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Sun W, Zhang P, Zhang W, Xu J, Huang Y, Li L. Synchronous Mutual Learning Network and Asynchronous Multi-Scale Embedding Network for miRNA-Disease Association Prediction. Interdiscip Sci 2024; 16:532-553. [PMID: 38310628 DOI: 10.1007/s12539-023-00602-x] [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: 10/09/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 02/06/2024]
Abstract
MicroRNA (miRNA) serves as a pivotal regulator of numerous cellular processes, and the identification of miRNA-disease associations (MDAs) is crucial for comprehending complex diseases. Recently, graph neural networks (GNN) have made significant advancements in MDA prediction. However, these methods tend to learn one type of node representation from a single heterogeneous network, ignoring the importance of multiple network topologies and node attributes. Here, we propose SMDAP (Sequence hierarchical modeling-based Mirna-Disease Association Prediction framework), a novel GNN-based framework that incorporates multiple network topologies and various node attributes including miRNA seed and full-length sequences to predict potential MDAs. Specifically, SMDAP consists of two types of MDA representation: following a heterogeneous pattern, we construct a transfer learning-like synchronous mutual learning network to learn the first MDA representation in conjunction with the miRNA seed sequence. Meanwhile, following a homogeneous pattern, we design a subgraph-inspired asynchronous multi-scale embedding network to obtain the second MDA representation based on the miRNA full-length sequence. Subsequently, an adaptive fusion approach is designed to combine the two branches such that we can score the MDAs by the downstream classifier and infer novel MDAs. Comprehensive experiments demonstrate that SMDAP integrates the advantages of multiple network topologies and node attributes into two branch representations. Moreover, the area under the receiver operating characteristic curve is 0.9622 on DB1, which is a 5.06% increase from the baselines. The area under the precision-recall curve is 0.9777, which is a 7.33% increase from the baselines. In addition, case studies on three human cancers validated the predictive performance of SMDAP. Overall, SMDAP represents a powerful tool for MDA prediction.
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Affiliation(s)
- Weicheng Sun
- College of Informatics, Huazhong Agricultural University, Wuhan, 430070, China
| | - Ping Zhang
- College of Informatics, Huazhong Agricultural University, Wuhan, 430070, China
| | - Weihan Zhang
- College of Informatics, Huazhong Agricultural University, Wuhan, 430070, China
| | - Jinsheng Xu
- College of Informatics, Huazhong Agricultural University, Wuhan, 430070, China
| | | | - Li Li
- College of Informatics, Huazhong Agricultural University, Wuhan, 430070, China.
- Hubei Hongshan Laboratory, Huazhong Agricultural University, Wuhan, 430070, China.
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Fink CA, Weykamp F, Adeberg S, Bozorgmehr F, Christopoulos P, Lang K, König L, Hörner-Rieber J, Thomas M, Steins M, El-Shafie RA, Rieken S, Bernhardt D, Debus J. Comorbidity in limited disease small-cell lung cancer: Age-adjusted Charlson comorbidity index and its association with overall survival following chemoradiotherapy. Clin Transl Radiat Oncol 2023; 42:100665. [PMID: 37564923 PMCID: PMC10410177 DOI: 10.1016/j.ctro.2023.100665] [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: 04/22/2023] [Revised: 07/03/2023] [Accepted: 07/22/2023] [Indexed: 08/12/2023] Open
Abstract
Background Combined, platinum-based thoracic chemoradiotherapy (TCR) is the current state-of-the-art treatment for patients with limited disease (LD) small-cell lung cancer (SCLC). There is only limited data available regarding the effect of comorbidities on survival following TRC. The purpose of this study is to assess the age-adjusted Charlson comorbidity index (ACCI) as a predictor of overall survival in LD-SCLC patients undergoing TCR. Patients and methods We retrospectively analyzed 367 SCLC patients diagnosed with LD-SCLC who received TCR between 2003 and 2017. We evaluated the ACCI (n = 348) as a predictor of overall survival (OS). In this cohort, 322 patients (88%) received platinum-based TCR (either cisplatin or carboplatin), and 37 (10%) patients received vincristine based TCR. Median radiation dose was 60 Gy (range 24-66 Gy). Additionally, 83% of patients (n = 303) received prophylactic cranial irradiation (PCI, 30 Gy in 2 Gy fractions). Kaplan-Meier survival analysis was performed for OS. For comparison of survival curves, Log-rank (Mantel-Cox) test was used. Univariate and multivariate Cox proportional-hazards ratios (HRs) were used to assess the influence of cofactors on OS. Results Patients with an ACCI > 6 had a significantly shorter OS compared with patients with an ACCI ≤ 6 (median 11 vs. 20 months; p = 0.005). Univariate analysis for OS revealed a statistically significant effect for ACCI > 6 (HR 1.7; 95% CI 1.2-2.4; p = 0.003), PCI (HR 0.5; 95% CI 0.3-0.7; p < 0.001), and Karnofsky performance status ≤ 70% (KPS) (HR 1.4; 95% CI 1.1-1.90; p = 0.015). In multivariate analysis, OS was significantly associated with PCI (HR 0.6; 95% CI 0.4-0.9; p = 0.022) and ACCI > 6 (HR 1.5; 95% CI 1.0-2.1; p = 0.049). Conclusion Comorbidity is significantly associated with survival in patients with LD-SCLC undergoing TCR. The ACCI may be a valuable tool to identify patients with a shorter survival and thus might be used for risk stratification and oncological decision making.
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Affiliation(s)
- Christoph A. Fink
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
| | - Fabian Weykamp
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian Adeberg
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Marburg Ion-Beam Therapy Center (MIT), Department of Radiation Oncology, Heidelberg University Hospital, Marburg, Germany
- Department of Radiation Oncology, Marburg University Hospital, Marburg, Germany
| | - Farastuk Bozorgmehr
- National Center for Tumor diseases (NCT), Heidelberg, Germany
- Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Heidelberg, Germany Translational Lung Research Centre Heidelberg (TLRC-H), Germany
- Member of the German Centre for Lung Research (DZL), Heidelberg, Germany
| | - Petros Christopoulos
- Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Heidelberg, Germany Translational Lung Research Centre Heidelberg (TLRC-H), Germany
- Member of the German Centre for Lung Research (DZL), Heidelberg, Germany
| | - Kristin Lang
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
| | - Laila König
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
| | - Juliane Hörner-Rieber
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
| | - Michael Thomas
- Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Heidelberg, Germany Translational Lung Research Centre Heidelberg (TLRC-H), Germany
- Member of the German Centre for Lung Research (DZL), Heidelberg, Germany
| | - Martin Steins
- Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Heidelberg, Germany Translational Lung Research Centre Heidelberg (TLRC-H), Germany
| | - Rami A. El-Shafie
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Goettingen, Goettingen, Germany
- Comprehensive Cancer Center Niedersachsen, partner site Goettingen, Germany
| | - Stefan Rieken
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
- Department of Radiation Oncology, University Hospital Goettingen, Goettingen, Germany
- Comprehensive Cancer Center Niedersachsen, partner site Goettingen, Germany
| | - Denise Bernhardt
- Department of Radiation Oncology, Technical University, Klinikum rechts der Isar, Munich, Germany
| | - Jürgen Debus
- University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg, Germany
- Heidelberg Institute of Radiation Oncology (HIRO), Germany
- National Center for Tumor diseases (NCT), Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany
- German Cancer Consortium (DKTK), partner site Heidelberg, Germany
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Paiva CE, Preto DD, de Lima C, Paiva BSR. To Treat or Not to Treat? Dilemmas when Deciding on Antineoplastic Treatment in Patients With Far Advanced Cancers. Cancer Control 2023; 30:10732748231176639. [PMID: 37178323 PMCID: PMC10184254 DOI: 10.1177/10732748231176639] [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: 03/27/2023] [Revised: 04/16/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Patients with advanced cancers and their oncologists are often faced with difficult treatment decisions, especially when there are borderline situations of expected benefit or increased risk of complications. In this narrative review, we will explore the decision-making process for patients with advanced cancers and provide insights on how to approach this complex task, while didactically dividing the oncologist's assessments according to a mnemonic rule of the ABCDE of therapeutic decision-making. Part A (advanced cancer) recalls that the rule is to be used specifically for advanced cancers. Parts B (potential benefits) and C (clinical conditions and risks) represents the traditional risk vs benefit scale. In Part D, we discuss ways to identify and understand patients' desires, values, preferences, and beliefs. The prognostic estimation, from Part E, may function as an "adjust" for the antineoplastic treatment decision-making. Treatment decisions need to be conducted by skilled oncologists, in a patient-centered care, aiming to promote valuable oncology with lower rates of aggressive care.
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Affiliation(s)
- Carlos Eduardo Paiva
- Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, Brazil
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Brazil
| | - Daniel D’Almeida Preto
- Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, Brazil
- Department of Clinical Oncology, Barretos Cancer Hospital, Barretos, Brazil
| | - Crislaine de Lima
- Palliative Care and Quality of Life Research Group (GPQual), Barretos Cancer Hospital, Barretos, Brazil
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Disparities in Comorbidities in Lung Cancer: Findings From the Behavioral Risk Factor Surveillance System. Cancer Nurs 2022; 45:E883-E889. [PMID: 35728011 DOI: 10.1097/ncc.0000000000001049] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND In persons with lung cancer, sex and race are independent predictors of comorbidities and are associated survival. It is unclear how comorbidity profiles differ across sex and race. OBJECTIVE The objective was to examine comorbidity differences between men and women and Blacks and Whites. METHODS Data from the 2014, 2016, 2017, and 2018 Behavioral Risk Factor Surveillance System were analyzed using descriptive statistics, χ2 test of independence, and multiple logistic regression. Variables included sociodemographics and comorbidities. RESULTS Among individuals with lung cancer (N = 594), men were more likely to experience a heart attack (odds ratio [OR], 3.59; 95% confidence interval [CI], 1.62-7.96) and diabetes (OR, 2.83; 95% CI, 1.57-5.10) and less likely to experience depressive disorder (OR, 0.360; 95% CI, 0203-0.637). Black men (OR, 28.57; 95% CI, 9.22-88.55) and women (OR, 2.48; 95% CI, 1.02-6.05) were more likely to have a history of stroke. CONCLUSION Findings show that there may be differences in patterns of comorbidities among individuals with lung cancer. As we continue to move toward individualized medicine in cancer care, future work in this area should examine social determinants of health and how they may influence the patterns of comorbidities. IMPLICATION FOR NURSES Although nurses may be aware that certain groups have an increased risk for certain comorbid conditions, this study highlights what groups with lung cancer may be more likely to have certain comorbidities. Nurses can assess individuals for comorbidities and provide education on how to manage comorbidities during cancer treatment.
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Banfill K, Abravan A, van Herk M, Sun F, Franks K, McWilliam A, Faivre-Finn C. Heart dose and cardiac comorbidities influence death with a cardiac cause following hypofractionated radiotherapy for lung cancer. Front Oncol 2022; 12:1007577. [PMID: 36303830 PMCID: PMC9592751 DOI: 10.3389/fonc.2022.1007577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/16/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundThere is increasing evidence of cardiac toxicity of thoracic radiotherapy however, it is difficult to draw conclusions on cardiac dose constraints due to the heterogeneity of published studies. Moreover, few studies record data on cause of death. The aim of this paper is to investigate the relationship between conventional cardiac dosimetric parameters and death with cardiac causes using data from the UK national cause of death registry.MethodsData on cancer diagnosis, treatment and cause of death following radical lung cancer radiotherapy were obtained from Public Health England for all patients treated at the Christie NHS Foundation Trust between 1/1/10 and 31/12/16. Individuals with metastatic disease and those who received multiple courses of thoracic radiotherapy where excluded. All patients who received > 45Gy in 20 fractions were included. Cardiac cause of death was defined as the following ICD-10 codes on death certificate: I20-I25; I30-I32; I34-I37; I40-I52. Cardiac V5Gy, V30Gy, V50Gy and mean heart dose (MHD) were extracted. Cumulative incidence of death with cardiac causes were plotted for each cardiac dosimetric parameter. Multi-variable Fine and Gray competing risk analysis was used to model predictors for cardiac death with non-cardiac death as a competing risk.ResultsCardiac dosimetric parameters were available for 967 individuals, 110 died with a cardiac cause (11.4%). Patients with a cardiac comorbidity had an increased risk of death with a cardiac cause compared with those without a cardiac comorbidity (2-year cumulative incidence 21.3% v 6.2%, p<0.001). In patients with a pre-existing cardiac comorbidity, heart V30Gy ≥ 15% was associated with higher cumulative incidence of death with a cardiac cause compared to patients with heart V30Gy <15% (2-year rate 25.8% v 17.3%, p=0.05). In patients without a cardiac comorbidity, after adjusting for tumour and cardiac risk factors, MHD (aHR 1.07, 1.01-1.13, p=0.021), heart V5Gy (aHR 1.01, 1-1.13, p=0.05) and heart V30Gy (aHR 1.04, 1-1.07, p=0.039) were associated with cardiac death.ConclusionThe effect of cardiac radiation dose on cardiac-related death following thoracic radiotherapy is different in patients with and without cardiac comorbidities. Therefore patients’ cardiovascular risk factors should be identified and managed alongside radiotherapy for lung cancer.
