclusion, a comprehensive prognostic assessment using these factors may be useful for predicting the prognoses of patients with BMs from RCC. In addition, this scoring system may be useful in selecting the optimal RT dose.
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Affiliation(s)
- Kenji Makita
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
- Department of Radiology, Ehime Prefectural Central Hospital, Matsuyama, Ehime 790-0024, Japan
- Department of Radiation Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Yasushi Hamamoto
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
| | - Hiromitsu Kanzaki
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
| | - Kei Nagasaki
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
| | - Yoshihiro Kochi
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
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Hu Y, Geng Y, Wang H, Chen H, Wang Z, Fu L, Huang B, Jiang W. Improved Prediction of Epidermal Growth Factor Receptor Status by Combined Radiomics of Primary Nonsmall-Cell Lung Cancer and Distant Metastasis. J Comput Assist Tomogr 2024; 48:780-788. [PMID: 38498926 DOI: 10.1097/rct.0000000000001591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
OBJECTIVES This study aimed to investigate radiomics based on primary nonsmall-cell lung cancer (NSCLC) and distant metastases to predict epidermal growth factor receptor (EGFR) mutation status. METHODS A total of 290 patients (mean age, 58.21 ± 9.28) diagnosed with brain (BM, n = 150) or spinal bone metastasis (SM, n = 140) from primary NSCLC were enrolled as a primary cohort. An external validation cohort, consisting of 69 patients (mean age, 59.87 ± 7.23; BM, n = 36; SM, n = 33), was enrolled from another center. Thoracic computed tomography-based features were extracted from the primary tumor and peritumoral area and selected using the least absolute shrinkage and selection operator regression to build a radiomic signature (RS-primary). Contrast-enhanced magnetic resonance imaging-based features were calculated and selected from the BM and SM to build RS-BM and RS-SM, respectively. The RS-BM-Com and RS-SM-Com were developed by integrating the most important features from the primary tumor, BM, and SM. RESULTS Six computed tomography-based features showed high association with EGFR mutation status: 3 from intratumoral and 3 from peritumoral areas. By combination of features from primary tumor and metastases, the developed RS-BM-Com and RS-SM-Com performed well with areas under curve in the training (RS-BM-Com vs RS-BM, 0.936 vs 0.885, P = 0.177; RS-SM-Com vs RS-SM, 0.929 vs 0.843, P = 0.003), internal validation (RS-BM-Com vs RS-BM, 0.920 vs 0.858, P = 0.492; RS-SM-Com vs RS-SM, 0.896 vs 0.859, P = 0.379), and external validation (RS-BM-Com vs RS-BM, 0.882 vs 0.805, P = 0.263; RS-SM-Com vs RS-SM, 0.865 vs 0.816, P = 0.312) cohorts. CONCLUSIONS This study indicates that the accuracy of detecting EGFR mutations significantly enhanced in the presence of metastases in primary NSCLC. The established radiomic signatures from this approach may be useful as new predictors for patients with distant metastases.
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Affiliation(s)
- Yue Hu
- From the Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing
| | - Yikang Geng
- School of Intelligent Medicine, China Medical University, Liaoning
| | - Huan Wang
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of Dalian University of Technology (Liaoning Cancer Hospital & Institute), Liaoning
| | - Huanhuan Chen
- Department of Oncology, Shengjing Hospital of China Medical University, Shenyang
| | - Zekun Wang
- Department of Medical Iconography, Liaoning Cancer Hospital & Institute, Liaoning
| | - Langyuan Fu
- School of Intelligent Medicine, China Medical University, Liaoning
| | - Bo Huang
- Department of Pathology, Liaoning Cancer Hospital and Institute, Liaoning
| | - Wenyan Jiang
- Department of Scientific Research and Academic, Liaoning Cancer Hospital and Institute, Liaoning, People's Republic of China
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Liu Z, Yin R, Ma W, Li Z, Guo Y, Wu H, Lin Y, Chekhonin VP, Peltzer K, Li H, Mao M, Jian X, Zhang C. Bone metastasis prediction in non-small-cell lung cancer: primary CT-based radiomics signature and clinical feature. BMC Med Imaging 2024; 24:203. [PMID: 39103775 DOI: 10.1186/s12880-024-01383-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/29/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Radiomics provided opportunities to quantify the tumor phenotype non-invasively. This study extracted contrast-enhanced computed tomography (CECT) radiomic signatures and evaluated clinical features of bone metastasis in non-small-cell lung cancer (NSCLC). With the combination of the revealed radiomics and clinical features, the predictive modeling on bone metastasis in NSCLC was established. METHODS A total of 318 patients with NSCLC at the Tianjin Medical University Cancer Institute & Hospital was enrolled between January 2009 and December 2019, which included a feature-learning cohort (n = 223) and a validation cohort (n = 95). We trained a radiomics model in 318 CECT images from feature-learning cohort to extract the radiomics features of bone metastasis in NSCLC. The Kruskal-Wallis and the least absolute shrinkage and selection operator regression (LASSO) were used to select bone metastasis-related features and construct the CT radiomics score (Rad-score). Multivariate logistic regression was performed with the combination of the Rad-score and clinical data. A predictive nomogram was subsequently developed. RESULTS Radiomics models using CECT scans were significant on bone metastasis prediction in NSCLC. Model performance was enhanced with each information into the model. The radiomics nomogram achieved an AUC of 0.745 (95% confidence interval [CI]: 0.68,0.80) on predicting bone metastasis in the training set and an AUC of 0.808(95% confidence interval [CI]: 0.71,0.88) in the validation set. CONCLUSION The revealed invisible image features were of significance on guiding bone metastasis prediction in NSCLC. Based on the combination of the image features and clinical characteristics, the predictive nomogram was established. Such nomogram can be used for the auxiliary screening of bone metastasis in NSCLC.
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Affiliation(s)
- Zheng Liu
- Department of Bone and Soft Tissue Tumor, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Orthopedics, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong province, China
| | - Rui Yin
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- School of Biomedical Engineering & Technology, Tianjin Medical University, Tianjin, China
| | - Wenjuan Ma
- Department of Bone and Soft Tissue Tumor, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Zhijun Li
- Department of Bone and Soft Tissue Tumor, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Yijun Guo
- Department of Bone and Soft Tissue Tumor, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Haixiao Wu
- Department of Bone and Soft Tissue Tumor, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Yile Lin
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Vladimir P Chekhonin
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Basic and Applied Neurobiology, Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russian Federation
| | - Karl Peltzer
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
- Department of Psychology, University of the Free State, Turfloop, South Africa
| | - Huiyang Li
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China
| | - Min Mao
- Department of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Xiqi Jian
- School of Biomedical Engineering & Technology, Tianjin Medical University, Tianjin, China.
| | - Chao Zhang
- Department of Bone and Soft Tissue Tumor, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin, China.
- The Sino-Russian Joint Research Center for Bone Metastasis in Malignant Tumor, Tianjin, China.
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Yang Q, Wang W, Cheng D, Wang Y, Han Y, Huang J, Peng X. Non-coding RNA in exosomes: Regulating bone metastasis of lung cancer and its clinical application prospect. Transl Oncol 2024; 46:102002. [PMID: 38797017 PMCID: PMC11153237 DOI: 10.1016/j.tranon.2024.102002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/20/2024] [Accepted: 05/19/2024] [Indexed: 05/29/2024] Open
Abstract
Lung cancer is a highly prevalent malignancy with poor prognosis and rapid progression. It most frequently metastasizes to the bone, where it can pose a severe threat to the patient's survival. Once metastasized, the disease is often incurable and can result in severe complications such as hypercalcemia, bone pain, fractures, spinal cord compression, and subsequent paralysis. Exosomes are bilayer vesicle nanoparticles secreted by most of the extracellular vesicles, which can be found in almost all organisms and play an essential role in intercellular communication. Through their ability to regulate related bone cells, exosomes carry bioactive molecules, including proteins, lipids, and non-coding RNAs (ncRNAs), that can be extremely important in bone remodeling. Studies have been conducted on the role play by proteins, lncRNA, and microRNA-all ncRNAs-carried by exosomes in the bone metastases of lung cancer. In this review, the latest progress of the regulatory mechanism of ncRNAs carried by exosomes in lung cancer bone metastasis has been reviewed. The clinical use of exosomes as a promising biomarker, drug transporter, and therapeutic target was highlighted to offer a novel diagnostic and treatment approach for patients with lung cancer bone metastases.
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Affiliation(s)
- Qing Yang
- Nuclear Medicine Department, The First Affiliated Hospital of Yangtze University, Jingzhou 434000, Hubei, China; Health Science Center of Yangtze University, Jingzhou 434023, Hubei, China
| | - Wei Wang
- Department of Rehabilitation Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing 100144, China
| | - Dezhou Cheng
- Health Science Center of Yangtze University, Jingzhou 434023, Hubei, China
| | - Yiling Wang
- Health Science Center of Yangtze University, Jingzhou 434023, Hubei, China
| | - Yukun Han
- Health Science Center of Yangtze University, Jingzhou 434023, Hubei, China
| | - Jinbai Huang
- Nuclear Medicine Department, The First Affiliated Hospital of Yangtze University, Jingzhou 434000, Hubei, China; Hubei Province Key Laboratory of Molecular Imaging, Wuhan 430022, Hubei, China.
| | - Xiaochun Peng
- Department of Pathophysiology, School of Basic Medicine, Health Science Center, Yangtze University, Jingzhou 434023, Hubei, China.
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Wei S, Wei W, Wu B, Tian J, Hu P, Pan S, Song X. The Incidence and Effect of Different Organ Metastasis on the Prognosis of NSCLC. Thorac Cardiovasc Surg 2024; 72:217-226. [PMID: 37532228 DOI: 10.1055/a-2146-6879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
OBJECTIVE The aim of this study was to explore the effect of different organ metastasis on the prognosis of non-small cell lung cancer (NSCLC). METHODS Patients with distant metastatic NSCLC were selected from Surveillance, Epidemiology, and End Results database during 2016 to 2019. The incidence of different organ metastasis and their association with clinicopathological factors were explored. Overall survival (OS) and lung cancer-specific survival (LCSS) for metastatic NSCLC were calculated, and multivariate Cox regression analysis was performed with a nomogram for OS being constructed based on Cox regression. RESULTS Total 26,210 patients with distant metastatic NSCLC were included in this study. Around 48.9% of the metastatic NSCLC were multiple-organ metastasis and bone was the most commonly involved organ (44.4%). For patients with single-organ metastasis, the prognosis for lung or distant lymph nodes (LNs) metastasis was better than others (with median OS of 15 and 16 months for lung and distant LNs metastasis, respectively), and liver metastasis resulted in the worst prognosis with median OS of 8 months. A nomogram was constructed to visualize Cox regression model, along with the receiver operating characteristic (ROC) curve demonstrated good discrimination for the predictive model with 1- and 2-year area under the curve of ROC of 0.687 and 0.702, respectively. CONCLUSION The prognosis of NSCLC patients with distant metastasis was poor. Liver metastasis results in the worst prognosis among the single-organ metastasis. The nomogram developed based on the Cox regression model has provided a useful tool to estimate the probability of OS of the metastatic NSCLC.
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Affiliation(s)
- Shenhai Wei
- Department of Thoracic Surgery, The First Hospital of Tsinghua University, Beijing, China
| | - Wenchao Wei
- School of Computer Science and Technology, Beijing Institute of Technology, Beijing, China
| | - Bingqun Wu
- Department of Thoracic Surgery, The First Hospital of Tsinghua University, Beijing, China
| | - Jintao Tian
- Department of Thoracic Surgery, The First Hospital of Tsinghua University, Beijing, China
| | - Pengcheng Hu
- Department of Thoracic Surgery, The First Hospital of Tsinghua University, Beijing, China
| | - Shouqiang Pan
- Department of Thoracic Surgery, The First Hospital of Tsinghua University, Beijing, China
| | - Xiaoping Song
- Department of Thoracic Surgery, The First Hospital of Tsinghua University, Beijing, China
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10
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Gong J, Hu S, Shan Q, Qin J, Han N, Xie F, Lu H. Bone metastasis in non-small-cell lung cancer: genomic characterization and exploration of potential targets. Ther Adv Med Oncol 2024; 16:17588359241239293. [PMID: 38510678 PMCID: PMC10953105 DOI: 10.1177/17588359241239293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
Background Bone metastasis (BM) seriously affects the quality of life and reduces the survival time of patients with non-small-cell lung cancer (NSCLC). The genomic characteristics and potential targets of BMs are yet to be fully explored. Objective To explore the genetic characteristics and potential targets of BM in NSCLC. Design In all, 83 patients with NSCLC were retrospectively selected in this study. Genomic characterization of BMs was explored with the analysis of NGS results from primary tumors and BMs in 6 patients, then combined with NGS results of lung tumors in 16 patients with initial recurrence in bone to analyze mutations potentially associated with BMs, and finally, the correlation was further validated in 61 postoperative patients. Methods The next generation sequencing (NGS) was performed to identify genomic differences between pulmonary primary tumors and BM. Fluorescence in situ hybridization and immunohistochemistry were performed in postoperative tumor tissues from patients who had undergone radical surgery to validate the predictive role of molecular targets for BM. The correlation between cyclin-dependent kinase 4 (CDK4) and BM was evaluated by Pearson's chi-square test. The university of alabama at birminghan cancer data analysis portal (UALCAN) was carried out for the detection of CDK4 expression in lung cancer and the relationship between CDK4 and clinicopathological parameters. The relationship between prognosis and CDK4 expression was analyzed by the Kaplan-Meier plotter. Results The rate of gene amplification was increased (24% versus 36%) while gene substitution/indel was decreased (64% versus 52%) in BMs. The BM-specific mutations were analyzed in 16 recurrent patients which revealed the highest incidence of CDK4 amplification (18.8%). According to the Kaplan-Meier plotter database, the NSCLC patients with high CDK4 gene expression showed poor overall survival (OS) and recurrence-free survival (RFS) (p < 0.05). The incidence of CDK4 amplification tended to be higher in recurrent patients compared to the patients without BM (18.8% versus 4.7%, p = 0.118). Conclusion Compared to the primary tumors of NSCLC, the genome of BMs showed an increased proportion of amplification and a decreased proportion of gene substitution/indel. Furthermore, the CDK4 amplification ratio seemed to be elevated in NSCLC patients with BM which may be associated with poor OS and RFS.
