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Guo L, Ou S, Zhang S, Li D, Ma X. Neoadjuvant therapy bridging percutaneous coronary intervention (PCI) and video-assisted thoracoscopic (VATS) lobectomy: a retrospective study. Transl Cancer Res 2024; 13:2662-2673. [PMID: 38988932 PMCID: PMC11231793 DOI: 10.21037/tcr-24-132] [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: 01/17/2024] [Accepted: 05/13/2024] [Indexed: 07/12/2024]
Abstract
Background Currently, there is no unified standard for the treatment of coronary artery disease (CAD) in non-small cell lung cancer (NSCLC), and the treatments have their own advantages and disadvantages. Thus, this study aimed to analyze the safety and feasibility of neoadjuvant therapy during the dual antiplatelet therapy (DAPT) period before surgery in patients with NSCLC coexisting with CAD after percutaneous coronary intervention (PCI) treatment. Methods We retrospectively included 13 patients with T2aN0M0 (stage IB) NSCLC who also had concomitant CAD. After PCI treatment, neoadjuvant targeted or immunotherapy was administered based on the type of lung cancer, and the effects on treatment and impact on surgery were observed. Results The objective response rate (ORR) after neoadjuvant treatment in 13 patients was 53.8% [95% confidence interval (CI): 25.1-80.8%], and the disease control rate (DCR) reached 100%. Ten patients (76.9%) experienced adverse events (AEs) ≤ grade 2. All patients underwent standard VATS lobectomy with lymph node dissection. One case (7.7%) required conversion to open thoracotomy, and all cases achieved R0 resection. The median operative time was 150 [interquartile range (IQR) 125-250] minutes, median intraoperative blood loss was 180 (IQR 150-235) mL, median postoperative drainage tube placement time was 4 (IQR 3-5) days, median total drainage volume was 1,310 (IQR 780-1,705) mL, and the median postoperative hospitalization was 7 (IQR 7-8) days. One patient (7.7%) experienced rapid atrial fibrillation. No deaths occurred. Postoperative pathological evaluation in three cases achieved major pathological response (MPR) (23.1%, 95% CI: 5-53.8%), with two cases achieving pathological complete response (pCR) (15.4%, 95% CI: 1.9-45.4%). Conclusions The study presents initial evidence suggesting for the safety and feasibility of performing PCI treatment followed by neoadjuvant therapy during the DAPT period for patients with T2aN0M0 (IB) stage NSCLC coexisting with CAD. This approach presents a potential treatment option to control the disease while eliminating concerns about tumor progression and metastasis.
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Affiliation(s)
- Lin Guo
- Department of Thoracic Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Songlei Ou
- Department of Thoracic Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Shaoyan Zhang
- Department of Thoracic Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Dong Li
- Department of Thoracic Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Xuchen Ma
- Department of Thoracic Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
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2
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Seyrek Y, Akkuş M. How to facilitate concurrent lower lobectomy after coronary artery bypass grafting via median sternotomy without adding anterolateral thoracotomy? ANZ J Surg 2023. [PMID: 37095071 DOI: 10.1111/ans.18494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 01/03/2023] [Accepted: 04/15/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND AND AIM Median sternotomy is an unfavourable approach for performing lung resection and mediastinal lymphadenectomy. Some studies have speculated that concurrent pulmonary resections other than upper lobectomy, necessitate anterolateral thoracotomy in addition to sternotomy. In this study, we aimed to discuss the feasibility and advantages of concomitant video-thoracoscopy (VATS) assisted lower lobectomy after coronary artery bypass grafting (CABG). METHODS We analysed 21 patients who underwent a single combined procedure that includes CABG followed by anatomical pulmonary resection and divided them into two groups: patients who underwent upper lobectomy via median sternotomy incision (Group A, n = 12) and patients who underwent lower lobectomy with video-thoracoscopic assistance (VATS) next to sternotomy incision (Group B, n = 9). RESULTS There were no significant differences between the groups in age, sex, comorbidities, tumour side or size, tumour stage, tumour histopathology, number of dissected lymph node stations, N status, CABG type, number of grafts used, operative time, hospitalization and complication rates. CONCLUSION The feasibility of upper lobectomies via median sternotomy is clear; however, performing lower lobectomies is challenging. In our study, we concluded that the operative feasibility of concurrent lower lobectomy by VATS assistance showed no essential difference to that of concurrent upper lobectomy by presenting that there was no statistically significant difference between the groups in terms of any studied parameters. We can speculate that median sternotomy with VATS assistance should be especially considered instead of anterolateral thoracotomy for lower lobectomies at centres where VATS lobectomies are performed.