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Affiliation(s)
- Kathryn Banfill
- Department of Clinical Oncology, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
- *Correspondence: Kathryn Banfill,
| | - Azadeh Abravan
- Department of Clinical Oncology, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Marcel van Herk
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Fei Sun
- St James’s Institute of Oncology, Leeds Cancer Centre, Leeds, United Kingdom
| | - Kevin Franks
- St James’s Institute of Oncology, Leeds Cancer Centre, Leeds, United Kingdom
| | - Alan McWilliam
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
| | - Corinne Faivre-Finn
- Department of Clinical Oncology, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
- Division of Cancer Sciences, University of Manchester, Manchester, United Kingdom
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Shan X, Tian X, Wang B, He L, Zhang L, Xue B, Liu C, Zheng L, Yu Y, Luo B. A global burden assessment of lung cancer attributed to residential radon exposure during 1990-2019. INDOOR AIR 2022; 32:e13120. [PMID: 36305076 DOI: 10.1111/ina.13120] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/30/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to explore the spatial and temporal trends of lung cancer burden attributable to residential radon exposure at the global, regional, and national levels. Based on the Global Burden of Disease Study (GBD) 2019, we collected the age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life rate (ASDR) of lung cancer attributable to residential radon exposure from 1990 to 2019. The Joinpoint model was used to calculate the annual average percentage change (AAPC) to evaluate the trend of ASMR and ASDR from 1990 to 2019. The locally weighted regression (LOESS) was used to estimate the relationship of the socio-demographic index (SDI) with ASMR and ASDR. In 2019, the global ASMR and ASDR for lung cancer attributable to residential radon exposure were 1.03 (95% CI: 0.20, 2.00) and 22.66 (95% CI: 4.49, 43.94) per 100 000 population, which were 15.6% and 23.0% lower than in 1990, respectively. According to the estimation, we found the lung cancer burden attributable to residential radon exposure declined significantly in high and high-middle SDI regions, but substantially increased in middle and low-middle SDI regions from 1990 to 2019. Across age and sex, the highest burden of lung cancer attributable to residential radon exposure was found in males and elderly groups. In conclusion, the global burden of lung cancer attributable to residential radon exposure showed a declining trend from 1990 to 2019, but a relatively large increase was found in the middle SDI regions. In 2019, the burden of lung cancer attributable to residential radon exposure remained high, particularly in males, the elderly, and high-middle SDI regions compared with other groups.
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Affiliation(s)
- Xiaobing Shan
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoyu Tian
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Bo Wang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Li He
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ling Zhang
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Baode Xue
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ce Liu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Ling Zheng
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Yunhui Yu
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Bin Luo
- Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
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Abravan A, Price G, Banfill K, Marchant T, Craddock M, Wood J, Aznar MC, McWilliam A, van Herk M, Faivre-Finn C. Role of Real-World Data in Assessing Cardiac Toxicity After Lung Cancer Radiotherapy. Front Oncol 2022; 12:934369. [PMID: 35928875 PMCID: PMC9344971 DOI: 10.3389/fonc.2022.934369] [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: 05/02/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Radiation-induced heart disease (RIHD) is a recent concern in patients with lung cancer after being treated with radiotherapy. Most of information we have in the field of cardiac toxicity comes from studies utilizing real-world data (RWD) as randomized controlled trials (RCTs) are generally not practical in this field. This article is a narrative review of the literature using RWD to study RIHD in patients with lung cancer following radiotherapy, summarizing heart dosimetric factors associated with outcome, strength, and limitations of the RWD studies, and how RWD can be used to assess a change to cardiac dose constraints.
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Affiliation(s)
- Azadeh Abravan
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Gareth Price
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Kathryn Banfill
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Tom Marchant
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Matthew Craddock
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Joe Wood
- Christie Medical Physics and Engineering, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Marianne C. Aznar
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Alan McWilliam
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Marcel van Herk
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
| | - Corinne Faivre-Finn
- Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
- Department of Radiotherapy Related Research, The Christie National Health Service (NHS) Foundation Trust, Manchester, United Kingdom
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Cacicedo J, Casquero F, Navarro A, Martinez-Indart L, del Hoyo O, Frías A, de Zarate RO, Büchser D, Gómez-Iturriaga A, San Miguel I, Suarez F, Barcena A, López-Guerra JL. Prospective multicentre analysis of the therapeutic approach and prognostic factors determining overall survival in elderly patients with non-small-cell lung carcinoma treated with curative intent. BJR Open 2022; 4:20210058. [PMID: 36105426 PMCID: PMC9459856 DOI: 10.1259/bjro.20210058] [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: 09/24/2021] [Revised: 03/01/2022] [Accepted: 05/24/2022] [Indexed: 11/05/2022] Open
Abstract
Objective To analyse patterns of treatment with curative intent commonly used in elderly patients with locally advanced non-small-cell lung carcinoma (NSCLC) and predictive factors of overall survival in routine clinical practice. Methods This multicentre prospective study included consecutive patients aged ≥65 years old diagnosed with NSCLC between February 2014 and January 2018. Inclusion criteria: age ≥65 years, stage IIIA/IIIB NSCLC. Treatment decisions were taken by a multidisciplinary committee. Kaplan-Meier curves and log-rank test were used to identify which clinical/treatment-associated variables, or pre-treatment quality of life (QOL) considering EORTC QLQ-C30 (and LC13 module) were predictive of overall survival. Results A total of 139 patients were recruited. Median follow-up was 9.9 months (1.18-57.36 months) with a median survival of 14 months (range 11-17 months). In the group>75-year-old patients, the committee recommended chemotherapy and sequential radiotherapy (55.6%) or radiotherapy alone (22.2%), rather than surgery (3.7%) or concomitant radiochemotherapy (16.5%). However, in 65- to 75-year-old patients, surgery and concomitant radiochemotherapy were recommended in half of cases (p=0.003). Regarding multivariate analysis, the risk of death was higher in patients with pre-existing heart disease (p=0.002), low score for physical functioning (p=0.0001), symptoms of dysphagia (p=0,01), chest pain (p=0.001), and those not undergoing surgical treatment (p=0.024). Conclusions Patients >75 years received more conservative treatments. Surgery improved survival and should be carefully considered, regardless of patient age. Comorbidities and poor baseline QOL are predictive of shorter survival. Advances in knowledge Measuring these parameters before treatment may help us to define a population of frail patients with a poorer prognosis to facilitate decision making in clinical practice.
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Affiliation(s)
| | - Francisco Casquero
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - Arturo Navarro
- Department of Radiation Oncology, Instituto Catalan de Oncología, Avinguda de la Gran vía de l'Hospitalet, 199-203, 08907 L'Hospitalet de Llobregat, Barcelona, Spain
| | - Lorea Martinez-Indart
- Department of Bioinformatics and Statistics, Cruces University Hospital/Biocruces Health Research Institute, Barakaldo, Spain
| | - Olga del Hoyo
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - Andere Frías
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - Roberto Ortiz de Zarate
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - David Büchser
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | | | - Iñigo San Miguel
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - Fernan Suarez
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - Adrian Barcena
- Department of Radiation Oncology, Cruces University Hospital/Biocruces Bizkaia Health Research Institute, Vizcaya, Spain
| | - Jose Luis López-Guerra
- Department of Radiation Oncology, Hospital Virgen Del Rocío, Av Manuel Siurot, Sevilla, Spain
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Dai Q, Wang Z, Liu Z, Duan X, Song J, Guo M. Predicting miRNA-disease associations using an ensemble learning framework with resampling method. Brief Bioinform 2021; 23:6470964. [PMID: 34929742 DOI: 10.1093/bib/bbab543] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/05/2021] [Accepted: 11/25/2021] [Indexed: 12/11/2022] Open
Abstract
MOTIVATION Accumulating evidences have indicated that microRNA (miRNA) plays a crucial role in the pathogenesis and progression of various complex diseases. Inferring disease-associated miRNAs is significant to explore the etiology, diagnosis and treatment of human diseases. As the biological experiments are time-consuming and labor-intensive, developing effective computational methods has become indispensable to identify associations between miRNAs and diseases. RESULTS We present an Ensemble learning framework with Resampling method for MiRNA-Disease Association (ERMDA) prediction to discover potential disease-related miRNAs. Firstly, the resampling strategy is proposed for building multiple different balanced training subsets to address the challenge of sample imbalance within the database. Then, ERMDA extracts miRNA and disease feature representations by integrating miRNA-miRNA similarities, disease-disease similarities and experimentally verified miRNA-disease association information. Next, the feature selection approach is applied to reduce the redundant information and increase the diversity among these subsets. Lastly, ERMDA constructs an individual learner on each subset to yield primitive outcomes, and the soft voting method is introduced for making the final decision based on the prediction results of individual learners. A series of experimental results demonstrates that ERMDA outperforms other state-of-the-art methods on both balanced and unbalanced testing sets. Besides, case studies conducted on the three human diseases further confirm the ERMDA's prediction capability for identifying potential disease-related miRNAs. In conclusion, these experimental results demonstrate that our method can serve as an effective and reliable tool for researchers to explore the regulatory role of miRNAs in complex diseases.
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Affiliation(s)
- Qiguo Dai
- School of Computer Science and Engineering, Dalian Minzu University, 116600, Dalian, China.,SEAC Key Laboratory of Big Data Applied Technology, Dalian Minzu University, 116600, Dalian, China
| | - Zhaowei Wang
- School of Computer Science and Engineering, Dalian Minzu University, 116600, Dalian, China.,SEAC Key Laboratory of Big Data Applied Technology, Dalian Minzu University, 116600, Dalian, China
| | - Ziqiang Liu
- School of Computer Science and Engineering, Dalian Minzu University, 116600, Dalian, China.,SEAC Key Laboratory of Big Data Applied Technology, Dalian Minzu University, 116600, Dalian, China
| | - Xiaodong Duan
- SEAC Key Laboratory of Big Data Applied Technology, Dalian Minzu University, 116600, Dalian, China
| | - Jinmiao Song
- SEAC Key Laboratory of Big Data Applied Technology, Dalian Minzu University, 116600, Dalian, China
| | - Maozu Guo
- School of Electrical and Information Engineering, Beijing University of Civil Engineering and Architecture, 100044, Beijing, China
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10
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Pang S, Zhuang Y, Wang X, Wang F, Qiao S. EOESGC: predicting miRNA-disease associations based on embedding of embedding and simplified graph convolutional network. BMC Med Inform Decis Mak 2021; 21:319. [PMID: 34789236 PMCID: PMC8597227 DOI: 10.1186/s12911-021-01671-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A large number of biological studies have shown that miRNAs are inextricably linked to many complex diseases. Studying the miRNA-disease associations could provide us a root cause understanding of the underlying pathogenesis in which promotes the progress of drug development. However, traditional biological experiments are very time-consuming and costly. Therefore, we come up with an efficient models to solve this challenge. RESULTS In this work, we propose a deep learning model called EOESGC to predict potential miRNA-disease associations based on embedding of embedding and simplified convolutional network. Firstly, integrated disease similarity, integrated miRNA similarity, and miRNA-disease association network are used to construct a coupled heterogeneous graph, and the edges with low similarity are removed to simplify the graph structure and ensure the effectiveness of edges. Secondly, the Embedding of embedding model (EOE) is used to learn edge information in the coupled heterogeneous graph. The training rule of the model is that the associated nodes are close to each other and the unassociated nodes are far away from each other. Based on this rule, edge information learned is added into node embedding as supplementary information to enrich node information. Then, node embedding of EOE model training as a new feature of miRNA and disease, and information aggregation is performed by simplified graph convolution model, in which each level of convolution can aggregate multi-hop neighbor information. In this step, we only use the miRNA-disease association network to further simplify the graph structure, thus reducing the computational complexity. Finally, feature embeddings of both miRNA and disease are spliced into the MLP for prediction. On the EOESGC evaluation part, the AUC, AUPR, and F1-score of our model are 0.9658, 0.8543 and 0.8644 by 5-fold cross-validation respectively. Compared with the latest published models, our model shows better results. In addition, we predict the top 20 potential miRNAs for breast cancer and lung cancer, most of which are validated in the dbDEMC and HMDD3.2 databases. CONCLUSION The comprehensive experimental results show that EOESGC can effectively identify the potential miRNA-disease associations.