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Affiliation(s)
- Jiali Gong
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Hematology and Oncology, Ningbo No. 2 Hospital, Ningbo, Zhejiang, P.R. China
| | - Shumin Hu
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Qianyun Shan
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Jing Qin
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Na Han
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Fajun Xie
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou, P.R. China
| | - Hongyang Lu
- Zhejiang Key Laboratory of Diagnosis and Treatment Technology on Thoracic Oncology (Lung and Esophagus), Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, No. 1 East Banshan Road, Gongshu, Hangzhou 310022, P.R. China
- Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Institute of Basic and Cancer Medicine, Gongshu, Hangzhou 310022, P.R. China
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11
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Cazzato RL, Garnon J, Jennings JW, Gangi A. Interventional management of malignant bone tumours. J Med Imaging Radiat Oncol 2023; 67:862-869. [PMID: 37742284 DOI: 10.1111/1754-9485.13587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/03/2023] [Indexed: 09/26/2023]
Abstract
In the last few decades, interventional radiology (IR) has significantly increased its role in the management of bone tumours including bone metastases (BM) that represent the most common type of tumour involving the bone. The current IR management of BM is based on the 'palliative-curative' paradigm and relies on the use of consolidative (i.e. osteplasty, osteosynthesis) and/or ablation (i.e. cryoablation, radiofrequency ablation, electrochemotherapy) techniques. The present narrative review will overview the current role of IR for the management of BM.
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Affiliation(s)
- Roberto Luigi Cazzato
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - Julien Garnon
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
| | - Jack William Jennings
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Afshin Gangi
- Department of Interventional Radiology, University Hospital of Strasbourg, Strasbourg, France
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
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12
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Duan J, Fang W, Xu H, Wang J, Chen Y, Ding Y, Dong X, Fan Y, Gao B, Hu J, Huang Y, Huang C, Huang D, Liang W, Lin L, Liu H, Ma Z, Shi M, Song Y, Tang C, Wang J, Wang L, Wang Y, Wang Z, Yang N, Yao Y, Yu Y, Yu Q, Zhang H, Zhao J, Zhao M, Zhu Z, Niu X, Zhang L, Wang J. Chinese expert consensus on the diagnosis and treatment of bone metastasis in lung cancer (2022 edition). JOURNAL OF THE NATIONAL CANCER CENTER 2023; 3:256-265. [PMID: 39036661 PMCID: PMC11256524 DOI: 10.1016/j.jncc.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/28/2023] [Accepted: 08/08/2023] [Indexed: 07/23/2024] Open
Abstract
Lung cancer is the leading cause of cancer-related deaths worldwide. Bone is a common metastatic site of lung cancer, about 50% of bone metastatic patients will experience skeletal related events (SREs). SREs not only seriously impact the quality of life of patients, but also shorten their survival time. The treatment of bone metastasis requires multi-disciplinary therapy (MDT) and development of individualized treatment plan. In order to standardize the diagnosis and treatment of bone metastasis in lung cancer, the expert group of the MDT Committee of the Chinese Medical Doctor Association has developed the expert consensus on the diagnosis and treatment of lung cancer bone metastasis.
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Affiliation(s)
- Jianchun Duan
- CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Department of Respiratory Medicine, Shanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical University, Taiyuan, China
| | - Wenfeng Fang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Hairong Xu
- Department of Orthopaedic Oncology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Jinliang Wang
- Department of Oncology and Institute of Translational Medicine, Medical Innovation Research Center and the Fifth Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Yuan Chen
- Department of Oncology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Ding
- Department of Orthopaedic Oncology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Xiaorong Dong
- Cancer Center, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yun Fan
- Department of Thoracic Medical Oncology, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou, China
| | - Beili Gao
- Department of Thoracic Oncology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Jie Hu
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yan Huang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Cheng Huang
- Department of Medical Oncology, Fujian Cancer Hospital, Fuzhou, China
| | - Dingzhi Huang
- Department of Thoracic Medical Oncology, Lung Cancer Diagnosis and Treatment Centre, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Centre for Cancer, Tianjin, China
| | - Wenhua Liang
- Department of Thoracic Surgery/Oncology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou Institute of Respiratory Disease & Health, Guangzhou, China
| | - Lizhu Lin
- Department of Medical Oncology, The First Clinical Medical College, the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Hui Liu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhiyong Ma
- Department of Medical Oncology, the Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou, China
| | - Meiqi Shi
- Department of Medical Oncology, Jiangsu Cancer Hospital, Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Yong Song
- Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School of Nanjing University, Nanjing, China
| | - Chuanhao Tang
- Department of Oncology, Peking University International Hospital, Beijing, China
| | - Jialei Wang
- Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Lifeng Wang
- Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yongfeng Wang
- Department of Respiratory Medicine, Linyi Central Hospital, Linyi, China
| | - Zhehai Wang
- Department of Oncology, Shandong Cancer Hospital, Jinan, China
| | - Nong Yang
- Department of Medical Oncology, Hunan Cancer Hospital, Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, China
| | - Yu Yao
- Department of Oncology Internal Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yan Yu
- School of Public Health, Xi'an Jiaotong University, Xi'an, China
| | - Qitao Yu
- Department of Respiratory Oncology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Hongmei Zhang
- Department of Clinical Oncology, Xijing Hospital, the Fourth Military Medical University, Xi'an, China
| | - Jun Zhao
- Department of Thoracic Medical Oncology, Peking University Cancer Hospital & Institute, Beijing, China
| | - Mingfang Zhao
- Department of Medical Oncology, the First Hospital of China Medical University, Shenyang, China
| | - Zhengfei Zhu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Xiaohui Niu
- Department of Orthopaedic Oncology Surgery, Beijing Jishuitan Hospital, Capital Medical University, Beijing, China
| | - Li Zhang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Jie Wang
- CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
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13
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Cheng Y, Wang H, Yuan W, Wang H, Zhu Y, Chen H, Jiang W. Combined radiomics of primary tumour and bone metastasis improve the prediction of EGFR mutation status and response to EGFR-TKI therapy for NSCLC. Phys Med 2023; 116:103177. [PMID: 38000098 DOI: 10.1016/j.ejmp.2023.103177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 10/08/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023] Open
Abstract
PURPOSE To develop radiomics models of primary tumour and spinal metastases to predict epidermal growth factor receptor (EGFR) mutations and therapeutic response to EGFR-tyrosine kinase inhibitor (TKI) in patients with metastatic non-small-cell lung cancer (NSCLC). METHODS We enrolled 203 patients with spinal metastases between December 2017 and September 2021, classified as patients with the EGFR mutation or EGFR wild-type. All patients underwent thoracic CT and spinal MRI scans before any treatment. Radiomics analysis was performed to extract features from primary tumour and metastases images and identify predictive features with the least absolute shrinkage and selection operator. Radiomics signatures (RS) were constructed based on primary tumour (RS-Pri), metastases (RS-Met), and in combination (RS-Com) to predict EGFR mutation status and response to EGFR-TKI. Receiver operating characteristic (ROC) curve analysis with 10-fold cross-validation was applied to assess the performance of the models. RESULTS To predict the EGFR mutation status, the RS based on the combination of primary tumour and metastases improved the prediction AUCs compared to those based on the primary tumour or metastasis alone in the training (RS-Com-EGFR: 0.927) and validation (RS-Com-EGFR: 0.812) cohorts. To predict response to EGFR-TKI, the developed RS based on combined primary tumour and metastasis generated the highest AUCs in the training (RS-Com-TKI: 0.880) and validation (RS-Com-TKI: 0.798) cohort. CONCLUSIONS Primary NSCLC and spinal metastases can provide complementary information to predict the EGFR mutation status and response to EGFR-TKI. The developed models that integrate primary lesions and metastases may be potential imaging markers to guide individual treatment decisions.
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Affiliation(s)
- Yuan Cheng
- Department of Biomedical Engineering, School of Intelligent Medicine, China Medical University, Liaoning 110122, PR China
| | - Huan Wang
- Radiation Oncology Department of Thoracic Cancer, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning 110042, PR China
| | - Wendi Yuan
- Department of Biomedical Engineering, School of Intelligent Medicine, China Medical University, Liaoning 110122, PR China
| | - Haotian Wang
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning 110042, PR China
| | - Yuheng Zhu
- Department of Biomedical Engineering, School of Intelligent Medicine, China Medical University, Liaoning 110122, PR China
| | - Huanhuan Chen
- Department of Oncology, Shengjing Hospital of China Medical University, 110004 Shenyang, PR China.
| | - Wenyan Jiang
- Department of Scientific Research and Academic, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning 110042, PR China.
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14
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Martinez-Espinosa I, Serrato JA, Ortiz-Quintero B. The Role of Exosome-Derived microRNA on Lung Cancer Metastasis Progression. Biomolecules 2023; 13:1574. [PMID: 38002256 PMCID: PMC10669807 DOI: 10.3390/biom13111574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/26/2023] Open
Abstract
The high mortality from lung cancer is mainly attributed to the presence of metastases at the time of diagnosis. Despite being the leading cause of lung cancer death, the underlying molecular mechanisms driving metastasis progression are still not fully understood. Recent studies suggest that tumor cell exosomes play a significant role in tumor progression through intercellular communication between tumor cells, the microenvironment, and distant organs. Furthermore, evidence shows that exosomes release biologically active components to distant sites and organs, which direct metastasis by preparing metastatic pre-niche and stimulating tumorigenesis. As a result, identifying the active components of exosome cargo has become a critical area of research in recent years. Among these components are microRNAs, which are associated with tumor progression and metastasis in lung cancer. Although research into exosome-derived microRNA (exosomal miRNAs) is still in its early stages, it holds promise as a potential target for lung cancer therapy. Understanding how exosomal microRNAs promote metastasis will provide evidence for developing new targeted treatments. This review summarizes current research on exosomal miRNAs' role in metastasis progression mechanisms, focusing on lung cancer.
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Affiliation(s)
| | | | - Blanca Ortiz-Quintero
- Department of Molecular Biomedicine and Translational Research, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City CP 14080, Mexico; (I.M.-E.); (J.A.S.)
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15
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Liang H, Zhang L, Rong J. Potential roles of exosomes in the initiation and metastatic progression of lung cancer. Biomed Pharmacother 2023; 165:115222. [PMID: 37549459 DOI: 10.1016/j.biopha.2023.115222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/17/2023] [Accepted: 07/23/2023] [Indexed: 08/09/2023] Open
Abstract
Lung cancer (LC) incidence and mortality continue to increase annually worldwide. LC is insidious and readily metastasizes and relapses. Except for its early diagnosis and surgical resection, there is no effective cure for advanced metastatic LC, and the prognosis remains dismal. Exosomes, a class of nano-sized extracellular vesicles produced by healthy or diseased cells, are coated with a bilayer lipid membrane and contain various functional molecules such as proteins, lipids, and nucleic acids. They can be used for intracellular or intercellular signaling or the transportation of biological substances. A growing body of evidence supports that exosomes play multiple crucial roles in the occurrence and metastatic progression of many malignancies, including LC. The elucidation of the potential roles of exosomes in the initiation, invasion, and metastasis of LC and their underlying molecular mechanisms may contribute to improved early diagnosis and treatment.
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Affiliation(s)
- Hongyuan Liang
- Department of Radiology, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, PR China
| | - Lingyun Zhang
- Department of Medical Oncology, the First Hospital of China Medical University, No. 210 Baita Street, Hunnan District, Shenyang 110001, PR China.
| | - Jian Rong
- Department of Pediatrics, PICU, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Shenyang 110004, PR China.
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Makita K, Hamamoto Y, Kanzaki H, Nagasaki K, Kozuki T. Local control of bone metastasis treated with palliative radiotherapy in patients with lung cancer: An observational retrospective cohort study. Oncol Lett 2023; 26:303. [PMID: 37323814 PMCID: PMC10265332 DOI: 10.3892/ol.2023.13889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Accepted: 05/15/2023] [Indexed: 06/17/2023] Open
Abstract
Bone metastasis is common in advanced lung cancer, with the incidence reported to be 30%, and radiotherapy (RT) is used for pain relief from bone metastasis. The present study aimed to identify factors affecting local control (LC) of bone metastasis from lung cancer and to assess the significance of moderate RT dose escalation. This was a retrospective cohort study, where LC of bone metastasis from lung cancer that had received palliative RT was reviewed. LC at RT sites was evaluated with follow-up computed tomography (CT). The influence of treatment-, cancer- and patient-related risk factors for LC was assessed. A total of 317 metastatic lesions in 210 patients with lung cancer were evaluated. The median RT dose (biologically effective dose calculated using an α/β of 10 Gy; BED10) was 39.0 Gy (range, 14.4-50.7 Gy). The median follow-up time for survival and median radiographic follow-up time were 8 (range, 1-127) and 4 (range, 1-124) months, respectively. The 0.5-year overall survival and LC rates were 58.9 and 87.7%, respectively. The local recurrence rate in RT sites was 11.0%, and bone metastatic progression, except in RT sites, was observed in 46.1% at the time of local recurrence or the last follow-up CT of the RT sites. According to multivariate analysis, RT sites, pre-RT neutrophil to lymphocyte ratio (NLR), post-RT non-administration of molecular-targeting agents (MTs), and non-administration of bone modifying agents (BMAs) were significant unfavorable factors for LC of bone metastasis. Moderate RT dose escalation (BED10 >39 Gy) tended to improve the LC of RT sites. In cases without MTs, moderate dose escalation of RT dose improved the LC of RT sites. In conclusion, treatment (post-RT MTs and BMAs), cancer (RT sites) and patient (pre-RT NLR)-related risk factors had a large impact on improving the LC of RT sites. Moderate RT dose escalation seemed to have a small impact on improving the LC of RT sites.