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Affiliation(s)
- Yunus Seyrek
- Department of Thoracic Surgery, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
| | - Murat Akkuş
- Department of Thoracic Surgery, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
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3
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Cheng S, Jiang Y, Li X, Lu X, Zhang X, Sun D. Perioperative outcomes of combined heart surgery and lung tumor resection: a systematic review and meta-analysis. J Cardiothorac Surg 2021; 16:227. [PMID: 34372896 PMCID: PMC8351083 DOI: 10.1186/s13019-021-01607-7] [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: 09/28/2020] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
Objective The prevalence of patients with concomitant heart and lung lesions requiring surgical intervention is increasing. Simultaneous cardiac surgery and pulmonary resection avoids the need for a second operation. However, there are concerns regarding the potentially increased mortality and complication rates of simultaneous surgery and the adequacy of lung exposure during heart surgery. Therefore, we performed a meta-analysis to evaluate the perioperative mortality and complication rates of combined heart surgery and lung tumor resection. Methods A comprehensive literature search was performed in July 2020. The PubMed, Embase, and Web of Science databases were searched to identify studies that reported the perioperative outcomes of combined heart surgery and lung tumor resection. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias of included studies. Pooled proportions and 95% confidence intervals (95% CI) were calculated by R version 3.6.1 using the meta package. Results A total of 536 patients from 29 studies were included. Overall, the pooled proportion of operative mortality was 0.01 (95% CI: 0.00, 0.03) and the pooled proportion of postoperative complications was 0.40 (95% CI: 0.24, 0.57) for patients who underwent combined cardiothoracic surgery. Subgroup analysis by lung pathology revealed that, for patients with lung cancer, the pooled proportion of anatomical lung resection was 0.99 (95% CI: 0.95, 1.00) and the pooled proportion of systematic lymph node dissection or sampling was 1.00 (95% CI: 1.00, 1.00). Subgroup analysis by heart surgery procedure found that the pooled proportion of postoperative complications of patients who underwent coronary artery bypass grafting (CABG) patients using the off-pump method was 0.17 (95% CI: 0.01, 0.43), while the pooled proportion of complications after CABG using the on-pump method was 0.61 (95% CI: 0.38, 0.82). Conclusion Combined heart surgery and lung tumor resection had a low mortality rate and an acceptable complication rate. Subgroup analyses revealed that most patients with lung cancer underwent uncompromised anatomical resection and mediastinal lymph node sampling or dissection during combined cardiothoracic surgery, and showed off-pump CABG may reduce the complication rate compared with on-pump CABG. Further researches are still needed to verify these findings.
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Affiliation(s)
- Shizhao Cheng
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300222, China
| | - Yiyao Jiang
- Department of Cardiac Surgery, Tianjin First Central Hospital, Tianjin, 300074, China
| | - Xin Li
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300222, China
| | - Xike Lu
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300222, China
| | - Xun Zhang
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300222, China
| | - Daqiang Sun
- Department of Thoracic Surgery, Tianjin Chest Hospital, Tianjin, 300222, China.