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Affiliation(s)
- Shanchen Pang
- College of Computer Science and Technology, China University of Petroleum, Qingdao, China
| | - Yu Zhuang
- College of Computer Science and Technology, China University of Petroleum, Qingdao, China
| | - Xinzeng Wang
- College of Mathematics and Systems Science, Shandong University of Science and Technology, Qingdao, China
| | - Fuyu Wang
- College of Computer Science and Technology, China University of Petroleum, Qingdao, China
| | - Sibo Qiao
- College of Computer Science and Technology, China University of Petroleum, Qingdao, China
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11
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Zhou C, Li S, Liu J, Chu Q, Miao L, Cai L, Cai X, Chen Y, Cui F, Dong Y, Dong W, Fang W, He Y, Li W, Li M, Liang W, Lin G, Lin J, Lin X, Liu H, Liu M, Mu X, Hu Y, Hu J, Jin Y, Li Z, Qin Y, Ren S, Sun G, Shen Y, Su C, Tang K, Wu L, Wang M, Wang H, Wang K, Wang Y, Wang P, Wang H, Wang Q, Wang Z, Xie X, Xie Z, Xu X, Xu F, Yang M, Yang B, Yi X, Ye X, Ye F, Yu Z, Yue D, Zhang B, Zhang J, Zhang J, Zhang X, Zhang W, Zhao W, Zhu B, Zhu Z, Zhong W, Bai C, Chen L, Han B, Hu C, Lu S, Li W, Song Y, Wang J, Zhou C, Zhou J, Zhou Y, Saito Y, Ichiki Y, Igai H, Watanabe S, Bravaccini S, Fiorelli A, Petrella F, Nakada T, Solli P, Tsoukalas N, Kataoka Y, Goto T, Berardi R, He J, Zhong N. International consensus on severe lung cancer-the first edition. Transl Lung Cancer Res 2021; 10:2633-2666. [PMID: 34295668 PMCID: PMC8264326 DOI: 10.21037/tlcr-21-467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/17/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Chengzhi Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Shiyue Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jun Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qian Chu
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Liyun Miao
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Linbo Cai
- Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Xiuyu Cai
- Department of General Internal Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yu Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Fei Cui
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yuchao Dong
- Department of Pulmonary and Critical Care Medicine, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Wen Dong
- Department of Oncology, Hainan Cancer Hospital, Haikou, 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
| | - Yong He
- Department of Respiratory Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Weifeng Li
- Department of Respiratory Medicine, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China
| | - Min Li
- Department of Respiratory Medicine, Xiangya Cancer Center, Xiangya Hospital, Central South University, Changsha, China
| | - Wenhua Liang
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Gen Lin
- Department of Thoracic Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jie Lin
- Department of Medical Oncology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xinqing Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Hongbing Liu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Ming Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xinlin Mu
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Yi Hu
- Department of Medical Oncology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Jie Hu
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yang Jin
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziming Li
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yinyin Qin
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Shengxiang Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China
| | - Gengyun Sun
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yihong Shen
- Department of Respiratory Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chunxia Su
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kejing Tang
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, China
| | - Lin Wu
- Thoracic Medicine Department II, Hunan Cancer Hospital, Changsha, China
| | - Mengzhao Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Huijuan Wang
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Kai Wang
- Department of Respiratory Medicine, Fourth Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Yuehong Wang
- Department of Respiratory Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ping Wang
- Department of Respiratory and Critical Care Medicine, the Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Hongmei Wang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qi Wang
- Department of Respiratory Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhijie Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong Xie
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zhanhong Xie
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xin Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Fei Xu
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Meng Yang
- Department of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
| | - Boyan Yang
- Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangjun Yi
- Department of Medical Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoqun Ye
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Ye
- Department of Medical Oncology, The first affiliated hospital of Xiamen University, Xiamen, China
| | - Zongyang Yu
- Department of Pulmonary and Critical Care Medicine, The th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China
| | - Dongsheng Yue
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Bicheng Zhang
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jian Zhang
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jianqing Zhang
- Second Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiaoju Zhang
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Zhao
- Department of Pulmonary and Critical Care Medicine, The General Hospital of People's Liberation Army, Beijing, China
| | - Bo Zhu
- Institute of Cancer, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Zhengfei Zhu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wenzhao Zhong
- Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chunxue Bai
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liangan Chen
- Department of Respiratory, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Baohui Han
- Department of Pulmonology, Shanghai Chest Hospital, Shanghai, China
| | - Chengping Hu
- Department of Pulmonary Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Shun Lu
- Department of Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Song
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing, China
| | - Jie Wang
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Caicun Zhou
- Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jianying Zhou
- Department of Respiratory Diseases, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China
| | - Yanbin Zhou
- Department of Internal Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuichi Saito
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshinobu Ichiki
- Department of General Thoracic Surgery, National Hospital Organization, Saitama Hospital, Wako, Japan
| | - Hitoshi Igai
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sara Bravaccini
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, Universitàdella Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Petrella
- Division of Thoracic Surgery, IRCCS European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Takeo Nakada
- Division of Thoracic Surgery, Department of Surgery, the Jikei University School of Medicine, Tokyo, Japan
| | - Piergiorgio Solli
- Department of Cardio-Thoracic Surgery and Hearth & Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan
| | - Taichiro Goto
- Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, Yamanashi, Japan
| | - Rossana Berardi
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi di Ancona, Italy
| | - Jianxing He
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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12
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Zhu D, Ding R, Ma Y, Chen Z, Shi X, He P. Comorbidity in lung cancer patients and its association with hospital readmission and fatality in China. BMC Cancer 2021; 21:557. [PMID: 34001011 PMCID: PMC8130249 DOI: 10.1186/s12885-021-08272-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Accepted: 04/29/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Comorbidity has been established as one of the important predictors of poor prognosis in lung cancer. In this study, we analyzed the prevalence of main comorbidities and its association with hospital readmission and fatality for lung cancer patients in China. METHODS The analyses are based on China Urban Employees' Basic Medical insurance (UEBMI) and Urban Residents' Basic Medical Insurance (URBMI) claims database and Hospital Information System (HIS) Database in the Beijing University Cancer Hospital in 2013-2016. We use Elixhauser Comorbidity Index to identify main types of comorbidities. RESULTS Among 10,175 lung cancer patients, 32.2% had at least one comorbid condition, and the proportion of patients with one, two, and three or more comorbidities was 21.7, 8.3 and 2.2%, respectively. The most prevalent comorbidities identified were other malignancy (7.5%), hypertension (5.4%), pulmonary disease (3.7%), diabetes mellitus (2.5%), cardiovascular disease (2.4%) and liver disease (2.3%). The predicted probability of having comorbidity and the predicted number of comorbidities was higher for middle elderly age groups, and then decreased among patients older than 85 years. Comorbidity was positively associated with increased risk of 31-days readmission and in-hospital death. CONCLUSION Our study is the first to provide an overview of comorbidity among lung cancer patients in China, underlines the necessity of incorporating comorbidity in the design of screening, treatment and management of lung cancer patients in China.
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Affiliation(s)
- Dawei Zhu
- China Center for Health Development Studies, Peking University, Beijing, 100191, China
| | - Ruoxi Ding
- China Center for Health Development Studies, Peking University, Beijing, 100191, China
| | - Yong Ma
- China Health Insurance Research Association, Beijing, 100013, China
| | - Zhishui Chen
- Department of Medical Insurance, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, 100142, China
| | - Xuefeng Shi
- School of Management, Beijing University of Chinese Medicine, Beijing, 100029, China.
| | - Ping He
- China Center for Health Development Studies, Peking University, Beijing, 100191, China.
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13
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Chu Y, Wang X, Dai Q, Wang Y, Wang Q, Peng S, Wei X, Qiu J, Salahub DR, Xiong Y, Wei DQ. MDA-GCNFTG: identifying miRNA-disease associations based on graph convolutional networks via graph sampling through the feature and topology graph. Brief Bioinform 2021; 22:6261915. [PMID: 34009265 DOI: 10.1093/bib/bbab165] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/02/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Accurate identification of the miRNA-disease associations (MDAs) helps to understand the etiology and mechanisms of various diseases. However, the experimental methods are costly and time-consuming. Thus, it is urgent to develop computational methods towards the prediction of MDAs. Based on the graph theory, the MDA prediction is regarded as a node classification task in the present study. To solve this task, we propose a novel method MDA-GCNFTG, which predicts MDAs based on Graph Convolutional Networks (GCNs) via graph sampling through the Feature and Topology Graph to improve the training efficiency and accuracy. This method models both the potential connections of feature space and the structural relationships of MDA data. The nodes of the graphs are represented by the disease semantic similarity, miRNA functional similarity and Gaussian interaction profile kernel similarity. Moreover, we considered six tasks simultaneously on the MDA prediction problem at the first time, which ensure that under both balanced and unbalanced sample distribution, MDA-GCNFTG can predict not only new MDAs but also new diseases without known related miRNAs and new miRNAs without known related diseases. The results of 5-fold cross-validation show that the MDA-GCNFTG method has achieved satisfactory performance on all six tasks and is significantly superior to the classic machine learning methods and the state-of-the-art MDA prediction methods. Moreover, the effectiveness of GCNs via the graph sampling strategy and the feature and topology graph in MDA-GCNFTG has also been demonstrated. More importantly, case studies for two diseases and three miRNAs are conducted and achieved satisfactory performance.
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Affiliation(s)
- Yanyi Chu
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, China
| | - Xuhong Wang
- School of Electronic, Information and Electrical Engineering (SEIEE), Shanghai Jiao Tong University, China
| | - Qiuying Dai
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, China
| | - Yanjing Wang
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, China
| | - Qiankun Wang
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, China
| | - Shaoliang Peng
- College of Computer Science and Electronic Engineering, Hunan University, China
| | | | | | - Dennis Russell Salahub
- Department of Chemistry, University of Calgary, Fellow Royal Society of Canada and Fellow of the American Association for the Advancement of Science, China
| | - Yi Xiong
- State Key Laboratory of Microbial Metabolism, Shanghai-Islamabad-Belgrade Joint Innovation Center on Antibacterial Resistances, Joint International Research Laboratory of Metabolic & Developmental Sciences and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200030, P.R. China
| | - Dong-Qing Wei
- State Key Laboratory of Microbial Metabolism, Shanghai-Islamabad-Belgrade Joint Innovation Center on Antibacterial Resistances, Joint International Research Laboratory of Metabolic & Developmental Sciences and School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200030, P.R. China
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14
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Jiang H, Jiang W, Tan L, Yu Q, Liu F, Huang Y, He J, Zhou S. The predictive value of pretreatment haemoglobin-to-red cell distribution width ratio for overall survival of patients with advanced non-small cell lung cancer: a propensity score matching analysis. J Int Med Res 2021; 49:3000605211004229. [PMID: 33823630 PMCID: PMC8033480 DOI: 10.1177/03000605211004229] [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] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the prognostic value of pretreatment haemoglobin-to-red cell
distribution width radio (HRR) in predicting overall survival (OS) in
patients with advanced non-small cell lung cancer (NSCLC). Methods This retrospective study analysed patients with advanced NSCLC. Kaplan–Meier
survival analysis and Cox proportional hazards regression analysis were
conducted to evaluate the predictive value of HRR for OS. A propensity
matching analysis was used to reduce the impact of other confounding factors
on the results. Results A total of 448 patients were enrolled in the study. The median HRR was 0.984,
which was used as the cut-off value. Regardless of matching or not, a lower
HRR was correlated with an unfavourable risk of death. After propensity
matching, univariate and multivariate analysis showed that HRR was an
independent factor for the prognosis of NSCLC (hazard ratio [HR] 1.55, 95%
confidence interval [CI] 1.17, 2.04; HR 1.57, 95% CI, 1.17, 2.10;
respectively). Kaplan–Meier analysis showed that low HRR was associated with
shortened OS. The relationship between HRR and the risk of death was
consistent across all patient subgroups after stratification by subgroup
analysis. Conclusions These findings showed that a lower pretreatment HRR could be a potentially
valuable prognostic factor in patients with advanced NSCLC.