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Affiliation(s)
- Kenji Makita
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
- Department of Radiology, Ehime University Graduate School of Medicine, Toon, Ehime 791-0295, Japan
- Department of Radiology, Ehime Prefectural Central Hospital, Matsuyama, Ehime 790-0024, Japan
| | - Yasushi Hamamoto
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
| | - Hiromitsu Kanzaki
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
| | - Kei Nagasaki
- Department of Radiation Oncology, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
| | - Toshiyuki Kozuki
- Department of Thoracic Oncology and Medicine, National Hospital Organization Shikoku Cancer Center, Matsuyama, Ehime 791-0280, Japan
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17
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Terzi S, Trentin F, Griffoni C, Carretta E, Bandiera S, Ferrari C, Vita F, Righi A, Maioli M, De Biase D, Monetta A, Barbanti Brodano G, Evangelisti G, Girolami M, Pipola V, Gambarotti M, Gasbarrini A. Indications and Limits of Surgery for Spinal Metastases Derived from Lung Cancer: A Single-Center Experience. Diagnostics (Basel) 2023; 13:2093. [PMID: 37370988 DOI: 10.3390/diagnostics13122093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Lung cancer is the second most frequently diagnosed cancer in the world, and surgery is an integral part of the treatment for spinal metastases. The aims of this retrospective study were to assess the overall survival of surgically treated patients affected by lung cancer spinal metastases and identify any factors related to a better survival rate. We recruited 56 consecutive patients (34 male and 22 female) surgically treated for metastatic lung cancer in the spine from 2009 to 2019. Surgical indications were based on a previously published and validated flow chart following a multidisciplinary evaluation. We assessed the localization of vertebral metastases, the presence of other bone or visceral metastases, neurological status according to the Frankel score, ambulatory autonomy, and general status, measured with the Karnofsky performance scale. The expected prognosis was retrospectively assessed according to the revised Tokuhashi score. The median survival was 8.1 months, with over a third of patients surviving more than 1 year. We observed a global improvement in all clinical parameters after surgical treatment. The Tokuhashi predictive score did not correlate with survival after surgery. The results of this study suggest that the surgical treatment of symptomatic spinal metastases from lung cancer can improve quality of life, even in patients with a shorter life expectancy, by controlling pain and improving autonomy.
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Affiliation(s)
- Silvia Terzi
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Federica Trentin
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Cristiana Griffoni
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Elisa Carretta
- Department of Programming and Monitoring, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Stefano Bandiera
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Cristina Ferrari
- Laboratory of Experimental Oncology, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Fabio Vita
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Alberto Righi
- Anatomy and Pathological Histology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Margherita Maioli
- Anatomy and Pathological Histology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Dario De Biase
- Molecular Diagnostics Unit, Department of Pharmacy and Biotechnology, University of Bologna, 40136 Bologna, Italy
| | - Annalisa Monetta
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | | | - Gisberto Evangelisti
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Marco Girolami
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Valerio Pipola
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Marco Gambarotti
- Anatomy and Pathological Histology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Alessandro Gasbarrini
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
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Gamage S, Mohamed Jiffry MZ, Sriharan P, Velayuthum S, Gunawardana T. Bony Metastasis to the Radius as the Initial Presentation of a Lung Adenocarcinoma. Cureus 2023; 15:e36855. [PMID: 37123729 PMCID: PMC10143081 DOI: 10.7759/cureus.36855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 03/31/2023] Open
Abstract
When considering tumors of the bone, metastatic disease from a distant primary is more common than primary tumors of the bone itself. The commonest sites to which skeletal metastasis occur are in the axial skeleton, and with regard to the appendicular skeleton, metastasis to the forearm bones is uncommon. Almost a third of patients who present with skeletal metastases do not have any evidence of their primary tumor at presentation. We report a case of a 68-year-old female diagnosed with lung adenocarcinoma after presenting with metastatic deposits involving the right radius as the first clinical manifestation of her disease. She presented initially complaining of painful swelling of her right forearm for a duration of one year. Imaging investigations of her right forearm showed an expansile mixed lytic and sclerotic lesion involving the full length of the right radius. A contrast-enhanced computed tomography scan of her chest to investigate the possible site of primary malignancy showed a peripherally located, well-defined, irregularly shaped mass lesion with enlarged mediastinal lymph nodes. A fluorodeoxyglucose positron emission tomography (FDG-PET) bone scan also noted oligometastatic disease in her right proximal humerus. She was started on palliative docetaxel for six cycles with palliative external beam radiotherapy. Although a variety of tumors metastasize to the bone, metastasis to the appendicular skeleton, and in particular the forearm bones, is a rare phenomenon that is poorly described in the existing literature. Skeletal metastasis may also be the primary presenting feature in a minority of cases. Lung cancer is among the more commonly associated primary sites, and further workup should include appropriate imaging to evaluate for a lung primary as well as an FDG-PET/CT or a bone scan to detect occult metastatic disease.
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Wu M, Kong D, Zhang Y. SPON2 promotes the bone metastasis of lung adenocarcinoma via activation of the NF-κB signaling pathway. Bone 2023; 167:116630. [PMID: 36427776 DOI: 10.1016/j.bone.2022.116630] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
Bone metastasis severely affects the life span and quality of life of survivors of lung adenocarcinoma (ADC). There is a pressing need to identify viable biomarkers for this incurable, fatal disease. Spondin-2 (SPON2) has been reported to be involved in metastasis and cancer progression, but its role in bone metastasis in patients with lung ADC has rarely been studied. Here, we showed that the upregulation of SPON2 increased the migration, invasion, and epithelial-to-mesenchymal transition of ADC cells in vitro, whereas silencing SPON2 repressed these processes. Consistently, silencing SPON2 significantly reduced the bone metastasis of ADC cells in vivo. Mechanistically, SPON2 activated the nuclear factor-κB (NF-κB) signaling pathway and increased the expression levels of MMP2 and MMP9. Blocking NF-κB using an inhibitor attenuated the SPON2-induced migration and invasion of ADC cells. In addition, we found that SPON2 expression levels were increased in metastatic bone tissues compared to primary ADC tissues. The upregulation of SPON2 was positively correlated with MMP2 and MMP9 expression levels in metastatic bone tissues. In conclusion, these results illustrate that SPON2 plays a key role in ADC by activating the NF-κB pathway to promote bone metastasis, which suggests that it may be a target for future drug development.
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Affiliation(s)
- Ming Wu
- Postgraduate Training Base in Shanghai Gongli Hospital, Ningxia Medical University, Shanghai 200135, China
| | - Dewei Kong
- Postgraduate Training Base in Shanghai Gongli Hospital, Ningxia Medical University, Shanghai 200135, China
| | - Yan Zhang
- Department of Orthopaedics, Gongli Hospital of Pudong New Area, Shanghai 200135, China.
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20
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Miyagi M, Katagiri H, Murata H, Wasa J, Takahashi T, Murakami H, Harada H, Mori K, Takahashi M. Osteosclerotic change as a therapeutic response to gefitinib in symptomatic non-small cell lung cancer bone metastasis. BMC Pulm Med 2022; 22:491. [PMID: 36581856 PMCID: PMC9801654 DOI: 10.1186/s12890-022-02226-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 11/05/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Despite improvement in the overall survival of patients with non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation, the effects of EGFR tyrosine kinase inhibitor (EGFR-TKI) treatment on bone metastasis remain unclear. This study investigated radiological responses to gefitinib regarding bone metastasis in patients. METHODS We treated 260 patients with NSCLC and symptomatic bone metastasis. Thirty-seven patients harboring EGFR mutation were treated with gefitinib for more than 30 days and followed up for more than 3 months (GEF group). We performed a retrospective observational study by selecting 36 cases without EGFR-TKI treatment, at least 3 months of follow-up, and at least two radiological evaluations as the control group. We assessed the best overall radiological response, interval from treatment initiation to appearance of a radiological response, and the local response maintenance rate. RESULTS The best effect in the GEF group was 98% partial response or better, which was significantly higher than the 57% observed in the control group (p < 0.001). The GEF and control groups maintained 83% and 42% local response maintenance rates at one year, respectively (p < 0.001). In the GEF with radiotherapy group, the local response maintenance rate was maintained at 92% at 1 year, while in the GEF without RT group, there was a decrease in the local response maintenance rate from 270 days. CONCLUSION Gefitinib treatment for bone metastases in patients harboring EGFR mutation resulted in a beneficial osteosclerotic change in most patients. Combined gefitinib and radiotherapy provide long-lasting local control of bone metastases.
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Affiliation(s)
- Michihito Miyagi
- Devision of Orthopedic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hirohisa Katagiri
- Devision of Orthopedic Oncology, Shizuoka Cancer Center, Shizuoka, Japan.
| | - Hideki Murata
- Devision of Orthopedic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Junji Wasa
- Devision of Orthopedic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | | | - Haruyasu Murakami
- Devision of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hideyuki Harada
- Division of Radiation Therapy, Radiation and Proton Therapy Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Keita Mori
- Department of Biostatistics, Clinical Research Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - Mitsuru Takahashi
- Devision of Orthopedic Oncology, Shizuoka Cancer Center, Shizuoka, Japan
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21
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Colosia A, Njue A, Bajwa Z, Dragon E, Robinson RL, Sheffield KM, Thakkar S, Richiemer SH. The Burden of Metastatic Cancer-Induced Bone Pain: A Narrative Review. J Pain Res 2022; 15:3399-3412. [PMID: 36317162 PMCID: PMC9617513 DOI: 10.2147/jpr.s371337] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 09/01/2022] [Indexed: 11/06/2022] Open
Abstract
Bone pain is one of the most common forms of pain reported by cancer patients with metastatic disease. We conducted a review of oncology literature to further understand the epidemiology of and treatment approaches for metastatic cancer–induced bone pain and the effect of treatment of painful bone metastases on the patient’s quality of life. Two-thirds of patients with advanced, metastatic, or terminal cancer worldwide experience pain. Cancer pain due to bone metastases is the most common form of pain in patients with advanced disease and has been shown to significantly reduce patients’ quality of life. Treatment options for cancer pain due to bone metastases include nonsteroidal anti-inflammatory drugs, palliative radiation, bisphosphonates, denosumab, and opioids. Therapies including palliative radiation and opioids have strong evidence supporting their efficacy treating cancer pain due to bone metastases; other therapies, like bisphosphonates and denosumab, do not. There is sufficient evidence that patients who experience pain relief after radiation therapy have improved quality of life; however, a substantial proportion are nonresponders. For those still requiring pain management, even with available analgesics, many patients are undertreated for cancer pain due to bone metastases, indicating an unmet need. The studies in this review were not designed to determine why cancer pain due to bone metastases was undertreated. Studies specifically addressing cancer pain due to bone metastases, rather than general cancer pain, are limited. Additional research is needed to determine patient preferences and physician attitudes regarding choice of analgesic for moderate to severe cancer pain due to bone metastases.
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Affiliation(s)
- Ann Colosia
- Department of Market Access and Outcomes Strategy, RTI Health Solutions, Research Triangle Park, NC, USA
| | - Annete Njue
- Department of Market Access and Outcomes Strategy, RTI Health Solutions, Manchester, UK
| | - Zahid Bajwa
- Medical Affairs, Eli Lilly and Company, Indianapolis, IN, USA
| | | | - Rebecca L Robinson
- Value, Evidence, and Outcomes, Eli Lilly and Company, Indianapolis, IN, USA,Correspondence: Rebecca L Robinson, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA, Tel +1 3174331323, Fax +1 3172777444, Email
| | | | | | - Steven H Richiemer
- Division of Pain Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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22
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Nistor CE, Ciuche A, Cucu AP, Nitipir C, Slavu C, Serban B, Cursaru A, Cretu B, Cirstoiu C. Management of Lung Cancer Presenting with Solitary Bone Metastasis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58101463. [PMID: 36295624 PMCID: PMC9612355 DOI: 10.3390/medicina58101463] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/09/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
Lung neoplasm is the main cause of cancer-related mortality, and bone metastasis is among the most common secondary tumors. The vast majority of patients also present with multiple bone metastases, which makes systemic and adjuvant pain therapy preferable to surgery. The optimal approach for a resectable non-small-cell lung tumor that also presents a unique, resectable bone metastasis is not fully established. The number of papers addressing this subject is small, and most are case reports; nevertheless, survival rates seem to increase with radical surgery. The sequencing of local versus systemic treatment should always be discussed within the multidisciplinary team that will choose the best approach for each patient. As targeted systemic therapies become more accessible, radical surgery, together with existing reconstructive methods, will lead to an increase in life expectancy and a better quality of life.
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Affiliation(s)
- Claudiu-Eduard Nistor
- Department Thoracic Surgery, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Adrian Ciuche
- Department Thoracic Surgery, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Anca Pati Cucu
- Department Thoracic Surgery, Dr. Carol Davila Central Military Emergency University Hospital, 010825 Bucharest, Romania
| | - Cornelia Nitipir
- Department of Medical Oncology, Carol Davila University Medicine & Pharmacy, Elias University Emergency Hospital, 011468 Bucharest, Romania
| | - Cristina Slavu
- Department of Medical Oncology, Carol Davila University Medicine & Pharmacy, Elias University Emergency Hospital, 011468 Bucharest, Romania
| | - Bogdan Serban
- Department Orthopedic & Traumatology, Carol Davila University Medicine & Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania
| | - Adrian Cursaru
- Department Orthopedic & Traumatology, Carol Davila University Medicine & Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania
| | - Bogdan Cretu
- Department Orthopedic & Traumatology, Carol Davila University Medicine & Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania
- Correspondence:
| | - Catalin Cirstoiu
- Department Orthopedic & Traumatology, Carol Davila University Medicine & Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania
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Cui Y, Shi X, Wang S, Qin Y, Wang B, Che X, Lei M. Machine learning approaches for prediction of early death among lung cancer patients with bone metastases using routine clinical characteristics: An analysis of 19,887 patients. Front Public Health 2022; 10:1019168. [PMID: 36276398 PMCID: PMC9583680 DOI: 10.3389/fpubh.2022.1019168] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/20/2022] [Indexed: 01/28/2023] Open
Abstract
Purpose Bone is one of the most common sites for the spread of malignant tumors. Patients with bone metastases whose prognosis was shorter than 3 months (early death) were considered as surgical contraindications. However, the information currently available in the literature limits our capacity to assess the risk likelihood of 3 month mortality. As a result, the study's objective is to create an accurate prediction model utilizing machine-learning techniques to predict 3 month mortality specifically among lung cancer patients with bone metastases according to easily available clinical data. Methods This study enrolled 19,887 lung cancer patients with bone metastases between 2010 and 2018 from a large oncologic database in the United States. According to a ratio of 8:2, the entire patient cohort was randomly assigned to a training (n = 15881, 80%) and validation (n = 4,006, 20%) group. In the training group, prediction models were trained and optimized using six approaches, including logistic regression, XGBoosting machine, random forest, neural network, gradient boosting machine, and decision tree. There were 13 metrics, including the Brier score, calibration slope, intercept-in-large, area under the curve (AUC), and sensitivity, used to assess the model's prediction performance in the validation group. In each metric, the best prediction effectiveness was assigned six points, while the worst was given one point. The model with the highest sum score of the 13 measures was optimal. The model's explainability was performed using the local interpretable model-agnostic explanation (LIME) according to the optimal model. Predictor importance was assessed using H2O automatic machine learning. Risk stratification was also evaluated based on the optimal threshold. Results Among all recruited patients, the 3 month mortality was 48.5%. Twelve variables, including age, primary site, histology, race, sex, tumor (T) stage, node (N) stage, brain metastasis, liver metastasis, cancer-directed surgery, radiation, and chemotherapy, were significantly associated with 3 month mortality based on multivariate analysis, and these variables were included for developing prediction models. With the highest sum score of all the measurements, the gradient boosting machine approach outperformed all the other models (62 points), followed by the XGBooting machine approach (59 points) and logistic regression (53). The area under the curve (AUC) was 0.820 (95% confident interval [CI]: 0.807-0.833), 0.820 (95% CI: 0.807-0.833), and 0.815 (95% CI: 0.801-0.828), respectively, calibration slope was 0.97, 0.95, and 0.96, respectively, and accuracy was all 0.772. Explainability of models was conducted to rank the predictors and visualize their contributions to an individual's mortality outcome. The top four important predictors in the population according to H2O automatic machine learning were chemotherapy, followed by liver metastasis, radiation, and brain metastasis. Compared to patients in the low-risk group, patients in the high-risk group were more than three times the odds of dying within 3 months (P < 0.001). Conclusions Using machine learning techniques, this study offers a number of models, and the optimal model is found after thoroughly assessing and contrasting the prediction performance of each model. The optimal model can be a pragmatic risk prediction tool and is capable of identifying lung cancer patients with bone metastases who are at high risk for 3 month mortality, informing risk counseling, and aiding clinical treatment decision-making. It is better advised for patients in the high-risk group to have radiotherapy alone, the best supportive care, or minimally invasive procedures like cementoplasty.