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4
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Leedy D, Tiwana JK, Mamas M, Hira R, Cheng R. Coronary revascularisation outcomes in patients with cancer. Heart 2021; 108:507-516. [PMID: 34415850 DOI: 10.1136/heartjnl-2020-318531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/24/2021] [Indexed: 11/04/2022] Open
Abstract
Cancer and coronary artery disease (CAD) overlap in traditional risk factors as well as molecular mechanisms underpinning the development of these two disease states. Patients with cancer are at increased risk of developing CAD, representing a high-risk population that are increasingly undergoing coronary revascularisation. Over 1 in 10 patients with CAD that require revascularisation with either percutaneous coronary intervention or coronary artery bypass grafting have either a history of cancer or active cancer. These patients are typically older, have more comorbidities and have more extensive CAD compared with patients without cancer. Haematological abnormalities with competing risks of thrombosis and bleeding pose further unique challenges during and after revascularisation. Management of patients with concurrent cancer and CAD requiring revascularisation is challenging as these patients carry a higher risk of morbidity and mortality compared with those without cancer, often driven by the underlying cancer and associated comorbidities. However, due to variability by different types and stages of cancer, revascularisation outcomes are specific to cancer characteristics such as the timing of onset, cancer subtype and site, stage, presence of metastases, and cancer-related therapies received. Recent studies have provided insights into defining revascularisation outcomes, procedural considerations and best practices in managing patients with cancer. Nevertheless, many gaps remain that require further studies to inform clinical best practices in this population.
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Affiliation(s)
- Douglas Leedy
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Jasleen K Tiwana
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
| | - Mamas Mamas
- Keele Cardiovascular Research Group, Institute for Prognosis Research, University of Keele, Keele, UK
| | - Ravi Hira
- Division of Cardiology, Pulse Heart Institute, Tacoma, Washington, USA
| | - Richard Cheng
- Division of Cardiology, University of Washington Medical Center, Seattle, Washington, USA
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Reshetov AV, Elkin AV, Nikolaev GV, Stepanov SS. Surgical treatment of lung cancer in patients with coronary artery surgery. GREKOV'S BULLETIN OF SURGERY 2021. [DOI: 10.24884/0042-4625-2021-180-1-60-64] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The objective was to improve the surgical treatment tactics in patients with non-small cell lung cancer (NSCLC) and coronary heart disease (CHD), requiring myocardial revascularization.Methods and materials. Two groups consisting of 24 patients operated on for NSCLC were examined. In one group, operations for NSCLC were performed in the second stage after coronary artery bypass grafting (CABG). Survival rates in both groups and factors influencing them were evaluated.Results. The number of postoperative complications in both groups was comparable: 20.8 % in patients with CABG and 16.6 % in the group operated only for NSCLC. Indicators of relapse-free and overall survival did not differ significantly from each other (p=0.90 and p=0.95). Only the stage of the disease (p=0.009) and the implementation of complex cancer treatment in case of its necessity (p=0.035) had a reliably impact on the long-term results of the operation. The first stage of myocardial revascularization surgery did not affect the results of treatment (p=0.94), as well as the age of patients, the volume of performed surgery, the morphological picture of the tumor.Conclusion. The staging approach to the treatment of patients with NSCLC and critical forms of CHD requiring myocardial revascularization is reliable, convenient and does not affect the long-term results of treatment.
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Affiliation(s)
- A. V. Reshetov
- North-Western State Medical University named after I.I. Mechnikov, Russia, St. Petersburg
| | - A. V. Elkin
- North-Western State Medical University named after I.I. Mechnikov, Russia, St. Petersburg
| | - G. V. Nikolaev
- National Medical Research Center named after V.A. Almazova, Russia, St. Petersburg
| | - S. S. Stepanov
- National Medical Research Center named after V.A. Almazova, Russia, St. Petersburg
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6
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Garatti A, D’Ovidio M, Saitto G, Daprati A, Canziani A, Mossuto E, D’Oria V, Scarpanti M, De Vincentiis C, Parolari A, Menicanti L. Coronary artery bypass grafting in patients with concomitant solid tumours: early and long-term results. Eur J Cardiothorac Surg 2020; 58:528-536. [DOI: 10.1093/ejcts/ezaa114] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 02/15/2020] [Accepted: 02/18/2020] [Indexed: 12/20/2022] Open
Abstract
Abstract
OBJECTIVES
Our goal was to analyse a consecutive series of patients with solid organ tumours undergoing coronary artery bypass grafting (CABG) by defining the risk factors for early and long-term outcomes.