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Affiliation(s)
- Huiqin Jiang
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Wei Jiang
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Liping Tan
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Qitao Yu
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Feiwen Liu
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Yucong Huang
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Jianbo He
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
| | - Shaozhang Zhou
- Department of Respiratory Oncology, 117981Guangxi Cancer Hospital and Guangxi Medical University Affiliated Cancer Hospital, Nanning, Guangxi Zhuang Autonomous Region, China *Huiqin Jiang, Wei Jiang contributed equally to this work
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15
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Banfill K, Giuliani M, Aznar M, Franks K, McWilliam A, Schmitt M, Sun F, Vozenin MC, Faivre Finn C. Cardiac Toxicity of Thoracic Radiotherapy: Existing Evidence and Future Directions. J Thorac Oncol 2021; 16:216-227. [PMID: 33278607 PMCID: PMC7870458 DOI: 10.1016/j.jtho.2020.11.002] [Citation(s) in RCA: 103] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 11/01/2020] [Accepted: 11/02/2020] [Indexed: 12/13/2022]
Abstract
The impact of radiotherapy on the heart has become an area of interest in recent years. Many different cardiac dose-volume constraints have been associated with cardiac toxicity and survival; however, no consistent constraint has been found. Many patients undergoing treatment for lung cancer have risk factors for cardiovascular disease or known cardiac comorbidities; however, there is little evidence on the effects of radiotherapy on the heart in these patients. We aim to provide a summary of the existing literature on cardiac toxicity of lung cancer radiotherapy, propose strategies to avoid and manage cardiac toxicity, and suggest avenues for future research.
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Affiliation(s)
- Kathryn Banfill
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom.
| | - Meredith Giuliani
- Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - Marianne Aznar
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Kevin Franks
- Leeds Cancer Centre, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom; Radiotherapy Research Group, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Alan McWilliam
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Matthias Schmitt
- Cardiovascular Division, Manchester University Foundation Trust, North West Heart Centre, Wythenshawe Campus, Manchester, United Kingdom
| | - Fei Sun
- Leeds Cancer Centre, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom; Radiotherapy Research Group, Leeds Institute of Medical Research at St James's, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Marie Catherine Vozenin
- Laboratory of Radiation Oncology/DO/Radio-Oncology/CHUV, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Corinne Faivre Finn
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom; The Christie NHS Foundation Trust, Manchester, United Kingdom
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16
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Bossert J, Ludwig M, Wronski P, Koetsenruijter J, Krug K, Villalobos M, Jacob J, Walker J, Thomas M, Wensing M. Lung cancer patients' comorbidities and attendance of German ambulatory physicians in a 5-year cross-sectional study. NPJ Prim Care Respir Med 2021; 31:2. [PMID: 33510177 PMCID: PMC7844218 DOI: 10.1038/s41533-020-00214-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/07/2020] [Indexed: 12/16/2022] Open
Abstract
The majority of lung cancer patients are diagnosed with an advanced stage IV, which has short survival time. Many lung cancer patients have comorbidities, which influence treatment and patients’ quality of life. The aim of the study is to describe comorbidities in incident lung cancer patients and explore their attendance of ambulatory care physicians in Germany. In the observed period, 13,111 persons were first diagnosed with lung cancer (1-year incidence of 36.4 per 100,000). The mean number of comorbidities over 4 quarters was 30.77 ± 13.18; mean Charlson Comorbidity Index was 6.66 ± 2.24. In Germany, ambulatory care physicians most attended were general practitioners (2.6 quarters with contact within 4 quarters). Lung cancer was diagnosed by a general practitioner in 38% of the 13,111 incident patients. The average number of ambulatory care physician contacts over 4 quarters was 35.82 ± 27.31. High numbers of comorbidities and contacts in ambulatory care are common in patients with lung cancer. Therefore, a cross-sectoral and interdisciplinary approach is required for effective, patient-centred care. This was a 5-year cross-sectoral study, based on the InGef research database, which covers anonymized health insurance data of 7.2 million individuals in Germany. Incident lung cancer patients in a 5-year period (2013–2017) were identified. Descriptive statistics were calculated for sociodemographic characteristics, comorbidities, and attendance of ambulatory care physicians.
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Affiliation(s)
- Jasmin Bossert
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Marion Ludwig
- InGef - Institute for Applied Health Research Berlin GmbH, Spittelmarkt 12, 10117, Berlin, Germany
| | - Pamela Wronski
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Jan Koetsenruijter
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Katja Krug
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Matthias Villalobos
- Department of Thoracic Oncology, University Hospital Heidelberg and Translational Lung Research Centre Heidelberg (TLRC-H), Member of the German Centre for Lung Research (DZL), Heidelberg, Germany
| | - Josephine Jacob
- InGef - Institute for Applied Health Research Berlin GmbH, Spittelmarkt 12, 10117, Berlin, Germany
| | - Jochen Walker
- InGef - Institute for Applied Health Research Berlin GmbH, Spittelmarkt 12, 10117, Berlin, Germany
| | - Michael Thomas
- Department of Thoracic Oncology, University Hospital Heidelberg and Translational Lung Research Centre Heidelberg (TLRC-H), Member of the German Centre for Lung Research (DZL), Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
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17
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Bossert J, Forstner J, Villalobos M, Siegle A, Jung C, Deis N, Thomas M, Wensing M, Krug K. What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study. BMJ Open 2020; 10:e036495. [PMID: 32753449 PMCID: PMC7406021 DOI: 10.1136/bmjopen-2019-036495] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patients with lung cancer with comorbidity often require treatment and care by different health professionals, in different settings and at different points in time during the course of the disease. In order to organise and coordinate healthcare efficiently, effective information exchange and collaboration between all involved care providers are required. The aim of this study was to assess the views of patients with advanced lung cancer with comorbidity regarding coordination of treatment and care across healthcare sectors. METHODS This qualitative study, as part of the main study, The Heidelberg Milestones Communication Approach, used face-to-face guide-based semistructured interviews with patients with advanced lung cancer and their informal caregivers to explore cross-sectoral information exchange and collaboration in Germany. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA. RESULTS In 15 interviews, participants reported that cross-sectoral collaboration functioned well, if treatments occurred as planned. However, treatment gaps were experienced, especially regarding medication and regimen. As a result, participants felt insecure and obliged to take responsibility for the coordination of healthcare. Patients reported to be in favour of an active patient role but felt that healthcare coordination should still be a responsibility of a care provider. A more intensive information exchange, potentially by using an electronic platform, was expected to strengthen cross-sectoral collaboration. CONCLUSION Patients with lung cancer are uncertain about their role in the coordination of treatment and care across healthcare sectors. Healthcare providers should be more aware of care recipients' willingness of taking on a more active role in healthcare coordination. TRIAL REGISTRATION NUMBER DRKS00013469.
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Affiliation(s)
- Jasmin Bossert
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Johanna Forstner
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Matthias Villalobos
- Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany
| | - Anja Siegle
- Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany
| | - Corinna Jung
- Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany
- Department Pädagogik und Soziales, MSB Medical School Berlin GmbH, Berlin, Germany
| | - Nicole Deis
- Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany
| | - Michael Thomas
- Department of Thoracic Oncology, Thoraxklinik-Heidelberg gGmbH, Heidelberg, Baden-Württemberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Katja Krug
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
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18
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Bossert J, Wensing M, Thomas M, Villalobos M, Jung C, Siegle A, Hagelskamp L, Deis N, Jünger J, Krug K. Implementation of the milestones communication approach for patients with limited prognosis: evaluation of intervention fidelity. BMC Palliat Care 2020; 19:21. [PMID: 32070311 PMCID: PMC7029500 DOI: 10.1186/s12904-020-0527-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 02/14/2020] [Indexed: 11/27/2022] Open
Abstract
Background Despite improvements in diagnostics and therapy, the majority of lung tumours are diagnosed at advanced stage IV with a poor prognosis. Due to the nature of an incurable disease, patients need to engage in shared decision making on advance care planning. To implement this in clinical practice, effective communication between patients, caregivers and healthcare professionals is essential. The Heidelberg Milestones Communication Approach (MCA) is delivered by a specifically trained interprofessional tandem and consists of four milestone conversations (MCs) at pivotal times in the disease trajectory. MC 1 (Diagnosis): i.e. prognosis; MC 2 (Stable disease): i.e. prognostic awareness; MC 3 (Progression): i.e. reassessment; MC 4 (Best supportive care): i.e. end of treatment. In between MCs, follow-up calls are carried out to sustain communication. This study aimed to assess to what extent the MCA was implemented as planned and consolidated in specialized oncology practice. Methods A prospective observational process evaluation study was conducted, which focused on the implementation fidelity of the MCA. All MCs during two assessment periods were included. We analysed all written records of the conversations, which are part of the routine documentation during MCs and follow-up calls. Adherence to key aspects of the manual was documented on structured checklists at the beginning of the implementation of the MCA and after 6 months. The analysis was descriptive. Differences between the two assessment periods are analysed with chi-square tests. Results A total of 133 MCs and 54 follow-up-calls (t1) and of 172 MCs and 92 follow-up calls (t2) were analysed. MC 2 were the most frequently completed conversations (n = 51 and n = 47). Advance care planning was discussed in 26 and 13% of MC 2 in the respective assessment periods; in 31 and 47% of MC 2, prognostic awareness was recorded. The most frequently documented topic in the follow-up calls was the physical condition in patients (82 and 83%). Conclusion The implementation of a trajectory-specific communication concept was largely successful. Additional studies are needed to understand how fidelity could be further improved. Trial registration DRKS00013469 / Date of registration: 22.12.2017.
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Affiliation(s)
- Jasmin Bossert
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
| | - Michel Wensing
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
| | - Michael Thomas
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Matthias Villalobos
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Corinna Jung
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Anja Siegle
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Laura Hagelskamp
- Department of Thoracic Oncology, Thoraxklinik Heidelberg, Heidelberg University Hospital, Röntgenstraße 1, D-69126, Heidelberg, Germany
| | - Nicole Deis
- Institute of Medical and Pharmaceutical Proficiency Assessment, Malakoff Passage, Rheinstraße 4, D-55116, Mainz, Germany
| | - Jana Jünger
- Institute of Medical and Pharmaceutical Proficiency Assessment, Malakoff Passage, Rheinstraße 4, D-55116, Mainz, Germany
| | - Katja Krug
- Department of General Practice and Health Service Research, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany
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19
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Chen X, Xie D, Zhao Q, You ZH. MicroRNAs and complex diseases: from experimental results to computational models. Brief Bioinform 2019; 20:515-539. [PMID: 29045685 DOI: 10.1093/bib/bbx130] [Citation(s) in RCA: 401] [Impact Index Per Article: 80.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/13/2017] [Indexed: 12/22/2022] Open
Abstract
Plenty of microRNAs (miRNAs) were discovered at a rapid pace in plants, green algae, viruses and animals. As one of the most important components in the cell, miRNAs play a growing important role in various essential and important biological processes. For the recent few decades, amounts of experimental methods and computational models have been designed and implemented to identify novel miRNA-disease associations. In this review, the functions of miRNAs, miRNA-target interactions, miRNA-disease associations and some important publicly available miRNA-related databases were discussed in detail. Specially, considering the important fact that an increasing number of miRNA-disease associations have been experimentally confirmed, we selected five important miRNA-related human diseases and five crucial disease-related miRNAs and provided corresponding introductions. Identifying disease-related miRNAs has become an important goal of biomedical research, which will accelerate the understanding of disease pathogenesis at the molecular level and molecular tools design for disease diagnosis, treatment and prevention. Computational models have become an important means for novel miRNA-disease association identification, which could select the most promising miRNA-disease pairs for experimental validation and significantly reduce the time and cost of the biological experiments. Here, we reviewed 20 state-of-the-art computational models of predicting miRNA-disease associations from different perspectives. Finally, we summarized four important factors for the difficulties of predicting potential disease-related miRNAs, the framework of constructing powerful computational models to predict potential miRNA-disease associations including five feasible and important research schemas, and future directions for further development of computational models.