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Affiliation(s)
- Yunpeng Cui
- Department of Orthopedic Surgery, Peking University First Hospital, Beijing, China
| | - Xuedong Shi
- Department of Orthopedic Surgery, Peking University First Hospital, Beijing, China,*Correspondence: Xuedong Shi
| | - Shengjie Wang
- Department of Orthopaedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Yong Qin
- Department of Joint and Sports Medicine Surgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China,Yong Qin
| | - Bailin Wang
- Department of Thoracic Surgery, Hainan Hospital of Chinese PLA General Hospital, Sanya, China
| | - Xiaotong Che
- Department of Evaluation Office, Hainan Cancer Hospital, Haikou, China
| | - Mingxing Lei
- Department of Orthopedic Surgery, Hainan Hospital of PLA General Hospital, Sanya, China,Chinese PLA Medical School, Beijing, China,National Clinical Research Center for Orthopedics, Sports Medicine and Rehabilitation, Chinese PLA General Hospital, Beijing, China,Mingxing Lei
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24
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Gupta S, Jawanda MK, Ganganna A, Basavaraju S, Kashav N, Dhawan J, Yadav SK, Yadav AB. Jaw bone metastasis from Lung cancer as sole primary source: A systematic review. J Clin Exp Dent 2022; 14:e573-e593. [PMID: 35912028 PMCID: PMC9328481 DOI: 10.4317/jced.59554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 05/04/2022] [Indexed: 01/25/2023] Open
Abstract
Background Lung cancer is one of the leading causes of death worldwide. Lung cancer metastasis to oral region is very rare. Very few research work has been conducted till date to analyse the jaw bone metastasis from Lung cancer as the primary source. The goal of this research was to examine published cases of jaw bone metastasis from lung cancer as the sole primary source from 1st December 1961 to 31st December 2021 and to learn about their characteristics.
Material and Methods An electronic search of the published English literature was performed in PubMed/ Medline, Scopus, Google Scholar, and Research gate databases, using keywords like ‘Lung cancer’, OR/AND ‘Lung carcinoma’, OR/AND ‘Metastasis’, OR/AND ‘Primary’, OR/AND ‘Source’, OR/AND ‘Oral cavity’ OR/AND ‘Jaw’, OR/ AND ‘Mandible’, OR/AND ‘Maxilla’, OR/ AND ‘Temporomandibular joint’, OR/ AND ‘Condyle’, OR/ AND ‘Ramus’, OR/ AND ‘Maxillary sinus’, AND Initial’, OR/ AND ‘Treatment’, OR/AND ‘Prognosis’, OR/ AND ‘Follow-up’, OR/AND ‘Recurrence’, OR/ AND ‘Survival rate’. We also searched all related journals manually. Reference list of all articles was also checked. Data extracted were tabulated and summarized.
Results In total, we found 60 relevant publications with 66 patients in our research. The prognosis was poor, with a survival time of 1 week to 1.5 years. The most prevalent diagnosed metastatic lung cancer to jaw bones was adenocarcinoma and mandible was the predominant site.
Conclusions Jaw bone metastasis from lung cancer is rare and has a bad prognosis. Because of their resemblance to other jaw problems and late clinical signs, these lesions go unnoticed the majority of the time, making detection difficult. More cases need to be published in order to raise awareness of these lesions and gain a better understanding of their characteristics. Key words:Jaw bone, lung cancer, metastasis, primary, prognosis.
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Affiliation(s)
- Sonia Gupta
- MDS, Reader, Department of Oral Pathology and Microbiology & Forensic odontology, Rayat and Bahra Dental college and hospital, Mohali, Punjab, India
| | - Manveen-Kaur Jawanda
- MDS, Professor & Head, Department of Oral Pathology and Microbiology & Forensic odontology. Laxmi bai institute of dental sciences and hospital, Patiala, Punjab, India
| | - Aruna Ganganna
- MDS, Assistant Professor, Department of Periodontology, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - Suman Basavaraju
- MDS, Reader, Department of Periodontology, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - Neha Kashav
- MDS, Senior Lecturer, Department of Pediatric and Preventive Dentistry, Bhojia Dental College and Hospital, Baddi, HP, India
| | - Jayata Dhawan
- MDS, Senior Lecturer, Department of Pediatric and Preventive Dentistry, MM College of Dental Sciences and Research, Mullana, Haryana, India
| | - Sumit-Kumar Yadav
- MDS, Professor, Department of Orthodontics & Dentofacial Orthopedics, D J College of Dental Sciences & Research, Modinagar, UP, India
| | - Achla-Bharti Yadav
- MDS, Professor, Department of Oral Pathology & Microbiology, D J College of Dental Sciences and Research, Modinagar, UP, India
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Zhong G, Zeng L, He Y, Zeng X, Huang W, Yang T, Chu X, Xiao J, Yin D, Chang Y, Cheng S, Zhang Y. The effects of combined microwave ablation and open surgery for the treatment of lung cancer-derived thoracolumbar metastases. Orthop Surg 2022; 14:1300-1308. [PMID: 35603553 PMCID: PMC9251282 DOI: 10.1111/os.13236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 01/06/2022] [Accepted: 01/19/2022] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To investigate the clinical effects of microwave ablation (MWA) in addition to open surgery for the treatment of lung cancer-derived thoracolumbar metastases. METHODS This was a single-institution, retrospective, cohort study. From January 2019 to December 2020, a total of 47 patients with lung cancer-derived thoracolumbar metastases underwent posterior spinal canal decompression and fixation surgery in our hospital. Two independent surgical teams treated these patients. One group underwent open surgery combined with MWA therapy, while the other had open surgery only (control). The pre- and post-operative visual analog scale (VAS) scores and the overall survival (OS) were compared between the MWA and control groups. The Frankel Grade classification was applied for the evaluation of the post-surgical spinal cord function. Improvement was defined as an increase of at least one rank from the pre-operative scores. Each patient was evaluated pre- and post-operatively at 48 h, 1 month, and 3-month intervals. Data on surgical-related complications were recorded. RESULTS Thirty men and 17 women were included, with an average age of 57.9 ± 11.4 years (range, 26-81 years). Twenty-eight patients underwent MWA and were in the MWA group, and 19 patients were included in the control group. Post-operatively all patients were followed up regularly; the median follow-up time was 12 months (range, 3-24 months), and their median OS was 14 months. Patients in the MWA group had a lower VAS score than those in the control group at the 48-h (1.75 ± 1.01 vs 2.47 ± 0.96, P = 0.01) and 1-month (1.79 ± 0.92 vs 2.53 ± 1.35, P = 0.048) check-ups. At the 3-month evaluation, the VAS score differences between the two groups were not significant (P = 0.133). After surgery, spinal cord function improvement was not significantly different between the MWA and control groups (P = 0.515). MWA therapy combined with open surgery was not associated with increased OS compared with the control group (P = 0.492). CONCLUSION MWA can be an effective and safe pain-relief method but may not extend the OS of patients with lung cancer.
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Affiliation(s)
- Guoqing Zhong
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
- Shantou University Medical CollegeShantouChina
| | - Longhui Zeng
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Yue He
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Xiaolong Zeng
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Wenhan Huang
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Tao Yang
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Xiao Chu
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Jin Xiao
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Dong Yin
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Yunbing Chang
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Shi Cheng
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
| | - Yu Zhang
- Department of Orthopaedic Oncology, Guangdong Provincial People's HospitalGuangdong Academy of Medical SciencesGuangzhouChina
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Fan Y, Dong Y, Wang H, Wang H, Sun X, Wang X, Zhao P, Luo Y, Jiang X. Development and externally validate MRI-based nomogram to assess EGFR and T790M mutations in patients with metastatic lung adenocarcinoma. Eur Radiol 2022; 32:6739-6751. [PMID: 35729427 DOI: 10.1007/s00330-022-08955-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/20/2022] [Accepted: 06/08/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aims to explore values of multi-parametric MRI-based radiomics for detecting the epidermal growth factor receptor (EGFR) mutation and resistance (T790M) mutation in lung adenocarcinoma (LA) patients with spinal metastasis. METHODS This study enrolled a group of 160 LA patients from our hospital (between Jan. 2017 and Feb. 2021) to build a primary cohort. An external cohort was developed with 32 patients from another hospital (between Jan. 2017 and Jan. 2021). All patients underwent spinal MRI (including T1-weighted (T1W) and T2-weighted fat-suppressed (T2FS)) scans. Radiomics features were extracted from the metastasis for each patient and selected to develop radiomics signatures (RSs) for detecting the EGFR and T790M mutations. The clinical-radiomics nomogram models were constructed with RSs and important clinical parameters. The receiver operating characteristics (ROC) curve was used to evaluate the predication capabilities of each model. Calibration and decision curve analyses (DCA) were constructed to verify the performance of the models. RESULTS For detecting the EGFR and T790M mutation, the developed RSs comprised 9 and 4 most important features, respectively. The constructed nomogram models incorporating RSs and smoking status showed favorite prediction efficacy, with AUCs of 0.849 (Sen = 0.685, Spe = 0.885), 0.828 (Sen = 0.964, Spe = 0.692), and 0.778 (Sen = 0.611, Spe = 0.929) in the training, internal validation, and external validation sets for detecting the EGFR mutation, respectively, and with AUCs of 0.0.842 (Sen = 0.750, Spe = 0.867), 0.823 (Sen = 0.667, Spe = 0.938), and 0.800 (Sen = 0.875, Spe = 0.800) in the training, internal validation, and external validation sets for detecting the T790M mutation, respectively. CONCLUSIONS Radiomics features from the spinal metastasis were predictive on both EGFR and T790M mutations. The constructed nomogram models can be potentially considered as new markers to guild treatment management in LA patients with spinal metastasis. KEY POINTS • To our knowledge, this study was the first approach to detect the EGFR T790M mutation based on spinal metastasis in patients with lung adenocarcinoma. • We identified 13 MRI features that were strongly associated with the EGFR T790M mutation. • The proposed nomogram models can be considered as potential new markers for detecting EGFR and T790M mutations based on spinal metastasis.
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Affiliation(s)
- Ying Fan
- School of Intelligent Medicine, China Medical University, Liaoning, 110122, People's Republic of China
| | - Yue Dong
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning, 110042, People's Republic of China
| | - Huan Wang
- Radiation Oncology Department of Thoracic Cancer, Liaoning Cancer Hospital and Institute, Liaoning, 110042, People's Republic of China
| | - Hongbo Wang
- Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, 110004, People's Republic of China
| | - Xinyan Sun
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning, 110042, People's Republic of China
| | - Xiaoyu Wang
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning, 110042, People's Republic of China
| | - Peng Zhao
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning, 110042, People's Republic of China
| | - Yahong Luo
- Department of Radiology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Liaoning, 110042, People's Republic of China
| | - Xiran Jiang
- School of Intelligent Medicine, China Medical University, Liaoning, 110122, People's Republic of China.
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Wei Z, Pan B, Jia D, Yu Y. Long-term safety and efficacy of bisphosphonate therapy in advanced lung cancer with bone metastasis. Future Oncol 2022; 18:2257-2267. [PMID: 35414201 DOI: 10.2217/fon-2022-0098] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aim: This retrospective, observational study evaluated the long-term (>12 months) safety and effectiveness of bisphosphonate. Methods: Data collected for 359 patients included quantity and proportion of adverse events (AEs) and skeletal-related events (SREs), and times to first AE and first SRE. Results: Patients in the ≤24-month group experienced significantly fewer AEs compared with the >24-month treatment group (p = 0.008), and treatment for >24 months was a potential risk factor for AEs (p = 0.05). Neither the proportion nor the risk of SRE was significantly associated with therapy duration (p = 0.525 and 0.084, respectively). Conclusion: Bisphosphonate treatment beyond 2 years may increase the risk of AEs, but may prolong SRE-free survival early after 24 months, compared with medication administered for ≤24 months.