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Affiliation(s)
- Xing Chen
- School of Information and Control Engineering, China University of Mining and Technology, Xuzhou, China
| | - Di Xie
- School of Mathematics, Liaoning University
| | - Qi Zhao
- School of Mathematics, Liaoning University
| | - Zhu-Hong You
- Xinjiang Technical Institute of Physics and Chemistry, Chinese Academy of Science
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20
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Affiliation(s)
- Cecilia L Benz
- Department of Surgery, University of North Dakota, Grand Forks, ND, USA
| | - Cornelius Dyke
- Department of Surgery, University of North Dakota, Grand Forks, ND, USA.,Sanford Health, Fargo, ND, USA
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21
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Mignard X, Ruppert AM, Lavolé A, Vieira T, Rozensztajn N, Cadranel J, Wislez M. Is chemotherapy rechallenge feasible in advanced-stage non-small-cell lung cancer? Bull Cancer 2019; 106:725-733. [PMID: 31202557 DOI: 10.1016/j.bulcan.2019.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/02/2018] [Accepted: 04/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Despite recent progress, non-small cell lung cancer (NSCLC) first-line treatment remains a platinum-based doublet in most cases. No guidelines exist beyond third line. Chemotherapy rechallenge is an option, but little data is available in NSCLC. Our study aims to describe patients who underwent chemotherapy rechallenge while assessing its efficacy and safety. METHODS Consecutive patients with advanced-stage NSCLC receiving first-line treatment in Tenon hospital in 2011 were included, with a 5-year follow-up. Patients were analyzed according to chemotherapy rechallenge or not. Chemotherapy rechallenge was defined as re-initiation of a previously administered chemotherapy agent at any point in the treatment sequence, with at least one treatment regimen between first use and rechallenge. RESULTS Of 149 patients, 18 underwent chemotherapy rechallenge (12%). They were younger (56 vs. 61 years, P=0.04), mostly women (61% vs. 30%, P=0.02), with lepidic adenocarcinoma (23% vs. 3.5%, P=0.03), a better general state of health (100% performance status 0-1 vs. 74%, P=0.04), and fewer cardiovascular comorbidities (16% vs. 42%, P=0.04). They were more likely to have received a receptor tyrosine kinase inhibitor treatment (89% vs. 43%, P=0.0003). Progression-free survival was longer at first use than at rechallenge (median 9.2 vs. 2.7 months, P=0.002). No increased toxicity was observed at rechallenge compared to first use. Finally, a subsequent line of treatment was given after rechallenge in 61% of the patients. CONCLUSION Patients eligible for chemotherapy rechallenge were those with good prognostic factors. Chemotherapy rechallenge may provide a well-tolerated additional line of treatment, with decreased efficacy compared to its first application.
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Affiliation(s)
- Xavier Mignard
- Sorbonne université, UPMC Univ Paris 06, GRC n(o) 04, Theranoscan, 75252 Paris, France
| | - Anne-Marie Ruppert
- AP-HP, Tenon university hospital, pneumology department, 75970 Paris, France
| | - Armelle Lavolé
- AP-HP, Tenon university hospital, pneumology department, 75970 Paris, France
| | - Thibault Vieira
- Institut Mutualiste Montsouris, pneumology department, Paris, France
| | | | - Jacques Cadranel
- AP-HP, Tenon university hospital, pneumology department, 75970 Paris, France
| | - Marie Wislez
- AP-HP, Tenon university hospital, pneumology department, 75970 Paris, France; Sorbonne université, UPMC Univ Paris 06, GRC n(o) 04, Theranoscan, 75252 Paris, France.
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22
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Lu J, Zhong H, Chu T, Zhang X, Li R, Sun J, Zhong R, Yang Y, Alam MS, Lou Y, Xu J, Zhang Y, Wu J, Li X, Zhao X, Li K, Lu L, Han B. Role of anlotinib-induced CCL2 decrease in anti-angiogenesis and response prediction for nonsmall cell lung cancer therapy. Eur Respir J 2019; 53:13993003.01562-2018. [PMID: 30578392 DOI: 10.1183/13993003.01562-2018] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/29/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Anlotinib has been demonstrated in clinical trials to be effective in prolonging the progression-free survival (PFS) and overall survival (OS) of refractory advanced nonsmall cell lung cancer (NSCLC) patients. However, the underlying molecular mechanisms and predictive biomarkers of anlotinib are still unclear. METHODS A retrospective analysis of anlotinib administered to 294 NSCLC patients was performed to screen for underlying biomarkers of anlotinib-responsive patients. Transcriptome and functional assays were performed to understand the antitumour molecular mechanisms of anlotinib. Changes in serum CCL2 levels were analysed to examine the correlation of the anlotinib response between responders and nonresponders. RESULTS Anlotinib therapy was beneficial for prolonging OS in NSCLC patients harbouring positive driver gene mutations, especially patients harbouring the epithelial growth factor receptor (EGFR)T790M mutation. Moreover, anlotinib inhibited angiogenesis in an NCI-H1975-derived xenograft model via inhibiting CCL2. Finally, anlotinib-induced serum CCL2 level decreases were associated with the benefits of PFS and OS in refractory advanced NSCLC patients. CONCLUSIONS Our study reports a novel anti-angiogenesis mechanism of anlotinib via inhibiting CCL2 in an NCI-H1975-derived xenograft model and suggests that changes in serum CCL2 levels may be used to monitor and predict clinical outcomes in anlotinib-administered refractory advanced NSCLC patients using third-line therapy or beyond.
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Affiliation(s)
- Jun Lu
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Central laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Institute of Immunology, Shanghai Jiao Ton University School of Medicine, Shanghai, China
| | - Hua Zhong
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Institute of Immunology, Shanghai Jiao Ton University School of Medicine, Shanghai, China
| | - Tianqing Chu
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xueyan Zhang
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Rong Li
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jiayuan Sun
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Runbo Zhong
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yuqin Yang
- Central laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Mohammad Shah Alam
- Bio-ID Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yuqing Lou
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jianlin Xu
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yanwei Zhang
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Wu
- School of Life Science, East China Normal University, Shanghai, China
| | - Xiaowei Li
- Bio-ID Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaodong Zhao
- Shanghai Center for Systems Biomedicine, Shanghai Jiao Tong University, Shanghai, China.,These authors contributed equally: Jun Lu and Hua Zhong
| | - Kai Li
- Dept of Thoracic Oncology, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.,These authors contributed equally: Jun Lu and Hua Zhong
| | - Liming Lu
- Central laboratory, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,Shanghai Institute of Immunology, Shanghai Jiao Ton University School of Medicine, Shanghai, China.,These authors contributed equally: Xiaodong Zhao, Kai Li, Liming Lu and Baohui Han
| | - Baohui Han
- Dept of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China.,These authors contributed equally: Jun Lu and Hua Zhong
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23
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Bernhardt D, Aufderstrasse S, König L, Adeberg S, Bozorgmehr F, Christopoulos P, Shafie RAE, Hörner-Rieber J, Kappes J, Thomas M, Herth F, Steins M, Debus J, Rieken S. Impact of inflammatory markers on survival in patients with limited disease small-cell lung cancer undergoing chemoradiotherapy. Cancer Manag Res 2018; 10:6563-6569. [PMID: 30555261 PMCID: PMC6280890 DOI: 10.2147/cmar.s180990] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Systemic inflammation appears to play a role in the progression of numerous solid tumors by promoting tumor proliferation. Our current study aimed to evaluate the role of inflammatory markers in limited disease (LD) small-cell lung cancer (SCLC) patients undergoing thoracic chemoradiotherapy (TCR). Patients and methods We retrospectively analyzed a total number of 350 SCLC patients diagnosed with LD SCLC who received TCR between 1999 and 2017 and had available blood tests within 2 weeks prior to the start of TCR. Serum C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase (LDH), hemoglobin (Hb) levels, and platelet count (Pc) were evaluated as potential inflammatory markers. Kaplan–Meier survival analysis was performed for overall survival (OS). For comparison of survival curves, the log-rank (Mantel–Cox) test was used. Univariate and multivariate Cox proportional HRs were used to assess the influence of cofactors on OS. Results Univariate analysis for OS revealed a statistically significant effect for LDH >400 U/L (HR 2.05 U/L; 95% CI 1.29–3.26 U/L; P=0.002), prophylactic cranial irradiation (PCI; HR 0.58; 95% CI 0.40–0.85; P=0.005), CRP >50 mg/L (HR 1.49 mg/L; 95% CI 1.05–2.10 mg/L; P=0.026), and Karnofsky performance scale (KPS) <70% (HR 1.35%; 95% CI 1.02–1.80%; P=0.035). NLR, age (>70 years), Hb levels, and Pc did not influence survival. In multivariate analysis, OS was significantly affected by PCI (HR 0.64; 95% CI 0.43–0.94; P=0.026), LDH >400 U/L (HR 1.91 U/L; 95% CI 1.21–3.05 U/L; P=0.006), and CRP >50 mg/L (HR 1.43 mg/L; 95% CI 1.01–2.04 mg/L; P=0.045). KPS (≤70%) did not influence survival in multivariate analysis. Conclusion Elevated CRP and LDH seem to be the independent prognostic factors for OS in LD SCLC patients undergoing TCR. However, elevated NLR was not found to be an independent prognostic factor for OS if taken prior to TCR. LDH and CRP are easily available blood tests and do not require additional resources for routine use and could be useful for clinical decision making.
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Affiliation(s)
- Denise Bernhardt
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany,
| | - Sophie Aufderstrasse
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany,
| | - Laila König
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany,
| | - Sebastian Adeberg
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany, .,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Farastuk Bozorgmehr
- Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Translational Lung Research Centre Heidelberg (TLRC-H), Heidelberg, Germany.,German Centre for Lung Research (DZL), Heidelberg, Germany
| | - Petros Christopoulos
- Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Translational Lung Research Centre Heidelberg (TLRC-H), Heidelberg, Germany.,German Centre for Lung Research (DZL), Heidelberg, Germany
| | - Rami A El Shafie
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany,
| | - Juliane Hörner-Rieber
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany,
| | - Jutta Kappes
- German Centre for Lung Research (DZL), Heidelberg, Germany.,Department of Pneumology, Thoraxklinik, Heidelberg University, Heidelberg, Germany
| | - Michael Thomas
- Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Translational Lung Research Centre Heidelberg (TLRC-H), Heidelberg, Germany.,German Centre for Lung Research (DZL), Heidelberg, Germany
| | - Felix Herth
- German Centre for Lung Research (DZL), Heidelberg, Germany.,Department of Pneumology, Thoraxklinik, Heidelberg University, Heidelberg, Germany
| | - Martin Steins
- Department of Thoracic Oncology, Thoraxklinik, Heidelberg University, Translational Lung Research Centre Heidelberg (TLRC-H), Heidelberg, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany, .,Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stefan Rieken
- Department of Radiation Oncology, University Hospital Heidelberg, Heidelberg, Germany, .,Heidelberg Institute of Radiation Oncology (HIRO), Heidelberg, Germany, .,Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany,
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Rich A, Baldwin D, Alfageme I, Beckett P, Berghmans T, Brincat S, Burghuber O, Corlateanu A, Cufer T, Damhuis R, Danila E, Domagala-Kulawik J, Elia S, Gaga M, Goksel T, Grigoriu B, Hillerdal G, Huber RM, Jakobsen E, Jonsson S, Jovanovic D, Kavcova E, Konsoulova A, Laisaar T, Makitaro R, Mehic B, Milroy R, Moldvay J, Morgan R, Nanushi M, Paesmans M, Putora PM, Samarzija M, Scherpereel A, Schlesser M, Sculier JP, Skrickova J, Sotto-Mayor R, Strand TE, Van Schil P, Blum TG. Achieving Thoracic Oncology data collection in Europe: a precursor study in 35 Countries. BMC Cancer 2018; 18:1144. [PMID: 30458807 PMCID: PMC6247748 DOI: 10.1186/s12885-018-5009-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 10/29/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND A minority of European countries have participated in international comparisons with high level data on lung cancer. However, the nature and extent of data collection across the continent is simply unknown, and without accurate data collection it is not possible to compare practice and set benchmarks to which lung cancer services can aspire. METHODS Using an established network of lung cancer specialists in 37 European countries, a survey was distributed in December 2014. The results relate to current practice in each country at the time, early 2015. The results were compiled and then verified with co-authors over the following months. RESULTS Thirty-five completed surveys were received which describe a range of current practice for lung cancer data collection. Thirty countries have data collection at the national level, but this is not so in Albania, Bosnia-Herzegovina, Italy, Spain and Switzerland. Data collection varied from paper records with no survival analysis, to well-established electronic databases with links to census data and survival analyses. CONCLUSION Using a network of committed clinicians, we have gathered validated comparative data reporting an observed difference in data collection mechanisms across Europe. We have identified the need to develop a well-designed dataset, whilst acknowledging what is feasible within each country, and aspiring to collect high quality data for clinical research.