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Affiliation(s)
- Zixin Wei
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China
| | - Bo Pan
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China
| | - Dexin Jia
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China
| | - Yan Yu
- Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, 150081, China
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Asano Y, Yamamoto N, Demura S, Hayashi K, Takeuchi A, Kato S, Miwa S, Igarashi K, Higuchi T, Yonezawa H, Araki Y, Morinaga S, Saito S, Sone T, Kasahara K, Tsuchiya H. The Therapeutic Effect and Clinical Outcome of Immune Checkpoint Inhibitors on Bone Metastasis in Advanced Non-Small-Cell Lung Cancer. Front Oncol 2022; 12:871675. [PMID: 35433422 PMCID: PMC9010859 DOI: 10.3389/fonc.2022.871675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/11/2022] [Indexed: 12/17/2022] Open
Abstract
Introduction In advanced non-small-cell lung cancer (NSCLC), immune checkpoint inhibitors (ICIs) have been reported a better treatment outcome on primary lesions, however, the therapeutic effect on bone metastases has not been clarified. This study investigates the therapeutic effect of ICIs on bone metastases in advanced NSCLC. Methods The data of patients with advanced NSCLC, treated with ICIs from 2016 to 2019 at our hospital, were analyzed. The therapeutic effects of ICIs on primary lung and metastatic bone lesions, concomitant use of bone modifying agents (BMA), treatment outcomes, and frequency of immune-related adverse events (irAEs) and skeletal-related events (SREs) were investigated. Results A total of 29 patients were included (19 men and 10 women; mean age, 64.2 years). Among the ICIs, pembrolizumab was the most used (55.2%), and concomitant use of BMA was prevalent in 21 patients (zoledronic acid=1, denosumab=20). The therapeutic effect was partial response (PR) in 10.3% (n=3) on primary lung lesions by RECIST 1.1, complete response (CR) in 6.9% (n=2) and PR in 17.2% (n=5) on bone metastatic lesions by MDA criteria. ICIs suppressed the progression of bone metastasis in 21 cases (72.4%). All patients in CR and PR were treated with pembrolizumab and denosumab. SREs and irAEs were developed in 3.4% (n=1) and 20.7% (n=6), respectively. The median survival time after treatment with ICIs was 11.0 months. Concomitant therapy with ICIs and denosumab significantly prolonged the overall survival compared to ICI-only therapy (16.0 months vs. 2.5 months, p<0.01). Conclusions This study showed that treatment with ICIs may successfully suppress the progression of bone metastasis in advanced NSCLC. Pembrolizumab with denosumab had the highest therapeutic effect on both primary lung lesions and bone metastases. Systemic treatment with this combination and conservative treatment of bone metastasis could be one of the options in the treatment of advanced NSCLC.
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Affiliation(s)
- Yohei Asano
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Norio Yamamoto
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Satoru Demura
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Katsuhiro Hayashi
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Akihiko Takeuchi
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
- *Correspondence: Akihiko Takeuchi,
| | - Satoshi Kato
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Shinji Miwa
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Kentaro Igarashi
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Takashi Higuchi
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Hirotaka Yonezawa
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Yoshihiro Araki
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Sei Morinaga
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Shiro Saito
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
| | - Takashi Sone
- Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Kazuo Kasahara
- Department of Respiratory Medicine, Kanazawa University Hospital, Kanazawa, Japan
| | - Hiroyuki Tsuchiya
- Department of Orthopedic Surgery, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan
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Chen YH, Ho UC, Kuo LT. Oligometastatic Disease in Non-Small-Cell Lung Cancer: An Update. Cancers (Basel) 2022; 14:cancers14051350. [PMID: 35267658 PMCID: PMC8909159 DOI: 10.3390/cancers14051350] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 02/11/2022] [Accepted: 03/02/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Approximately 7–50% of patients with non-small-cell lung cancer (NSCLC) develop oligometastases, which are new tumors found in another part of the body, arising from cancer cells of the original tumor that have travelled through the body. In recent years, these patients have been increasingly regarded as a distinct group that could benefit from treatment that intends to cure the disease, rather than palliative care, to achieve a better clinical outcome. Various treatment procedures have been developed for treating NSCLC patients with different oligometastatic sites. In addition, the newly proposed uniform definition for oligometastases as well as ongoing trials may lead to increased appropriate patient selection and evaluation of treatment effectiveness. The aim of this review article is to summarize the latest evidence regarding optimal management strategies for NSCLC patients with oligometastases. Abstract Oligometastatic non-small-cell lung cancer (NSCLC) is a distinct entity that is different from localized and disseminated diseases. The definition of oligometastatic NSCLC varies across studies in past decades owing to the use of different imaging modalities; however, a uniform definition of oligometastatic NSCLC has been proposed, and this may facilitate trial design and evaluation of certain interventions. Patients with oligometastatic NSCLC are candidates for curative-intent management, in which local ablative treatment, such as surgery or stereotactic radiosurgery, should be instituted to improve clinical outcomes. Although current guidelines recommend that local therapy for thoracic and metastatic lesions should be considered for patients with oligometastatic NSCLC with stable disease after systemic therapy, optimal management strategies for different oligometastatic sites have not been established. Additionally, the development of personalized therapies for individual patients with oligometastatic NSCLC to improve their quality of life and overall survival should also be addressed. Here, we review relevant articles on the management of patients with oligometastatic NSCLC and categorize the disease according to the site of metastases. Ongoing trials are also summarized to determine future directions and expectations for new treatment modalities to improve patient management.
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Affiliation(s)
- Yi-Hsing Chen
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Douliu 640, Taiwan; (Y.-H.C.); (U.-C.H.)
| | - Ue-Cheung Ho
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital Yunlin Branch, Douliu 640, Taiwan; (Y.-H.C.); (U.-C.H.)
| | - Lu-Ting Kuo
- Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital, Taipei 100, Taiwan
- Correspondence: ; Tel.: +886-2-2312-3456
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Lung cancer with post-fracture healing changes causing difficulty in staging. Respir Med Case Rep 2022; 38:101694. [PMID: 35799861 PMCID: PMC9253643 DOI: 10.1016/j.rmcr.2022.101694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/26/2022] [Accepted: 06/20/2022] [Indexed: 11/22/2022] Open
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Congedo MT, Nachira D, Bertolaccini L, Chiappetta M, Zanfrini E, Meacci E, Vita ML, Lococo F, D'Argento E, Spaggiari L, Margaritora S. Multimodal therapy for synchronous bone oligometastatic NSCLC: The role of surgery. J Surg Oncol 2021; 125:782-789. [PMID: 34918785 DOI: 10.1002/jso.26773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 10/27/2021] [Accepted: 12/02/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The study aimed to assess the feasibility of radical surgical treatment for selected bone-oligometastatic non-small cell lung cancer (NSCLC) patients and to identify prognostic factors associated with survival. MATERIALS AND METHODS The clinical records of 27 patients with bone synchronous oligometastatic NSCLC were retrospectively analyzed. RESULTS Thirteen (48.1%) bone metastases were treated by surgery and 14 (51.9%) by local radiotherapy. Eighteen (66.7%) patients underwent induction chemotherapy before lung surgery, and 3 (11.1%) concurrent radiotherapy. Pulmonary surgery was a major lung resection in 23 (85.2%) cases. Intraoperative and 30-days mortality was null. Only one major (ARDS) and 10 (37.04%) mild complications (like air leakage, arrhythmia, and mucus retention) were recorded. 1-year and 5-years OS from the diagnosis and 1-year, 3- years disease-free survival (DFS) were 96%, 38%, and 66%, 30%, respectively. After stepwise Cox regression analysis, local recurrence (p = 0.05) and metachronous metastases (p = 0.04) maintained their independent prognostic value as overall survival negative determinants. Nodal upstaging (p = 0.04) and nonsurgical treatment of bone lesion (p = 0.03) turned out to be independent risk factors for shorter DFS; the vertebral localization of bone metastases showed only a remarkable trend towards significance (p = 0.06) as a risk factor for a worse DFS. CONCLUSIONS In selected patients, surgical treatment of primary NSCLC and bone synchronous metastasis seems to be safe and feasible and rewarding survivals may be expected.
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Affiliation(s)
- Maria Teresa Congedo
- Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Dania Nachira
- Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Luca Bertolaccini
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Marco Chiappetta
- Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Edoardo Zanfrini
- Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elisa Meacci
- Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Letizia Vita
- Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Filippo Lococo
- Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Ettore D'Argento
- Department of Medical Oncology, , Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Lorenzo Spaggiari
- Department of Thoracic Surgery, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Stefano Margaritora
- Department of Thoracic Surgery, Fondazione Policlinico Universitario "A.Gemelli" IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
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[ 18F]AlF-NOTA-FAPI-04 PET/CT uptake in metastatic lesions on PET/CT imaging might distinguish different pathological types of lung cancer. Eur J Nucl Med Mol Imaging 2021; 49:1671-1681. [PMID: 34870727 PMCID: PMC8940861 DOI: 10.1007/s00259-021-05638-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 11/24/2021] [Indexed: 01/20/2023]
Abstract
Purpose Heterogeneity is found in the tumor microenvironment among different pathological types of tumors. Radionuclide-labeled fibroblast-activation-protein inhibitor (FAPI), as an important tracer for non-invasive imaging of the tumor microenvironment, can be used to evaluate the expression of FAP in cancer-associated fibroblasts, macrophages, and tumor cells. Our aim was to explore the ability of [18F]AlF-NOTA-FAPI-04 positron emission tomography (PET)/computed tomography (CT) to distinguish different types of lung cancer by evaluating the uptake of this tracer in primary and metastatic lesions. Methods We prospectively enrolled 61 patients with histopathologically proven primary lung cancer with metastases. PET/CT scanning was performed before any antitumor therapy and 1 h after injection of 235.10 ± 3.89 MBq of [18F]AlF-NOTA-FAPI-04. Maximum standard uptake values (SUVmax) were calculated for comparison among primary and metastatic lesions. Immunohistochemical staining for FAP was performed on tumor specimens. Results Sixty-one patients with adenocarcinoma (ADC, n = 30), squamous cell carcinoma (SCC, n = 17), and small cell lung cancer (SCLC, n = 14) were enrolled in this study, and 61 primary tumors and 199 metastases were evaluated. No difference in [18F]AlF-NOTA-FAPI-04 uptake was observed among primary ADC, SCC, and SCLC tumors (P = 0.198). Additionally, no difference in uptake was found between primary and metastatic lesions of lung cancer with the same pathological type (P > 0.05). However, uptake did differ among metastases of differing pathological types (P < 0.001). The SUVmax of metastatic lymph nodes was highest for SCC, followed by ADC and then SCLC (P < 0.001). The SUVmax of bone metastases also was highest for SCC, followed by ADC and SCLC (P < 0.05), but no difference was observed between ADC and SCLC. The SUVmax of metastases in other organs was higher in SCC cases than in ADC cases but did not differ between SCC and SCLC or ADC and SCLC. Bone metastases exhibited higher uptake than those of lymph nodes and other organs in SCC and ADC (P < 0.05) but not in SCLC. Positive correlations were found between FAPI uptake and FAP expression in surgical plus biopsy specimens (r = 0.439, P = 0.012) and surgical specimens (r = 0.938, P = 0.005). Conclusion [18F]AlF-NOTA-FAPI-04 PET/CT imaging revealed differences in FAP expression in metastases of lung cancer, with the highest expression specifically in bone metastases, and thus, may be valuable for distinguishing different pathological types of lung cancer. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05638-z.
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Radeczky P, Moldvay J, Fillinger J, Szeitz B, Ferencz B, Boettiger K, Rezeli M, Bogos K, Renyi-Vamos F, Hoetzenecker K, Hegedus B, Megyesfalvi Z, Dome B. Bone-Specific Metastasis Pattern of Advanced-Stage Lung Adenocarcinoma According to the Localization of the Primary Tumor. Pathol Oncol Res 2021; 27:1609926. [PMID: 34629961 PMCID: PMC8496061 DOI: 10.3389/pore.2021.1609926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 08/26/2021] [Indexed: 01/17/2023]
Abstract
Background: Patients with advanced-stage lung adenocarcinoma (LADC) often develop distant metastases in the skeletal system. Yet, the bone-specific metastasis pattern is still controversial. We, therefore, aimed to examine how the primary tumor location affects bone specificity and survival in LADC patients diagnosed with skeletal metastases. Methods: In total, 209 bone-metastatic Caucasian LADC patients from two thoracic centers were included in this study. Focusing on the specific location of primary tumors and bone metastatic sites, clinicopathological variables were included in a common database and analyzed retrospectively. Skeletal metastases were diagnosed according to the contemporary diagnostic guidelines and confirmed by bone scintigraphy. Besides region- and side-specific localization, primary tumors were also classified as central or peripheral tumors based on their bronchoscopic visibility. Results: The most common sites for metastasis were the spine (n = 103) and the ribs (n = 60), followed by the pelvis (n = 36) and the femur (n = 22). Importantly, femoral (p = 0.022) and rib (p = 0.012) metastases were more frequently associated with peripheral tumors, whereas centrally located LADCs were associated with humeral metastases (p = 0.018). Moreover, we deduced that left-sided tumors give rise to skull metastases more often than right-sided primary tumors (p = 0.018). Of note, however, the localization of the primary tumor did not significantly influence the type of affected bones. Multivariate Cox regression analysis adjusted for clinical parameters demonstrated that central localization of the primary tumor was an independent negative prognostic factor for overall survival (OS). Additionally, as expected, both chemotherapy and bisphosphonate therapy conferred a significant benefit for OS. Conclusion: The present study demonstrates unique bone-specific metastasis patterns concerning primary tumor location. Peripherally located LADCs are associated with rib and femoral metastases and improved survival outcomes. Our findings might contribute to the development of individualized follow-up strategies in bone-metastatic LADC patients and warrant further clinical investigations on a larger sample size.