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Affiliation(s)
- Anna Rich
- Department of Respiratory Medicine, Nottingham University Hospitals, City campus, Hucknall Road, Nottingham, NG5 1PB UK
| | - David Baldwin
- Department of Respiratory Medicine, Nottingham University Hospitals, City campus, Hucknall Road, Nottingham, NG5 1PB UK
| | | | - Paul Beckett
- Department of Respiratory Medicine, Derby Teaching Hospitals NHS Foundation Trust, Derby, UK
| | - Thierry Berghmans
- Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Stephen Brincat
- Sir Anthony Mamo oncology centre, Mater Dei hospital, Msida, Malta
| | - Otto Burghuber
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology, Otto Wagner Hospital, Vienna, Austria
| | - Alexandru Corlateanu
- Department of Respiratory Medicine, State University of Medicine and Pharmacy “Nicolae Testemitanu”, Chisinau, Moldova
| | - Tanja Cufer
- University Clinic Golnik, Medical Faculty Ljubljana, Golnik, Slovenia
| | - Ronald Damhuis
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Edvardas Danila
- Clinic of Infectious and Chest Diseases, Dermatovenereology and Allergology, Vilnius University, Vilnius, Lithuania
- Centre of Pulmonology and Allergology, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania
| | | | - Stefano Elia
- Department of Thoracic Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Mina Gaga
- 7th Respiratory Medicine Department, Athens Chest Hospital, 152 Mesogion Ave Athens, 11527 Athens, Greece
| | - Tuncay Goksel
- Department of Pulmonary Medicine, School of Medicine, Ege University, Izmir, Turkey
| | - Bogdan Grigoriu
- Regional Institute of Oncology, University of Medicine and Pharmacy, Iasi, Romania
| | - Gunnar Hillerdal
- Department of Respiratory Diseases, Karolinska Hospital, Stockholm, Sweden
| | - Rudolf Maria Huber
- Division of Respiratory Medicine and Thoracic Oncology, University of Munich and Thoracic Oncology Centre, Munich, Germany
| | - Erik Jakobsen
- Department of Thoracic Surgery, Odense University Hospital, Odense, Denmark
| | - Steinn Jonsson
- Department of Medicine, Landspitali, University of Iceland, Reykjavik, Iceland
| | - Dragana Jovanovic
- University Hospital of Pulmonology, Clinical Center of Serbia, Belgrade, Serbia
| | - Elena Kavcova
- Clinic of Pneumology and Phthisiology, Comenius University Bratislava, Jessenius Faculty of Medicine Martin, University Hospital, Martin, Slovak Republic
| | - Assia Konsoulova
- Medical Oncology Department, University Hospital Sveta Marina, Varna, Bulgaria
| | - Tanel Laisaar
- Department of Thoracic Surgery, Tartu University Hospital, Tartu, Estonia
| | - Riitta Makitaro
- Department of Internal Medicine, Respiratory Research Unit, Medical Research Center Oulu, Oulu, Finland
- University Hospital and University of Oulu, POB 20, 90029 Oulu, Finland
| | - Bakir Mehic
- Clinic of Lung Diseases and TB, Sarajevo University Clinical Centre, Sarajevo, Bosnia and Herzegovina
| | - Robert Milroy
- Consultant Respiratory Physician & Chair, Scottish Lung Cancer Forum, Glasgow Royal Infirmary, Glasgow, Scotland
| | - Judit Moldvay
- Department of Tumor Biology, National Koranyi Institute, Semmelweis University, Budapest, Hungary
| | - Ross Morgan
- Department of Respiratory Medicine, Beaumont Hospital, Dublin, 9 Ireland
| | - Milda Nanushi
- University of Tirana, Service of Pulmonology, Tirana, Albania
| | - Marianne Paesmans
- Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Paul Martin Putora
- Department of Radiation Oncology, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland
| | - Miroslav Samarzija
- Department of Respiratory medicine, Klinički bolnički centar Zagreb, Zagreb, Croatia
| | - Arnaud Scherpereel
- Pulmonary and Thoracic Oncology, Univ. Lille, Inserm, CHU Lille, U1019 – CIIL, F-59000 Lille, France
| | - Marc Schlesser
- Respiratory Medicine Department, Centre Hospitalier Luxembourg, Luxembourg City, Luxembourg
| | - Jean-Paul Sculier
- Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Jana Skrickova
- Department Pulmonary Disease and TB, Masaryk University Faculty of Medicine & University Hospital, Brno, Czech Republic
| | - Renato Sotto-Mayor
- Pulmonology Service, Thoracic Department, North Lisbon Hospital Centre, Lisbon, Portugal
| | | | - Paul Van Schil
- Department of Thoracic and Vascular Surgery, Antwerp University Hospital, Edegem, Antwerp Belgium
| | - Torsten-Gerriet Blum
- Klinik für Pneumologie, Lungenklinik Heckeshorn, HELIOS Klinikum Emil von Behring, Berlin, Germany
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25
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Zhang L. Short- and long-term outcomes in elderly patients with locally advanced non-small-cell lung cancer treated using video-assisted thoracic surgery lobectomy. Ther Clin Risk Manag 2018; 14:2213-2220. [PMID: 30510426 PMCID: PMC6231434 DOI: 10.2147/tcrm.s175846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND In recent years, video-assisted thoracic surgery (VATS) lobectomy has been used to treat locally advanced non-small-cell lung cancer (LA-NSCLC). However, VATS has not been reported in elderly patients (≥70 years) with LA-NSCLC. The purpose of this study was to compare short- and long-term outcomes of patients with LA-NSCLC aged ≥70 years and 55-69 years treated with VATS. PATIENTS AND METHODS From January 2012 to January 2018, a total of 83 patients with LA-NSCLC who were ≥55 years of age underwent VATS. Patients were divided into ≥70 years group (37 cases) and 55-69 years group (46 cases), based on their age at the time of VATS. Short- and long-term outcomes of these two groups of patients were compared. RESULTS American Society of Anesthesiologists scores of ≥70 years patients were higher than those of 55-69 years patients. No significant differences were observed when comparing the general preoperative data. For short-term outcomes, there was no significant difference between the two groups of patients in length of surgery, intraoperative blood loss, conversion to thoracotomy, postoperative 30-day complication rate and severity, postoperative 30-day mortality, pathological results, compliance with adjuvant chemotherapy, or other factors. Long-term follow-up results showed that recurrence, overall survival, and disease-free survival were similar in both groups. Furthermore, multivariate analysis showed that age was not an independent predictor of overall and disease-free survival. CONCLUSIONS VATS in elderly patients (≥70 years) with LA-NSCLC can result in short- and long-term outcomes similar to those of 55-69 years patients with LA-NSCLC.
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Affiliation(s)
- Like Zhang
- Department of Thoracic Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang 050051, Hebei, People's Republic of China,
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26
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Rich AL, Baldwin DR, Beckett P, Berghmans T, Boyd J, Faivre-Finn C, Galateau-Salle F, Gamarra F, Grigoriu B, Hansen NCG, Hardavella G, Jakobsen E, Jovanovic D, Konsoulova A, Massard G, McPhelim J, Meert AP, Milroy R, Mutti L, Paesmans M, Peake MD, Putora PM, de Ruysscher DK, Sculier JP, Schepereel A, Subotic DR, Van Schil P, Blum T. ERS statement on harmonised standards for lung cancer registration and lung cancer services in Europe. Eur Respir J 2018; 52:13993003.00610-2018. [DOI: 10.1183/13993003.00610-2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 07/03/2018] [Indexed: 12/25/2022]
Abstract
The European Respiratory Society (ERS) task force for harmonised standards for lung cancer registration and lung cancer services in Europe recognised the need to create a single dataset for use in pan-European data collection and a manual of standards for European lung cancer services.The multidisciplinary task force considered evidence from two different sources, reviewing existing national and international datasets alongside the results of a survey of clinical data collection on lung cancer in 35 European countries. A similar process was followed for the manual of lung cancer services, with the task force using existing guidelines and national or international recommendations for lung cancer services to develop a manual of standards for services in Europe.The task force developed essential and minimum datasets for lung cancer registration to enable all countries to collect the same essential data and some to collect data with greater detail. The task force also developed a manual specifying standards for lung cancer services in Europe.Despite the wide variation in the sociopolitical landscape across Europe, the ERS is determined to encourage the delivery of high-quality lung cancer care. Both the manual of lung cancer services and the minimum dataset for lung cancer registration will support this aspiration.
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27
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Di Donato V, Page Z, Bracchi C, Tomao F, Musella A, Perniola G, Panici PB. The age-adjusted Charlson comorbidity index as a predictor of survival in surgically treated vulvar cancer patients. J Gynecol Oncol 2018; 30:e6. [PMID: 30479090 PMCID: PMC6304403 DOI: 10.3802/jgo.2019.30.e6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/05/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022] Open
Abstract
Objective To evaluate the impact of age-adjusted Charlson comorbidity index (ACCI) in predicting disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS) among surgically treated patients with vulvar carcinoma. The secondary aim is to evaluate its impact as a predictor of the pattern of recurrence. Methods We retrospectively evaluated data of patients that underwent surgical treatment for vulvar cancer from 1998 to 2016. ACCI at the time of primary surgery was evaluated and patients were classified as low (ACCI 0–1), intermediate (ACCI 2–3), and high risk (>3). DFS, OS and CSS were analyzed using the Kaplan-Meir and the Cox proportional hazard models. Logistic regression model was used to assess predictors of distant and local recurrence. Results Seventy-eight patients were included in the study. Twelve were classified as low, 36 as intermediate, and 30 as high risk according to their ACCI. Using multivariate analysis, ACCI class was an independent predictor of worse DFS (hazard ratio [HR]=3.04; 95% confidence interval [CI]=1.54–5.99; p<0.001), OS (HR=5.25; 95% CI=1.63–16.89; p=0.005) and CSS (HR=3.79; 95% CI=1.13–12.78; p=0.03). Positive nodal status (odds ratio=8.46; 95% CI=2.13–33.58; p=0.002) was the only parameter correlated with distant recurrence at logistic regression. Conclusion ACCI could be a useful tool in predicting prognosis in surgically treated vulvar cancer patients. Prospective multicenter trials assessing the role of ACCI in vulvar cancer patients are warranted.