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Affiliation(s)
- Peter Radeczky
- Department of Thoracic Surgery, National Institute of Oncology, Semmelweis University, Budapest, Hungary
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Judit Moldvay
- MTA-SE NAP, Brain Metastasis Research Group, Hungarian Academy of Sciences, Budapest, Hungary
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Janos Fillinger
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Beata Szeitz
- Division of Oncology, Department of Internal Medicine and Oncology, Semmelweis University, Budapest, Hungary
| | - Bence Ferencz
- Department of Thoracic Surgery, National Institute of Oncology, Semmelweis University, Budapest, Hungary
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Kristiina Boettiger
- Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Austria
| | - Melinda Rezeli
- Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - Krisztina Bogos
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Ferenc Renyi-Vamos
- Department of Thoracic Surgery, National Institute of Oncology, Semmelweis University, Budapest, Hungary
- National Koranyi Institute of Pulmonology, Budapest, Hungary
| | - Konrad Hoetzenecker
- Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Austria
| | - Balazs Hegedus
- Department of Thoracic Surgery, Ruhrlandklinik, University Clinic Essen, Essen, Germany
- 2nd Department of Pathology, Semmelweis University, Budapest, Hungary
| | - Zsolt Megyesfalvi
- Department of Thoracic Surgery, National Institute of Oncology, Semmelweis University, Budapest, Hungary
- National Koranyi Institute of Pulmonology, Budapest, Hungary
- Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Austria
| | - Balazs Dome
- Department of Thoracic Surgery, National Institute of Oncology, Semmelweis University, Budapest, Hungary
- National Koranyi Institute of Pulmonology, Budapest, Hungary
- Department of Thoracic Surgery, Comprehensive Cancer Center, Medical University of Vienna, Austria
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Peters S, Danson S, Ejedepang D, Dafni U, Hasan B, Radcliffe HS, Bustin F, Crequit J, Coate L, Guillot M, Surmont V, Rauch D, Rudzki J, O'Mahony D, Barneto Aranda I, Scherz A, Tsourti Z, Roschitzki-Voser H, Pochesci A, Demonty G, Stahel RA, O'Brien M. Combined, patient-level, analysis of two randomised trials evaluating the addition of denosumab to standard first-line chemotherapy in advanced NSCLC - The ETOP/EORTC SPLENDOUR and AMGEN-249 trials. Lung Cancer 2021; 161:76-85. [PMID: 34543941 DOI: 10.1016/j.lungcan.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 08/31/2021] [Accepted: 09/06/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION The efficacy of adding denosumab to standard first-line chemotherapy for advanced NSCLC patients has been evaluated in two separate randomised trials (SPLENDOUR and AMGEN-249). In this pooled analysis, we will assess the combination-treatment effect in the largest available population, in order to conclude about the potential impact of denosumab in NSCLC. METHODS Both trials included in this combined analysis, were randomised (SPLENDOUR 1:1, AMGEN-249 2:1) multi-centre trials stratified by histology, bone metastasis, geographical region and for SPLENDOUR only, ECOG PS. Cox proportional hazards models, were used to assess the treatment effect with respect to overall survival (OS; primary endpoint) and progression-free survival (PFS; secondary endpoint). Heterogeneity between trials was assessed, and subgroup analyses were performed. RESULTS The pooled analysis was based on 740 randomised patients (SPLENDOUR:514; AMGEN-249:226), with 407 patients in the chemotherapy-denosumab arm and 333 in the chemotherapy-alone arm. In the chemotherapy-denosumab arm, at a median follow-up of 22.0 months, 277 (68.1%) deaths were reported with median OS 9.2 months (95%CI:[8.0-10.7]), while in the chemotherapy-alone arm, with similar median follow-up of 20.3 months, 230 (69.1%) deaths with median OS 9.9 months (95%CI:[8.2-11.2]). No significant denosumab effect was found (HR = 0.98; 95%CI:[0.82-1.18]; P = 0.85). Among subgroups, interaction was found between treatment and histology subtypes (P = 0.020), with a statistically significant benefit in the squamous group (HR = 0.70; 95%CI:[0.49-0.98]; P = 0.038), from 7.6 to 9.0 months median OS. With respect to PFS, 363 (89.2%) and 298 (89.5%) events were reported in the chemotherapy-denosumab and chemotherapy-alone arms, respectively, with corresponding medians 4.8 months (95%CI:[4.4-5.3]) and 4.9 months (95%CI:[4.3-5.4]). HR for PFS was 0.97(95%CI:[0.83-1.15]; P = 0.76), indicating that no significant denosumab benefit existed for PFS. CONCLUSION In this pooled analysis, no statistically significant improvement was shown in PFS/OS with the combination of denosumab and chemotherapy for advanced NSCLC and no meaningful benefit in any of the subgroups.
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Affiliation(s)
- Solange Peters
- Department of Oncology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
| | - Sarah Danson
- Department of Oncology and Metabolism & Sheffield Experimental Cancer Medicine Centre, University of Sheffield, Weston Park Hospital, Sheffield, United Kingdom
| | - Dunson Ejedepang
- Headquarters, European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | - Urania Dafni
- National and Kapodistrian University of Athens & Frontier Science Foundation-Hellas, Athens, Greece
| | - Baktiar Hasan
- Headquarters, European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | | | | | - Linda Coate
- Mid-Western Cancer Centre, University Hospital Limerick, Limerick, Ireland; Cancer Trials, Ireland
| | - Monica Guillot
- Hospital Universitari Son Espases, Palma, Spain; Spanish Lung Cancer Group (GECP), Spain
| | | | - Daniel Rauch
- Spital STS AG Thun, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Switzerland
| | - Jakob Rudzki
- Innsbruck Universitaetsklinik, Austria; Central European Cooperative Oncology Group (CECOG), Austria
| | | | - Isidoro Barneto Aranda
- Hospital Universitario Reina Sofia, Córdoba, Spain; Spanish Lung Cancer Group (GECP), Spain
| | - Amina Scherz
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Switzerland
| | - Zoi Tsourti
- Frontier Science Foundation-Hellas, Athens, Greece
| | | | - Alessia Pochesci
- Headquarters, European Organisation for Research and Treatment of Cancer (EORTC), Brussels, Belgium
| | | | - Rolf A Stahel
- Coordinating Office, European Thoracic Oncology Platform (ETOP), Bern, Switzerland
| | - Mary O'Brien
- Department of Medical Oncology, Royal Marsden Hospital Sutton, UK
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Onoue K, Yakami M, Nishio M, Sakamoto R, Aoyama G, Nakagomi K, Iizuka Y, Kubo T, Emoto Y, Akasaka T, Satoh K, Yamamoto H, Isoda H, Togashi K. Temporal subtraction CT with nonrigid image registration improves detection of bone metastases by radiologists: results of a large-scale observer study. Sci Rep 2021; 11:18422. [PMID: 34531429 PMCID: PMC8446090 DOI: 10.1038/s41598-021-97607-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/25/2021] [Indexed: 12/25/2022] Open
Abstract
To determine whether temporal subtraction (TS) CT obtained with non-rigid image registration improves detection of various bone metastases during serial clinical follow-up examinations by numerous radiologists. Six board-certified radiologists retrospectively scrutinized CT images for patients with history of malignancy sequentially. These radiologists selected 50 positive and 50 negative subjects with and without bone metastases, respectively. Furthermore, for each subject, they selected a pair of previous and current CT images satisfying predefined criteria by consensus. Previous images were non-rigidly transformed to match current images and subtracted from current images to automatically generate TS images. Subsequently, 18 radiologists independently interpreted the 100 CT image pairs to identify bone metastases, both without and with TS images, with each interpretation separated from the other by an interval of at least 30 days. Jackknife free-response receiver operating characteristics (JAFROC) analysis was conducted to assess observer performance. Compared with interpretation without TS images, interpretation with TS images was associated with a significantly higher mean figure of merit (0.710 vs. 0.658; JAFROC analysis, P = 0.0027). Mean sensitivity at lesion-based was significantly higher for interpretation with TS compared with that without TS (46.1% vs. 33.9%; P = 0.003). Mean false positive count per subject was also significantly higher for interpretation with TS than for that without TS (0.28 vs. 0.15; P < 0.001). At the subject-based, mean sensitivity was significantly higher for interpretation with TS images than that without TS images (73.2% vs. 65.4%; P = 0.003). There was no significant difference in mean specificity (0.93 vs. 0.95; P = 0.083). TS significantly improved overall performance in the detection of various bone metastases.
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Affiliation(s)
- Koji Onoue
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan. .,Department of Radiology, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Masahiro Yakami
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan.,Preemptive Medicine and Lifestyle-Related Disease Research Center, Kyoto University Hospital, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan
| | - Mizuho Nishio
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan
| | - Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan
| | - Gakuto Aoyama
- Medical Products Technology Development Center, R&D Headquarters, Canon Inc., 30-2, Shimomaruko 3-chome, Ohta-ku, Tokyo, 146-8501, Japan
| | - Keita Nakagomi
- Medical Products Technology Development Center, R&D Headquarters, Canon Inc., 30-2, Shimomaruko 3-chome, Ohta-ku, Tokyo, 146-8501, Japan
| | - Yoshio Iizuka
- Medical Products Technology Development Center, R&D Headquarters, Canon Inc., 30-2, Shimomaruko 3-chome, Ohta-ku, Tokyo, 146-8501, Japan
| | - Takeshi Kubo
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan.,Department of Radiology, Tenri Hospital, 200 Mishima, Tenri, Nara, 632-8552, Japan
| | - Yutaka Emoto
- Kyoto College of Medical Science, 1-3 Imakita, Koyamahigashi-cho, Sonobe-cho, Nantan, Kyoto, 622-0041, Japan
| | - Thai Akasaka
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan
| | - Kiyohide Satoh
- Medical Products Technology Development Center, R&D Headquarters, Canon Inc., 30-2, Shimomaruko 3-chome, Ohta-ku, Tokyo, 146-8501, Japan
| | - Hiroyuki Yamamoto
- R&D Headquarters, Canon Inc., 30-2, Shimomaruko 3-chome, Ohta-ku, Tokyo, 146-8501, Japan
| | - Hiroyoshi Isoda
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan.,Preemptive Medicine and Lifestyle-Related Disease Research Center, Kyoto University Hospital, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan
| | - Kaori Togashi
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, Kyoto, 606-8507, Japan
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Liu Y, Yang P, Pi Y, Jiang L, Zhong X, Cheng J, Xiang Y, Wei J, Li L, Yi Z, Cai H, Zhao Z. Automatic identification of suspicious bone metastatic lesions in bone scintigraphy using convolutional neural network. BMC Med Imaging 2021; 21:131. [PMID: 34481459 PMCID: PMC8417997 DOI: 10.1186/s12880-021-00662-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 08/29/2021] [Indexed: 02/08/2023] Open
Abstract
Background We aimed to construct an artificial intelligence (AI) guided identification of suspicious bone metastatic lesions from the whole-body bone scintigraphy (WBS) images by convolutional neural networks (CNNs). Methods We retrospectively collected the 99mTc-MDP WBS images with confirmed bone lesions from 3352 patients with malignancy. 14,972 bone lesions were delineated manually by physicians and annotated as benign and malignant. The lesion-based differentiating performance of the proposed network was evaluated by fivefold cross validation, and compared with the other three popular CNN architectures for medical imaging. The average sensitivity, specificity, accuracy and the area under receiver operating characteristic curve (AUC) were calculated. To delve the outcomes of this study, we conducted subgroup analyses, including lesion burden number and tumor type for the classifying ability of the CNN. Results In the fivefold cross validation, our proposed network reached the best average accuracy (81.23%) in identifying suspicious bone lesions compared with InceptionV3 (80.61%), VGG16 (81.13%) and DenseNet169 (76.71%). Additionally, the CNN model's lesion-based average sensitivity and specificity were 81.30% and 81.14%, respectively. Based on the lesion burden numbers of each image, the area under the receiver operating characteristic curve (AUC) was 0.847 in the few group (lesion number n ≤ 3), 0.838 in the medium group (n = 4–6), and 0.862 in the extensive group (n > 6). For the three major primary tumor types, the CNN-based lesion identifying AUC value was 0.870 for lung cancer, 0.900 for prostate cancer, and 0.899 for breast cancer. Conclusion The CNN model suggests potential in identifying suspicious benign and malignant bone lesions from whole-body bone scintigraphic images. Supplementary Information The online version contains supplementary material available at 10.1186/s12880-021-00662-9.
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Affiliation(s)
- Yemei Liu
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China
| | - Pei Yang
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China
| | - Yong Pi
- Machine Intelligence Laboratory, College of Computer Science, Sichuan University, Chengdu, 610065, China
| | - Lisha Jiang
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China
| | - Xiao Zhong
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China
| | - Junjun Cheng
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China
| | - Yongzhao Xiang
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China
| | - Jianan Wei
- Machine Intelligence Laboratory, College of Computer Science, Sichuan University, Chengdu, 610065, China
| | - Lin Li
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China
| | - Zhang Yi
- Machine Intelligence Laboratory, College of Computer Science, Sichuan University, Chengdu, 610065, China
| | - Huawei Cai
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China.
| | - Zhen Zhao
- Laboratory of Clinical Nuclear Medicine, Department of Nuclear Medicine, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Chengdu, 610041, China.
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Sato H, Ooigawa H, Kikkawa Y, Kurita H. A case of lung cancer with osteoblastic metastasis diagnosed with visual impairment. INTERDISCIPLINARY NEUROSURGERY 2021. [DOI: 10.1016/j.inat.2021.101244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bozzo A, Deng J, Abbas U, Bhasin R, Deodat M, Wariach S, Sanger S, Axelrod D, Masrouha K, Turcotte R, Wilson D, Ghert M. Which Bone-Modifying Agent is Associated with Better Outcomes in Patients with Skeletal Metastases from Lung Cancer? A Systematic Review and Network Meta-analysis. Clin Orthop Relat Res 2021; 479:2047-2057. [PMID: 33835092 PMCID: PMC8373570 DOI: 10.1097/corr.0000000000001749] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/05/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Lung cancer is one of the most commonly diagnosed cancers and is the leading cause of cancer-related deaths. Metastatic bone disease occurs in 20% to 40% of patients with lung cancer, and these patients often present with pain or skeletal-related events (SREs) that are associated with decreased survival. Bone-modifying agents such as denosumab or bisphosphonates are routinely used; however, to our knowledge, there has been no quantitative synthesis of randomized controlled trial data to determine the most effective pharmacologic treatment of metastatic bone disease because of lung cancer. QUESTIONS/PURPOSES We aimed to perform a network meta-analysis of randomized trials to identify the bone-modifying agent that is associated with the (1) highest overall survival, (2) longest time to SRE, (3) lowest SRE incidence, and (4) greatest likelihood of pain resolution. METHODS We conducted our study according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol and pre-registered the analysis on PROSPERO (ID: CRD42019124364). We performed a librarian-assisted search of MEDLINE, PubMed, EMBASE, Cochrane Library, and Chinese databases including China National Knowledge Infrastructure and Wanfang Data. We included randomized controlled trials reporting outcomes specifically for patients with lung cancer treated with a bisphosphonate or denosumab. SREs included pathologic fractures, spinal cord compression, hypercalcemia of malignancy, or pain resulting in surgical intervention or radiation therapy. We excluded trials exclusively reporting surrogate outcomes such as changes in bone turnover markers. Screening, data extraction, risk of bias evaluation, and Grading of Recommendations Assessment, Development, and Evaluation evaluations were performed in duplicate. We included 131 randomized controlled trials that evaluated 11,105 patients with skeletal metastases from lung cancer. The network meta-analysis was performed using a frequentist model and the R statistical software. Results are reported as relative risks or mean differences, and the I2 value is reported for heterogeneity. The P-score, a measure of ranking certainty that accounts for standard error, is reported for each outcome. Heterogeneity in the network was considered moderate for overall survival and time to SRE, mild for the incidence of SRE, and low for pain resolution. RESULTS For overall survival, denosumab was ranked above zoledronic acid and estimated to confer a mean of 3.3 months (95% CI 0.3-6.3) of increased overall survival compared with untreated patients (P-score = 89%). For the time to SRE, denosumab was ranked first with a mean of 9.1 additional SRE-free months (95% CI 6.7-11.5) compared with untreated patients (P-score = 99%), while zoledronic acid conferred an additional 4.8 SRE-free months (95% CI 3.6-6.1). Reduction in the incidence of SREs was not different between patients treated with denosumab (relative risk 0.54; 95% CI 0.33-0.87) and those treated with zoledronic acid (relative risk 0.56; 95% CI 0.46-0.67). Patients treated with the combination of ibandronate and systemic therapy were more likely to experience successful pain resolution than untreated patients (relative risk 2.4; 95% CI 1.8-3.2). CONCLUSION In this comprehensive synthesis of all available randomized controlled trial evidence guiding the pharmacologic treatment of bone metastases from lung cancer, denosumab was ranked above zoledronic acid for overall survival and time to SRE and was not different for reducing the incidence of SRE. Both were superior to no treatment for each of these outcomes. Given this, we encourage physicians to consider the use of denosumab or zoledronic acid in treating this patient population. The combination of ibandronate and systemic therapy was the most effective at reducing pain because of metastases. No cost-effectiveness analysis has yet been performed for denosumab and zoledronic acid on patients with metastatic lung cancer, and this represents an avenue for future research. LEVEL OF EVIDENCE Level I, therapeutic study.