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Affiliation(s)
- Violante Di Donato
- Department of Gynecology Obstetrics Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Zoe Page
- Department of Gynecology Obstetrics Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Carlotta Bracchi
- Department of Gynecology Obstetrics Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy.
| | - Federica Tomao
- Department of Gynecology Obstetrics Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Angela Musella
- Department of Gynecology Obstetrics Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Giorgia Perniola
- Department of Gynecology Obstetrics Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
| | - Pierluigi Benedetti Panici
- Department of Gynecology Obstetrics Sciences and Urologic Sciences, Sapienza University of Rome, Rome, Italy
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28
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Somayaji D, Chang YP, Casucci S, Xue Y, Hewner S. Exploring Medicaid claims data to understand predictors of healthcare utilization and mortality for Medicaid individuals with or without a diagnosis of lung cancer: a feasibility study. Transl Behav Med 2018; 8:400-408. [DOI: 10.1093/tbm/iby023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Yu-Ping Chang
- University at Buffalo School of Nursing, Buffalo, NY, USA
| | - Sabrina Casucci
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA
| | - Yuqing Xue
- University at Buffalo School of Nursing, Buffalo, NY, USA
| | - Sharon Hewner
- University at Buffalo School of Nursing, Buffalo, NY, USA
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Abstract
microRNAs (miRs) are targets for genomic aberrations and emerging treatments against cancer. It has been demonstrated that targeting miR-569 may potentially benefit patients with ovarian or breast cancer. However, the exact roles of miR-569 remain unclear in human lung cancer cells. Using the reverse transcription-quantitative polymerase chain reaction (RT-qPCR), it was demonstrated that miR-569 expression was consistently decreased in lung cancer cells. As well as cell proliferation and migration inhibition, apoptosis and cell arrest at the G1 phase were induced following reversion of miR-569 expression in lung cancer cells. The present study demonstrated that miR-569 was able to downregulate FOS and high mobility group A2 mRNA and protein expression using RT-qPCR and western blot analysis. The observed role of miRNA-569 in lung cancer cells in the present study suggested that it may be a novel and promising therapeutic target, and a novel biomarker for detecting lung cancer.
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Affiliation(s)
- Yi Ping Zheng
- Department of Geriatrics, The First Affiliated Hospital of Dalian Medical College, Dalian, Liaoning 116000, P.R. China
| | - Linxia Wu
- Department of Geriatrics, The First Affiliated Hospital of Dalian Medical College, Dalian, Liaoning 116000, P.R. China
| | - Jie Gao
- Department of General Surgery, The First Affiliated Hospital of Dalian Medical College, Dalian, Liaoning 116000, P.R. China
| | - Yanfu Wang
- Department of Geriatrics, The First Affiliated Hospital of Dalian Medical College, Dalian, Liaoning 116000, P.R. China
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30
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Kahl A, du Bois A, Harter P, Prader S, Schneider S, Heitz F, Traut A, Alesina PF, Meier B, Walz M, Brueckner A, Groeben HT, Brunkhorst V, Heikaus S, Ataseven B. Prognostic Value of the Age-Adjusted Charlson Comorbidity Index (ACCI) on Short- and Long-Term Outcome in Patients with Advanced Primary Epithelial Ovarian Cancer. Ann Surg Oncol 2017; 24:3692-3699. [DOI: 10.1245/s10434-017-6079-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Indexed: 12/12/2022]
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31
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Ruparel M, Navani N. Young at Heart: Is That Good Enough for Computed Tomography Screening? Am J Respir Crit Care Med 2017; 196:539-541. [PMID: 28806529 DOI: 10.1164/rccm.201707-1504ed] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Mamta Ruparel
- 1 Lungs for Living Research Centre University College London London, United Kingdom and
| | - Neal Navani
- 2 University College London Hospital London, United Kingdom
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32
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Zhao L, Leung LH, Wang J, Li H, Che J, Liu L, Yao X, Cao B. Association between Charlson comorbidity index score and outcome in patients with stage IIIB-IV non-small cell lung cancer. BMC Pulm Med 2017; 17:112. [PMID: 28806935 PMCID: PMC5556668 DOI: 10.1186/s12890-017-0452-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 07/31/2017] [Indexed: 11/24/2022] Open
Abstract
Background This retrospective study investigated the association between the Charlson comorbidity index (CCI) score and the survival of patients with stage IIIB-IV (advanced, non-resectable) non-small cell lung cancer (NSCLC) who also did not have gene mutations in epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK). Methods The records of 165 patients (28–80 y, median 61 y) who met the above criteria and were admitted to Beijing Friendship Hospital Capital Medical University from 1 May 2010 to 1 October 2014were reviewed. Associations between baseline variables and the CCI score were assessed via univariate and multivariate logistic regression analysis. Overall survival was defined as the time from the first clinic visit to death from any cause, or to the end of follow-up. Survival curves were estimated via the Kaplan-Meier method and compared with the log-rank test. Results Logistic regression analyses indicated that smoking and performance status were independently associated with the CCI score. Smoking was associated with an increased risk of mortality (odds ratio (OR) 4.12 (95% confidence interval [CI] 1.92–8.84) compared to non-smokers), as was performance status 2 (ambulatory, capable of self-care, unable to perform any work activities; active for >50% of waking hours) (OR 2.22 (95% CI, 1.14–4.33) compared to performance status 1). Univariate Cox’s regression analyses showed that the hazard ratios were significantly associated with the CCI score (P = 0.009), smoking (P = 0.042), and male gender (P = 0.021). Conclusion The CCI score is an important prognostic factor for the prediction of overall survival in patients with stage IIIB-IV NSCLC who are negative for EGFR and ALK gene mutations.
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Affiliation(s)
- Lei Zhao
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Lai-Han Leung
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Taipa, Macau, 999078, China
| | - Jing Wang
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Huihui Li
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Juanjuan Che
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Lian Liu
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing, 100050, China
| | - Xiaojun Yao
- State Key Laboratory of Quality Research in Chinese Medicine, Macau Institute for Applied Research in Medicine and Health, Macau University of Science and Technology, Taipa, Macau, 999078, China.
| | - Bangwei Cao
- Cancer Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong An Road, Xicheng District, Beijing, 100050, China.
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Zhang Z, Liu T, Wang K, Qu X, Pang Z, Liu S, Liu Q, Du J. Down-regulation of long non-coding RNA MEG3 indicates an unfavorable prognosis in non-small cell lung cancer: Evidence from the GEO database. Gene 2017; 630:49-58. [PMID: 28782577 DOI: 10.1016/j.gene.2017.08.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/20/2017] [Accepted: 08/01/2017] [Indexed: 02/07/2023]
Abstract
Long non-coding RNA (lncRNA) MEG3 (maternally expressed gene 3) is an imprinted gene that suppresses cells growth in various tumors. However, the association between MEG3 expression and prognosis in non-small cell lung cancer (NSCLC) has not been fully investigated. Seven datasets with 1144 patients were obtained from Gene Expression Omnibus (GEO) database (Affymetrix U133 Plus 2.0 platform). Association between MEG3 and other variables was tested using the chi-squared test. Kaplan-Meier survival analysis was carried out to explore the association between MEG3 expression and overall survival (OS)/progression free survival (PFS). Results of univariate and multivariate Cox regression analysis were represented in HR and 95%CI form. Summarized results and publication bias were showed by forest plots and funnel plots respectively. Differential expression of MEG3 was related to stage (GSE31210OS and GSE31210PFS), histology (GSE29013OS and GSE29013PFS) and gender (GSE29013PFS). In summary, low MEG3 expression was associated with shorter long-term survival time in several datasets (GSE3141 (p=0.039), GSE30219 (p=0.008) for OS and GSE30219 (p=0.048) for PFS). We found that MEG3 was an independent prognostic factor in GSE30219 for PFS (HR 0.666, 95%CI 0.458-0.969, p=0.033). The summarized results suggested that low MEG3 expression was a poor prognostic factor in NSCLC (HR=0.77, 95%CI 0.63-0.95). Specifically, the association between low MEG3 expression and poor prognosis was markedly significant in younger patients (≤60years old) (HR0.602, 95%CI 0.417-0.867, p=0.007). These findings indicate that MEG3 could be a novel prognostic factor for NSCLC patients.
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Affiliation(s)
- Zichao Zhang
- School of Medicine, Shandong University, 44 Cultural West Road, Jinan 250012, PR China; Linyi Health School of Shandong Province, Linyi 276002, PR China
| | - Tiantian Liu
- School of Medicine, Shandong University, 44 Cultural West Road, Jinan 250012, PR China; Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China
| | - Kai Wang
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China; Department of Healthcare Respiratory, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China
| | - Xiao Qu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China
| | - Zhaofei Pang
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China
| | - Shaorui Liu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China
| | - Qi Liu
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China.
| | - Jiajun Du
- Institute of Oncology, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China; Department of Thoracic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, 324 Jingwu Road, Jinan 250021, PR China.
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Bowden JCS, Williams LJ, Simms A, Price A, Campbell S, Fallon MT, Fearon KCH. Prediction of 90 Day and Overall Survival after Chemoradiotherapy for Lung Cancer: Role of Performance Status and Body Composition. Clin Oncol (R Coll Radiol) 2017; 29:576-584. [PMID: 28652093 DOI: 10.1016/j.clon.2017.06.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/17/2017] [Accepted: 05/23/2017] [Indexed: 01/26/2023]
Abstract
AIMS If appropriate patients are to be selected for lung cancer treatment, an understanding of who is most at risk of adverse outcomes after treatment is needed. The aim of the present study was to identify predictive factors for 30 and 90 day mortality after chemoradiotherapy (CRT), and factors that were prognostic for overall survival. MATERIALS AND METHODS A retrospective cohort study of 194 patients with lung cancer who had undergone CRT in South East Scotland from 2008 to 2010 was undertaken. Gender, age, cancer characteristics, weight loss, body mass index (BMI), performance status (Eastern Cooperative Oncology Group; ECOG) and computed tomography-derived body composition variables were examined for prognostic significance using Cox's proportional hazards model and logistic regression. RESULTS The median overall survival was 19 months (95% confidence interval 16.3, 21.7). Four of 194 patients died within 30 days of treatment completion, for which there were no independent predictive variables; 22/194 (11%) died within 90 days of treatment completion. BMI < 20 and ECOG performance status ≥2 were independent predictors of death within 90 days of treatment completion (P = 0.001 and P = 0.004, respectively). Patients with either BMI < 20 or ECOG performance status ≥ 2 had an odds ratio of death within 90 days of 5.97 (95% confidence interval 2.20, 16.19), rising to an odds ratio of 13.27 (1.70, 103.47) for patients with both BMI < 20 and ECOG performance status ≥ 2. Patients with low muscle attenuation had significantly reduced overall survival (P = 0.004); individuals with low muscle attenuation had a median survival of 15.2 months (95% confidence interval 12.7, 17.7) compared with 23.0 months (95% confidence interval 18.3, 27.8) for those with high muscle attenuation, equating to a hazard ratio of death of 1.62 (95% confidence interval 1.17, 2.23, P = 0.003). CONCLUSION Poor performance status, low BMI and low muscle attenuation identify patients at increased risk of premature death after CRT. Risk factors for adverse outcomes should inform personalised discussions with patients about the potential harms as well as the intended benefits of treatment.
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Affiliation(s)
- J C S Bowden
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK; University of St Andrews, St Andrews, UK; NHS Fife, Kirkcaldy, UK.
| | - L J Williams
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | | | - A Price
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK; NHS Lothian, Edinburgh, UK
| | | | - M T Fallon
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK; NHS Lothian, Edinburgh, UK
| | - K C H Fearon
- Edinburgh Cancer Research Centre, University of Edinburgh, Edinburgh, UK; NHS Lothian, Edinburgh, UK
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35
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A novel label-free microfluidic paper-based immunosensor for highly sensitive electrochemical detection of carcinoembryonic antigen. Biosens Bioelectron 2016; 83:319-26. [DOI: 10.1016/j.bios.2016.04.062] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 04/01/2016] [Accepted: 04/20/2016] [Indexed: 02/04/2023]
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Driessen EJM, Bootsma GP, Hendriks LEL, van den Berkmortel FWPJ, Bogaarts BAHA, van Loon JGM, Dingemans AMC, Janssen-Heijnen MLG. Stage III Non-Small Cell Lung Cancer in the elderly: Patient characteristics predictive for tolerance and survival of chemoradiation in daily clinical practice. Radiother Oncol 2016; 121:26-31. [PMID: 27522577 DOI: 10.1016/j.radonc.2016.07.025] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 07/25/2016] [Accepted: 07/31/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND In unselected elderly with stage III Non-Small Cell Lung Cancer (NSCLC), evidence is scarce regarding motives and effects of treatment modalities. METHODS Hospital-based multicenter retrospective study including unresectable stage III NSCLC patients aged ⩾70 and diagnosed between 2009 and 2013 (N=216). Treatment motives and tolerance (no unplanned hospitalizations and completion of treatment), and survival were derived from medical records and the Netherlands Cancer Registry. RESULTS Patients received concurrent chemoradiation (cCHRT, 33%), sequential chemoradiation (sCHRT, 24%), radical radiotherapy (RT, 16%) or no curative treatment (27%). Comorbidity, performance status (58%) and patient refusal (15%) were the most common motives for omitting cCHRT. Treatment tolerance for cCHRT and sCHRT was worse in case of severe comorbidity (OR 6.2 (95%CI 1.6-24) and OR 6.4 (95%CI 1.8-22), respectively). One-year survival was 57%, 50%, 49% and 26% for cCHRT, sCHRT, RT and no curative treatment, respectively. Compared to cCHRT, survival was worse for no curative treatment (P=0.000), but not significantly worse for sCHRT and RT (P=0.38). CONCLUSION Although relatively fit elderly were assigned to cCHRT, treatment tolerance was worse, especially for those with severe comorbidity. Survival seemed not significantly better as compared to sCHRT or RT. Prospective studies in this vital and understudied area are needed.
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Affiliation(s)
| | - Gerbern P Bootsma
- Department of Pulmonology, Zuyderland Medical Centre, Heerlen, The Netherlands
| | - Lizza E L Hendriks
- Department of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands
| | | | | | - Judith G M van Loon
- MAASTRO Clinic, GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, The Netherlands
| | - Anne-Marie C Dingemans
- Department of Pulmonary Diseases, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, The Netherlands
| | - Maryska L G Janssen-Heijnen
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands; Department of Epidemiology, Maastricht University Medical Centre, GROW School for Oncology and Developmental Biology, The Netherlands
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Zhu L, Chen S, Ma S, Zhang S. Glasgow prognostic score predicts prognosis of non-small cell lung cancer: a meta-analysis. SPRINGERPLUS 2016; 5:439. [PMID: 27104127 PMCID: PMC4828364 DOI: 10.1186/s40064-016-2093-9] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 04/04/2016] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Glasgow prognostic score (GPS), an inflammation-based scoring system, has been evaluated in various cancers. However, its clinical significance remains unclear in non-small cell lung cancer (NSCLC). Therefore, it is necessary to conduct a meta-analysis to explore the prognostic value of GPS in NSCLC patients. METHODS A quantitative meta-analysis was performed through a systematic search in PubMed, Web of Science, and the Cochrane Library. The pooled hazard ratios (HRs) of overall survival (OS) were calculated and compared. RESULTS A total of 12 studies comprising 2669 patients were included in this meta-analysis. Compared with GPS 0 group, patients in GPS 1-2 group exhibited a reduced OS with a pooled HR of 1.89 (95 % CI 1.57-2.27, p < 0.001; I (2) = 54 %). Six studies had sufficient data to calculate HRs of OS for GPS 1 and GPS 2 groups. Analysis revealed that GPS 2 group had a statistically significant reduced OS compared with GPS 1 group with a pooled HR of 1.87 (95 % CI 1.18-2.97, p = 0.008; I (2) = 72 %). Study type (retrospective vs. prospective) and disease stage could partially explain the heterogeneity of each study by subgroup analysis. CONCLUSION Pretreatment GPS could serve as a simple and reliable prognosis predictor for NSCLC. More well-designed studies that consider GPS as a stratification factor are warranted.
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Affiliation(s)
- Lucheng Zhu
- Affiliated Hangzhou Hospital of Nanjing Medical University, No. 261, Huansha Road, Shangcheng District, Hangzhou, 310006 People's Republic of China.,Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou, 310006 People's Republic of China.,Hangzhou Cancer Hospital, Hangzhou, 310006 People's Republic of China
| | - Sumei Chen
- Affiliated Hangzhou First People's Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006 People's Republic of China.,Hangzhou Cancer Hospital, Hangzhou, 310006 People's Republic of China
| | - Shenglin Ma
- Affiliated Hangzhou Hospital of Nanjing Medical University, No. 261, Huansha Road, Shangcheng District, Hangzhou, 310006 People's Republic of China.,Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou, 310006 People's Republic of China.,Affiliated Hangzhou First People's Hospital of Zhejiang Chinese Medical University, Hangzhou, 310006 People's Republic of China
| | - Shirong Zhang
- Affiliated Hangzhou Hospital of Nanjing Medical University, No. 261, Huansha Road, Shangcheng District, Hangzhou, 310006 People's Republic of China.,Hangzhou First People's Hospital, No. 261, Huansha Road, Shangcheng District, Hangzhou, 310006 People's Republic of China
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Hayama M, Suzuki H, Shiroyama T, Tamiya M, Okamoto N, Tanaka A, Morishita N, Nishida T, Nishihara T, Hirashima T. Chemotherapy for patients with advanced lung cancer receiving long-term oxygen therapy. J Thorac Dis 2016; 8:116-23. [PMID: 26904219 DOI: 10.3978/j.issn.2072-1439.2016.01.42] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Long-term oxygen therapy (LTOT) is sometimes prescribed for patients with advanced lung cancer who are potential candidates for chemotherapy. The aim of this study was to assess the usefulness of chemotherapy for patients with this disease who require LTOT. METHODS The medical records of 40 patients with advanced lung cancer who received LTOT while undergoing systemic chemotherapy at our institution between January 2009 and December 2014 were retrospectively reviewed. Chemotherapy consisted of cytotoxic or molecular-targeted agents. RESULTS Twenty-four patients had adenocarcinoma, 6 had squamous cell carcinoma, and 10 had small cell lung cancer (SCLC). The median survival time from the date of the first chemotherapy cycle performed in conjunction with LTOT was 194 days. In a multivariate analysis, the only factor significantly associated with better prognosis was the line (first or second) of the first chemotherapy with LTOT (hazard ratio =0.42; 95% confidence interval, 0.18 to 0.94). Among the 40 patients, 10 (25%) received chemotherapy during the last 30 days of their lives, 2 of whom died of chemotherapy-related adverse events. CONCLUSIONS Chemotherapy for patients with advanced lung cancer who receive LTOT may be acceptable if it is the first- or second-line treatment. However, we should be mindful of the potential overuse of chemotherapy and its negative impact on quality of life.
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Affiliation(s)
- Manabu Hayama
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Hidekazu Suzuki
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Takayuki Shiroyama
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Motohiro Tamiya
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Norio Okamoto
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Ayako Tanaka
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Naoko Morishita
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Takuji Nishida
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Takashi Nishihara
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
| | - Tomonori Hirashima
- Department of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic Diseases, Habikino City, Japan
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Cuppens K, Oyen C, Derweduwen A, Ottevaere A, Sermeus W, Vansteenkiste J. Characteristics and outcome of unplanned hospital admissions in patients with lung cancer: a longitudinal tertiary center study. Towards a strategy to reduce the burden. Support Care Cancer 2016; 24:2827-35. [PMID: 26816091 DOI: 10.1007/s00520-016-3087-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 01/14/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Unplanned hospital admissions (UHAs) are frequent in lung cancer, but literature on this topic is scarce. The aim of this study is to gain insight in the demographics, patterns of referral, causes, presenting symptoms, and final outcome of these UHAs. A strategy to improve quality of care and reduce the number and cost of UHAs was suggested based upon these findings. PATIENTS AND METHODS In retrospective analysis of all consecutive UHAs in a 6-month period in a tertiary center, demographics, pattern of referral, clinical data, tumor control status, final diagnosis, duration of hospitalization, and outcome were examined. RESULTS Two hundred seven UHAs were recorded. Male/female ratio was 185/62, mean age 65.5 years, performance status (PS) on admission 0-1 in 32 %, 2 in 37.2 %, and 3-4 in 30.8 % of patients. Patient referral occurred by general practitioner in 33.6 % or specialist in 25.5 % and in 40.9 % on own initiative. UHAs were therapy-related in 23.9 %, cancer-related in 47.4 %, comorbidity-related in 19.4 %, or of unclear nature in 9.3 %. Most frequent causes were infections (21.9 %) and respiratory problems (17.0 %). Mean length of stay was 9.5 days. Final outcome was 10.1 % mortality, 6.9 % hospice care transfers, and 79.4 % home returns (including 18.2 % same day returns). CONCLUSION UHAs in lung cancer were more cancer- than therapy-related. Majority of patients (2/3) were not seen by their general practitioner. A significant number of same day returns were noted. UHAs in patients with poor PS, uncontrolled cancer and cancer-related events had the worst outcome. This work is a first step in identifying specific characteristics of UHAs in lung cancer patients, which may lead to strategies to reduce the burden of UHAs.
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Affiliation(s)
- Kristof Cuppens
- Department of Pulmonology, Respiratory Oncology Unit, University Hospital KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Christel Oyen
- Department of Pulmonology, Respiratory Oncology Unit, University Hospital KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Aurélie Derweduwen
- Department of Pulmonology, Respiratory Oncology Unit, University Hospital KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Anouck Ottevaere
- Department of Pulmonology, Respiratory Oncology Unit, University Hospital KU Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Walter Sermeus
- Centre for Health Services and Nursing Research, Catholic University Leuven, Leuven, Belgium
| | - Johan Vansteenkiste
- Department of Pulmonology, Respiratory Oncology Unit, University Hospital KU Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Liu HW, Gabos Z, Ghosh S, Roberts B, Lau H, Kerba M. Outcomes in stage I non-small cell lung cancer following the introduction of stereotactic body radiotherapy in Alberta - A population-based study. Radiother Oncol 2015; 117:71-6. [PMID: 26349589 DOI: 10.1016/j.radonc.2015.08.027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 08/17/2015] [Accepted: 08/22/2015] [Indexed: 12/25/2022]
Abstract
PURPOSE To review outcomes of patients with stage I non-small cell lung cancer (NSCLC) following the introduction of stereotactic body radiation therapy (SBRT). METHODS SBRT cases were linked to the cancer registry database along with clinical, treatment and health service parameters for n=2146 cases of stage I NSCLC diagnosed between 2005 and 2011. The pre-diagnosis Aggregated Clinical Risk Grouping score (ACRG3) was used as a proxy for pre-treatment patient comorbidity. A Cox regression model and the concordance statistic (C-statistic) were used to examine variables predicted for overall survival (OS). RESULTS The SBRT utilization rate increased annually with superior OS to conventional RT (median survival [MS] of 39.4 VS. 23.5months, P<0.001) despite higher ACRG3 scores. Surgical patients were younger, had lower ACRG3, achieving MS of 69.6months. Regression analysis indicated both Surgery (hazard ratio [HR]=0.23, 95% CI: 0.18-0.28) and SBRT (HR=0.33, 95% CI: 0.21-0.51) remained most strongly associated with OS. ACRG3 (HR=0.79, P<0.001) and age (HR=0.83, P=0.03) were independently associated with OS. The OS model was associated with the C-statistic at 0.86, 95% CI: 0.81-0.90. CONCLUSION In stage I NSCLC patients treated with surgery have the best survival. SBRT demonstrates improved OS compared to conventional RT. C-statistic result demonstrates discrimination of treatment selection factors on OS.
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Affiliation(s)
- Hong-Wei Liu
- Central Alberta Cancer Centre, Red Deer, Canada; Department of Oncology, University of Alberta, Canada; Department of Oncology, University of Calgary, Canada.
| | - Zsolt Gabos
- Cross Cancer Institute, Edmonton, Canada; Department of Oncology, University of Alberta, Canada
| | - Sunita Ghosh
- Cross Cancer Institute, Edmonton, Canada; Department of Oncology, University of Alberta, Canada
| | - Barbara Roberts
- Data Integration, Measurement & Reporting, Alberta Health Services, Canada
| | - Harold Lau
- Tom Baker Cancer Centre, Calgary, Canada; Department of Oncology, University of Calgary, Canada
| | - Marc Kerba
- Tom Baker Cancer Centre, Calgary, Canada; Department of Oncology, University of Calgary, Canada
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