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Affiliation(s)
- Anthony Bozzo
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Jiawen Deng
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Umaima Abbas
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Richa Bhasin
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Marisa Deodat
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Sajid Wariach
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Stephanie Sanger
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Daniel Axelrod
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Karim Masrouha
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Hamilton Health Sciences, Juravinski Hospital and Cancer Center, Hamilton, Ontario, Canada
| | - Robert Turcotte
- Division of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada
| | - David Wilson
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Hamilton Health Sciences, Juravinski Hospital and Cancer Center, Hamilton, Ontario, Canada
| | - Michelle Ghert
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Hamilton Health Sciences, Juravinski Hospital and Cancer Center, Hamilton, Ontario, Canada
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Sites of Synchronous Distant Metastases, Prognosis, and Nomogram for Small Cell Lung Cancer Patients with Bone Metastasis: A Large Cohort Retrospective Study. JOURNAL OF ONCOLOGY 2021; 2021:9949714. [PMID: 34367286 PMCID: PMC8342177 DOI: 10.1155/2021/9949714] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/20/2021] [Indexed: 11/28/2022]
Abstract
Background Small cell lung cancer (SCLC) is often associated with metastases at the time of diagnosis, and the bone is one of the most common sites. The primary aim of this study was to investigate the site of synchronous distant metastasis to other organs in SCLC patients with bone metastasis (BM) and develop a robust predictive prognostic model. Methods We retrospectively analyzed the data from patients diagnosed with SCLC with BM in the Surveillance, Epidemiology, and End Results database. Univariate and multivariate Cox analyses were used to identify independent prognostic factors. A prognostic nomogram was constructed and evaluated by calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA). Then, according to the sites of metastasis and treatment modality, all patients were stratified into several subgroups. The relationship among sites of metastasis, treatment modality, and overall survival was then analyzed. Results A total of 6253 patients were included. Independent prognostic factors for SCLC with BM were age, sex, primary site, radiotherapy, chemotherapy, brain metastasis, liver metastasis, and marital status. Calibration, ROC curves, and DCA indicated the excellent performance of the prognostic nomogram. The liver is the most common organ for extraskeletal metastases, followed by the lung. Patients with only BM had the longest mean survival time (9.30 ± 0.31 months). In the subgroup analysis, chemotherapy was an independent prognostic factor for all subgroups. In contrast, radiotherapy showed a positive effect on the prognosis of patients in all subgroups except those with bone and brain metastases and those with bone, lung, and brain metastases. Conclusions The prognostic nomogram is expected to be an accurate and personalized tool for predicting the prognosis of SCLC patients with BM. Additionally, the determination of the sites of synchronous extraskeletal metastases and the associated prognosis helps in treatment selection.
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Development of a generalizable natural language processing pipeline to extract physician-reported pain from clinical reports: Generated using publicly-available datasets and tested on institutional clinical reports for cancer patients with bone metastases. J Biomed Inform 2021; 120:103864. [PMID: 34265451 DOI: 10.1016/j.jbi.2021.103864] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 06/30/2021] [Accepted: 07/04/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The majority of cancer patients suffer from severe pain at the advanced stage of their illness. In most cases, cancer pain is underestimated by clinical staff and is not properly managed until it reaches a critical stage. Therefore, detecting and addressing cancer pain early can potentially improve the quality of life of cancer patients. The objective of this research project was to develop a generalizable Natural Language Processing (NLP) pipeline to find and classify physician-reported pain in the radiation oncology consultation notes of cancer patients with bone metastases. MATERIALS AND METHODS The texts of 1249 publicly-available hospital discharge notes in the i2b2 database were used as a training and validation set. The MetaMap and NegEx algorithms were implemented for medical terms extraction. Sets of NLP rules were developed to score pain terms in each note. By averaging pain scores, each note was assigned to one of the three verbally-declared pain (VDP) labels, including no pain, pain, and no mention of pain. Without further training, the generalizability of our pipeline in scoring individual pain terms was tested independently using 30 hospital discharge notes from the MIMIC-III database and 30 consultation notes of cancer patients with bone metastasis from our institution's radiation oncology electronic health record. Finally, 150 notes from our institution were used to assess the pipeline's performance at assigning VDP. RESULTS Our NLP pipeline successfully detected and quantified pain in the i2b2 summary notes with 93% overall precision and 92% overall recall. Testing on the MIMIC-III database achieved precision and recall of 91% and 86% respectively. The pipeline successfully detected pain with 89% precision and 82% recall on our institutional radiation oncology corpus. Finally, our pipeline assigned a VDP to each note in our institutional corpus with 84% and 82% precision and recall, respectively. CONCLUSION Our NLP pipeline enables the detection and classification of physician-reported pain in our radiation oncology corpus. This portable and ready-to-use pipeline can be used to automatically extract and classify physician-reported pain from clinical notes where the pain is not otherwise documented through structured data entry.
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Saito S, Abe T, Iino M, Aoshika T, Ryuno Y, Ohta T, Igari M, Hirai R, Kumazaki Y, Yamaguchi O, Kaira K, Kagamu H, Noda SE, Kato S. Incidence and risk factors for pneumonitis among patients with lung cancer who received immune checkpoint inhibitors after palliative thoracic radiotherapy. JOURNAL OF RADIATION RESEARCH 2021; 62:669-675. [PMID: 34121123 PMCID: PMC8273801 DOI: 10.1093/jrr/rrab051] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 05/06/2021] [Indexed: 06/12/2023]
Abstract
The aim of this study is to analyze the incidence and risk factors for pneumonitis when immune checkpoint inhibitors (ICIs) are combined with palliative thoracic radiotherapy (RT) for lung cancer. We retrospectively evaluated 29 patients with lung cancer who received ICIs after palliative thoracic RT (30 Gy in 10 fractions). Their ICIs were pembrolizumab (n = 17), nivolumab (n = 8) and atezolizumab (n = 4). Median follow-up period was 10 months. The median interval between starting RT and starting ICI was 25 days. Pneumonitis events were grade 1 (n = 10; 34%), grade 2 (n = 4; 14%) and grade 3 (n = 3; 10%). Obstructive pneumonia was significantly associated with grade ≥ 2 pneumonitis (P = 0.036). Age, sex, ICI agent, interval between RT and ICI and history of ICI before RT were not associated with grade ≥ 2 pneumonitis. Tumor volume; Brinkman index; dosimetric factors, such as lung V5, V10, V20, V30 and mean lung dose (MLD); lactate dehydrogenase; and C-reactive protein did not significantly differ between the grade ≤ 1 and grade ≥ 2 pneumonitis groups. Levels of sialylated carbohydrate antigen KL-6 were evaluated in 27 patients before RT; they significantly differed between patients with grade ≤ 2 pneumonitis (mean: 431 U/ml) and those with grade ≥ 3 pneumonitis (mean: 958 U/ml; P < 0.001). Patients who receive ICI after palliative thoracic RT should be carefully followed-up, especially those who have had obstructive pneumonia or high KL-6 levels.
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Affiliation(s)
| | - Takanori Abe
- Corresponding author: Department of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan. Fax: +81 42 984 4136; E-mail:
| | - Misaki Iino
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Tomomi Aoshika
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Yasuhiro Ryuno
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Tomohiro Ohta
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Mitsunobu Igari
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Ryuta Hirai
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Yu Kumazaki
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Ou Yamaguchi
- Respiratory Medicine, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Kyoichi Kaira
- Respiratory Medicine, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Hiroshi Kagamu
- Respiratory Medicine, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shin-ei Noda
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
| | - Shingo Kato
- Departments of Radiation Oncology, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka, Saitama 350-1298, Japan
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Chen X, Wang J, Han WL, Zhao K, Chen Z, Zhou JY, Shen YH. Sarcoidosis mimicking metastases in an echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase positive non-small-lung cancer patient: A case report. World J Clin Cases 2021; 9:3140-3146. [PMID: 33969101 PMCID: PMC8080747 DOI: 10.12998/wjcc.v9.i13.3140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/07/2021] [Accepted: 03/05/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Rearrangements of the anaplastic lymphoma kinase (ALK) gene (ALK-positive) represent an oncogenic driver in approximately 3%-5% of non-small-lung cancer (NSCLC) patients. Sarcoidosis is a multisystem disease, and its reported incidence in Asia is 1 or less per 100000 people per year. The co-occurrence of sarcoidosis and ALK-positive NSCLC is rare, and ALK-positive lung cancer is likely to spread quickly. Therefore, the co-occurrence of sarcoidosis is more easily misdiagnosed as metastatic lung cancer by radiological examination.
CASE SUMMARY A 50-year-old man had a nodule in the left superior lobe, many small nodules in left superior and right lungs, and enlarged bilateral hilar, mediastinal, and right supraclavicular lymph nodes. Computed tomography-guided pulmonary biopsy of the nodule in the left superior lobe revealed echinoderm microtubule-associated protein-like 4 gene-ALK positive NSCLC with concomitant noncaseating granuloma. This patient was treated with crizotinib. Thirty days later, a chest computed tomography scan revealed a dramatic decrease in the size of the left superior lobe nodule; however, the lesions in the right lung progressed. The right supraclavicular lymph nodes showed granulomas, and no tumor cells were identified in the specimens. The angiotensin-converting enzyme level was high. After 1 wk of methylprednisolone treatment, a significant response of all lesions was revealed. Following radical resection of the lung cancer, noncaseating granulomas were observed in both lung tissues and lymph nodes, which resulted in a diagnosis of echinoderm microtubule-associated protein-like 4-ALK positive NSCLC accompanied with sarcoidosis.
CONCLUSION Our experience illustrates that pathological evidence is needed to confirm metastatic disease, especially when some suspected metastatic lesions are negative for malignancy.
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Affiliation(s)
- Xi Chen
- Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Jie Wang
- Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Wei-Li Han
- Department of Lung Transplantation, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Kui Zhao
- Positron Emission Tomography Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Zhen Chen
- Department of Pathology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Jian-Ying Zhou
- Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
| | - Yi-Hong Shen
- Department of Respiratory Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
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Tian D, Ben X, Wang S, Zhuang W, Tang J, Xie L, Zhou H, Zhang D, Zhou Z, Shi R, Deng C, Ding Y, Zhang X, Qiao G. Surgical resection of primary tumors improved the prognosis of patients with bone metastasis of non-small cell lung cancer: a population-based and propensity score-matched study. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:775. [PMID: 34268388 PMCID: PMC8246174 DOI: 10.21037/atm-21-540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 03/05/2021] [Indexed: 02/05/2023]
Abstract
Background Most patients with lung cancer are in an advanced stage at the time of diagnosis due to occult onset. Bone is one of the most common sites of hematogenous metastasis of lung cancer. This study aimed to evaluate the impact of surgical resection of primary tumors on the prognosis of patients with bone metastasis of non-small cell lung cancer, using the Surveillance, Epidemiology, and End Results (SEER) database. Methods A total of 9,804 patients with only bone metastasis were identified from the SEER database. Propensity score matching was used to reduce the selection bias. Cancer-specific survival (CSS) and overall survival (OS) were compared between patients with or without primary tumor resection. The Cox regression model was applied to evaluate multiple prognostic factors. Results After propensity score matching, 424 patients were selected for survival analysis. No statistically significant differences were found in age, sex, race, tumor location, histology, T stage, and N stage between patients with or without surgical resection of primary tumors. The prognosis of patients who underwent surgical resection of primary tumors was significantly better than that of patients who had not undergone surgery. The surgical resection of primary tumors was an independent prognostic factor. The prognosis of patients who underwent lobectomy/bilobectomy was significantly better compared to other surgical types. Regional lymph node resection during surgery also significantly improved the prognosis of the patients. Conclusions For patients with only bone metastasis, surgical resection of primary tumors could significantly improve prognosis. Lobectomy/bilobectomy with regional lymph node resection was the best surgical strategy.
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Affiliation(s)
- Dan Tian
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaosong Ben
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Sichao Wang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Weitao Zhuang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,Shantou University Medical College, Shantou, China
| | - Jiming Tang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Liang Xie
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Haiyu Zhou
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Dongkun Zhang
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Zihao Zhou
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Ruiqing Shi
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Cheng Deng
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yu Ding
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.,The Second Clinical Medical School, Southern Medical University, Guangzhou, China
| | - Xuanye Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Guibin Qiao
- Department of Thoracic Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
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44
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Kowalski L. Functional Decline as an Indicator of Ill-Health: A Retrospective Case Study of the Process Leading to Lung Cancer. J Multidiscip Healthc 2021; 14:919-927. [PMID: 33948085 PMCID: PMC8088295 DOI: 10.2147/jmdh.s295498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 04/07/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Lung cancer claims more lives than any cancer in the world and remains difficult to diagnosis at early stages. Detecting lung cancer is challenging due to nonspecific symptom presentation. Literature was reviewed to consider functional decline as an indicator for ill-health. This study explored the process experienced from recognition in a change of health to receiving a lung cancer diagnosis from a patient’s perspective in order to examine this phase through a biopsychosocial lens. Patients and Methods A single-case design methodology was used for this study. The method of data collection was semi-structured interviews with people diagnosed with lung cancer utilizing criterion sampling. The case study was bound by diagnostic and geographical factors to frame the single-case: participants were limited to those living in Alaska diagnosed with stage III or stage IV lung cancer. Results One (n = 1) person participated in this study. Themes consistent with lung cancer detection process from a patient’s perspective include symptom denial, symptom reductionism, and gradual impact on function. Conclusion Although the number of participants was extremely limited due to the COVID-19 pandemic at the time of recruitment, this case study suggests a decline in function present prior to being diagnosed with lung cancer. Opportunities exist within the provider and patient interface to promote earlier detection include educating medical providers to ask specific, closed-ended, non-disease related functional questions to ascertain more details and a holistic representation of patients’ health. Raising public awareness of lung cancer symptoms, such as fatigue and dyspnea, is also warranted.
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Affiliation(s)
- Lesleigh Kowalski
- Department of Family Medicine, University of Washington, Seattle, WA, 98195, USA
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45
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Surgical Intervention for Patients With Spinal Metastasis From Lung Cancer: A Retrospective Study of 87 Cases. Clin Spine Surg 2021; 34:E133-E140. [PMID: 32868534 DOI: 10.1097/bsd.0000000000001062] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 07/24/2020] [Indexed: 12/21/2022]
Abstract
STUDY DESIGN This was a retrospective study. OBJECTIVE Evaluate the prognosis and surgical outcomes of patients with spinal metastasis from lung cancer undergoing surgical treatment. SUMMARY OF BACKGROUND DATA The spine is the most common site of metastatic lesions in patients with lung cancer. There have been a few studies, all small cohorts studying prognosis and surgical outcomes and the results were discordant. MATERIALS AND METHODS A retrospective study on a prospectively collected database was conducted. Data collected were the following: age, tobacco use, tumor histology, American Spinal Injury Association score, revised Tokuhashi score, ambulatory status, perioperative complications, postoperative adjuvant treatment, and survival time. Univariate and multivariate analyses were performed to identify the prognostic factors of survival. RESULTS The authors studied 87 patients with a mean age of 61.3±1.9 years. Median survival was 4.1±0.8 months. Twenty-eight patients (32.2%) lived >6 months and 14 patients (16.1%) lived >12 months. The medical complication rate was 13.8% and the surgical complication rate was 5.7%. The 30-day mortality rate was 4.6%. Univariate analysis showed tobacco use, revised Tokuhashi score, preoperative and postoperative American Spinal Injury Association score, postoperative walking ability, postoperative radiotherapy, and postoperative chemotherapy were prognostic factors. There was no significant difference in survival between adenoma lung cancers, nonadenoma lung cancers, and small cell lung cancers (P=0.51). Multivariate analysis revealed tobacco use, revised Tokuhashi score, postoperative walking ability, postoperative radiotherapy, and postoperative chemotherapy affected the survival. CONCLUSIONS This is the largest reported study of patients with spinal metastasis from lung cancer undergoing spinal surgery. It is the first study showing that tobacco use has a negative impact on survival. Spinal surgery improves the quality of life and offers nonambulatory patients a high chance of regaining walking ability with an acceptable risk of complications.
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46
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Kreps LM, Addison CL. Targeting Intercellular Communication in the Bone Microenvironment to Prevent Disseminated Tumor Cell Escape from Dormancy and Bone Metastatic Tumor Growth. Int J Mol Sci 2021; 22:ijms22062911. [PMID: 33805598 PMCID: PMC7998601 DOI: 10.3390/ijms22062911] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/06/2021] [Accepted: 03/11/2021] [Indexed: 02/07/2023] Open
Abstract
Metastasis to the bone is a common feature of many cancers including those of the breast, prostate, lung, thyroid and kidney. Once tumors metastasize to the bone, they are essentially incurable. Bone metastasis is a complex process involving not only intravasation of tumor cells from the primary tumor into circulation, but extravasation from circulation into the bone where they meet an environment that is generally suppressive of their growth. The bone microenvironment can inhibit the growth of disseminated tumor cells (DTC) by inducing dormancy of the DTC directly and later on following formation of a micrometastatic tumour mass by inhibiting metastatic processes including angiogenesis, bone remodeling and immunosuppressive cell functions. In this review we will highlight some of the mechanisms mediating DTC dormancy and the complex relationships which occur between tumor cells and bone resident cells in the bone metastatic microenvironment. These inter-cellular interactions may be important targets to consider for development of novel effective therapies for the prevention or treatment of bone metastases.
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Affiliation(s)
- Lauren M. Kreps
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Christina L. Addison
- Cancer Therapeutics Program, Ottawa Hospital Research Institute, Ottawa, ON K1H 8L6, Canada;
- Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, ON K1H 8L6, Canada
- Department of Medicine, University of Ottawa, Ottawa, ON K1H 8L6, Canada
- Correspondence: ; Tel.: +1-613-737-7700
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47
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Wu K, Huang YH. A rare case report: an inextricable shoulder pain as the exclusive presentation of lung adenocarcinoma with metastasis over contralateral clavicle. Eur J Med Res 2021; 26:23. [PMID: 33640029 PMCID: PMC7912515 DOI: 10.1186/s40001-021-00493-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/11/2021] [Indexed: 11/26/2022] Open
Abstract
Background Lung cancer is the fourth most common form of the tumor spreading to the bone. Among all patients of lung carcinoma, the most common sites of bone metastasis are vertebrae, ribs, and pelvis. By comparison, the clavicle is an extremely rare site of metastases not only in the population of lung cancers but among all types of tumors. Enlightened by this existing fact, we would like to share our experience of management of an uncommon clavicular metastasis and illuminate the obscure mechanism of its scarcity. Case presentation A 56-year-old female without any preknown systemic disease had suffered from a sole intermittent right shoulder pain without any other discomfort for 3 months. Physical examination performed at our orthopedic department showed tenderness over the right distal third of the clavicle with limited range-of-motion of the right shoulder. EGFR-mutated lung adenocarcinoma with metastasis over the right clavicle resulting in a pathological fracture was diagnosed according to the result of the incisional biopsy. Concurrent chemoradiation therapy accompanied with target therapy was performed. Eighteen months postoperatively, the clavicle pain was found to be subsided with stationary bony lesion under appropriate medication and palliative radiotherapy during the subsequent follow-up. Conclusions The clavicle is an exceedingly unusual site with 2% of metastatic involvement of all type of tumors and only 1% among the population of carcinoma of lung due to its scanty red marrow and sparse vascular supply. Despite the unpleasant prognosis of clavicular metastasis from primary lung adenocarcinoma, promising quality of life is achievable under multidisciplinary management.
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Affiliation(s)
- Karl Wu
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC. .,Department of Materials and Textiles, Oriental Institute of Technology, New Taipei City, Taiwan, ROC.
| | - Yu-Hao Huang
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan, ROC
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48
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Ma M, Ren W, Li M, Niu C, Dai J. Dosimetric comparison of coplanar and noncoplanar beam arrangements for radiotherapy of patients with lung cancer: A meta-analysis. J Appl Clin Med Phys 2021; 22:34-43. [PMID: 33634946 PMCID: PMC8035566 DOI: 10.1002/acm2.13197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 01/06/2021] [Accepted: 01/18/2021] [Indexed: 12/25/2022] Open
Abstract
Purpose Radiotherapy plays an important role in the treatment of lung cancer, and both coplanar beam arrangements (CBA) and noncoplanar beam arrangements (NCBA) are adopted in clinic practice. The aim of this study is to answer the question whether NCBA are dosimetrically superior to CBA. Methods Search of publications were performed in PubMed, Web of Science, and the Cochran Library till March 2020. The searching terms were as following: ((noncoplanar) or ("non coplanar") or ("4pi") or ("4π")) AND (("lung cancer") or ("lung tumor") or ("lung carcinoma")) AND ((radiotherapy) or ("radiation therapy")). The included studies and extracted data were manually screened. All forest and funnel plots were carried out with RevMan software, and the Egger’s regression asymmetry tests were conducted with STATA software. Results Nine studies were included and evaluated in the meta‐analysis and treatment plans were designed with both CBA and NCBA. For the planning target volumes (PTV), D98%, D2%, the conformity index (CI), and the gradient index (GI) had no statistically significant difference. For organs‐at‐risk (OAR), V20 of the whole lung and the maximum dose of the spinal cord were significantly reduced in NCBA plans compared with CBA ones. But V10, V5, and mean dose of the whole lung, the maximum dose of the heart, and the maximum dose of the esophagus exhibited no significant difference when the two types of beam arrangements were compared. Conclusion After combining multicenter results, NCBA plans have significant advantages in reducing V20 of the whole lung and max dose of spinal cord.
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Affiliation(s)
- Min Ma
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenting Ren
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minghui Li
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chuanmeng Niu
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianrong Dai
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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49
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Xiong A, Li C, Xu J, Yang X, Nie W, Zhong H, Chu T, Zhang W, Zhong R, Pan F, Shen Y, Lou Y, Zhang B, Han B, Zhang X. Solid subtype predicts early bone metastases in sensitive EGFR-mutated lung adenocarcinoma patients after surgery. Lung Cancer 2021; 154:124-130. [PMID: 33657514 DOI: 10.1016/j.lungcan.2021.02.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 02/17/2021] [Accepted: 02/21/2021] [Indexed: 12/21/2022]
Abstract
This study aimed to explore the prognostic significance of solid pattern for bone metastases (BM) in epidermal growth factor receptor (EGFR)-mutated lung adenocarcinoma patients after surgery. A total of 237 stage I-III lung adenocarcinoma patients with EGFR mutation were analyzed after procedure. The patients were divided into four groups: the solid-present patients with BM, the solid-absent patients with BM, the solid-present patients without BM and the solid-absent patients without BM. The bone disease-free survival (bDFS), systemic disease-free survival (DFS) and overall survival (OS) were assessed. The results revealed that the patients with solid pattern had shorter DFS (15 months vs. 19 months; P < 0.001) and OS (47 months vs. 77 months; P = 0.001). Moreover, bDFS of solid-present patients was significantly shorter than solid-absent patients (27 months vs. 14 months; P < 0.001). In addition, patients with solid component had worsened bDFS, no matter with BM as first-site development (12.5 months vs. 16.5 months; P = 0.016) or non-first-site development (16.5 months vs. 45.5 months; P < 0.001). These findings suggested that solid pattern predicted worse DFS and OS and also showed shortened interval between surgery and BM.
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Affiliation(s)
- Anning Xiong
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Changhui Li
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Jianlin Xu
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Xiaohua Yang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Wei Nie
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Hua Zhong
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Tianqing Chu
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Wei Zhang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Runbo Zhong
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Feng Pan
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Yinchen Shen
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Yuqing Lou
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Bo Zhang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China
| | - Baohui Han
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China.
| | - Xueyan Zhang
- Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiao Tong University, China.
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50
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Han L, Yao Z, Xie L, Li D, Wang C, Yang Y, Yang J, Huang Z, Li K, Zhang Y, Ye L, Tan Z, Liu Y, Chen Q, Wang T, Yang Z. Transcriptome Sequencing reveals the expressed profiles of mRNA and ncRNAs and regulate network via ceRNA mediated molecular mechanism of lung adenocarcinoma bone metastasis in Xuanwei. Transl Cancer Res 2021; 10:73-87. [PMID: 35116241 PMCID: PMC8799022 DOI: 10.21037/tcr-20-2376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 11/20/2020] [Indexed: 12/25/2022]
Abstract
Background The most ordinary subtype of lung cancer is lung adenocarcinoma (LuAC), which is characterized by strong metastatic ability. And LuAC rates in Xuanwei leads to the poor prognosis and high death rate. In this study, we systematically explored the molecular mechanism of LuAC bone metastasis in Xuanwei by transcriptome sequencing. Methods RNA Sequencing was conducted to explore the noncoding RNAs (ncRNAs) expression profiles in primary LuAC and LuAC bone metastasis. We identified differentially expressed mRNAs (DEmRNAs), miRNAs (DEmiRNAs), lncRNAs (DElncRNAs) and circRNAs (DEcircRNAs). Bioinformatics analyses the possible relationships and functions of the LuAC bone metastasis-related competing endogenous RNA (ceRNA). And qRT-PCR was performed to evaluate the expression of these differently expressed genes in serum. Results A total of 2,141 DEmRNAs, 43 DEmiRNAs, 136 DElncRNAs and 706 DEcircRNAs were identified in the Xuanwei patients with primary LuAC vs. LuAC bone metastasis, respectively. The circRNA/miRNA/mRNA and lncRNA/miRNA/mRNA networks of LuAC in Xuanwei with bone metastasis were built, and the gene expression mechanisms regulated by ncRNAs were unveiled via the ceRNA regulatory networks. We observe that lncRNA (ADAMTS9-AS2, TEX41, DLEU2, LINC00152)-miR-223-3p-SCARB1 and hsa_circ_0000053-miR-196a-5p/miR-196b-5p-HOXA5 ceRNA networks might play an important role in bone metastasis of Xuanwei LuAC. Conclusions We comprehensively identified ceRNA regulatory networks of LuAC in Xuanwei with bone metastasis as well as revealed the contribution of different ncRNAs expression profiles. Our data demonstrate the association between mRNAs and ncRNAs in the metastasis mechanism of LuAC in Xuanwei with bone metastasis.
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Affiliation(s)
- Lei Han
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Zhihong Yao
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Lin Xie
- Department of Medical Oncology, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Dongqi Li
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Cao Wang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Yihao Yang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Jifei Yang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Zeyong Huang
- Medical School, Kunming University of Science and Technology, Kunming, China
| | - Kecheng Li
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Ya Zhang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Lijuan Ye
- Department of Pathology, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Zunxian Tan
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Yan Liu
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Qiuyun Chen
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Tiying Wang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
| | - Zuozhang Yang
- Bone and Soft Tissue Tumors Research Center of Yunnan Province, Department of Orthopaedics, The Third Affiliated Hospital of Kunming Medical University (Cancer Hospital of Yunnan Province), Kunming, China
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