METHODS
Between 2005 and 2016, a consecutive series of 4079 patients underwent isolated CABG at our institution. Of 103 patients (2.5%) with active malignancy, we enrolled 82 patients (mean age 71 ± 7 years) with solid organ tumours, divided into 4 subgroups: lung (9 patients—11%), gastroenteric (16 patients—20%), urinary (48 patients—58%) and other solid tumours (9 patients—11%). A deterministic record linkage between the clinical database and the National Hospital Information System allowed identification of long-term survival rates and freedom from major adverse cardiovascular events (acute myocardial infarction, repeated admissions for percutaneous coronary intervention and heart failure).
RESULTS
The most common forms of cancer were prostate, colon and carcinoma of the lung. Compared to patients without cancer, patients with neoplasms were significantly older and had a higher rate of comorbidities, without significant differences among the cancer subgroups. The 30-day mortality rate was significantly higher in patients with cancer compared to those without cancer (4.9% vs 1.8%). However, on logistic regression analysis, cancer was an independent risk factor for postoperative pulmonary dysfunction but not for in-hospital death. The median follow-up time was 58 ± 12 months. The overall 5-year survival rate was 60% [95% confidence interval (CI) 47–71%], with a dismal 32% (95% CI 5–65%) survival rate among patients who had lung tumours only. The 5-year freedom from major adverse cardiovascular events was 64% (95% CI 52–74%), without significant differences among subgroups, and was comparable to that of the non-cancer population. Resolution of coronary heart disease allowed safe cancer surgical resection in 80% of the population.
CONCLUSIONS
Based on the results from the present study, CABG should not be denied to patients with solid organ tumours by claiming a worse prognosis or less graft durability. Further studies with larger numbers are warranted.
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Affiliation(s)
- Andrea Garatti
- Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Mariangela D’Ovidio
- Department of Epidemiology, Lazio Regional Health Service/ASL Roma 1, Rome, Italy
| | - Guglielmo Saitto
- Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Andrea Daprati
- Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Alberto Canziani
- Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Eugenio Mossuto
- Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Veronica D’Oria
- Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Matteo Scarpanti
- Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | | | | | - Lorenzo Menicanti
- Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
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7
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Teng JF, Qin DL, Mei QB, Qiu WQ, Pan R, Xiong R, Zhao Y, Law BYK, Wong VKW, Tang Y, Yu CL, Zhang F, Wu JM, Wu AG. Polyphyllin VI, a saponin from Trillium tschonoskii Maxim. induces apoptotic and autophagic cell death via the ROS triggered mTOR signaling pathway in non-small cell lung cancer. Pharmacol Res 2019; 147:104396. [PMID: 31404628 DOI: 10.1016/j.phrs.2019.104396] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 08/06/2019] [Accepted: 08/08/2019] [Indexed: 01/04/2023]
Abstract
Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Our previous studies have proven that Trillium tschonoskii Maxim. (TTM), a traditional Chinese medicine, possesses potent anti-tumor effect. However, the detailed components and molecular mechanism of TTM in anti-NSCLC are still unknown. In the present experiment, polyphyllin VI (PPVI) was successfully isolated from TTM with guidance of the anti-proliferative effect in A549 cells, and the cell death of PPVI treated A549 and H1299 cells was closely linked with the increased intracellular ROS levels. In addition, PPVI induced apoptosis by promoting the protein expression of Bax/Bcl2, caspase-3 and caspase-9, and activated autophagy by improving LC3 II conversion and GFP-LC3 puncta formation in A549 and H1299 cells. The mechanism study found that the activity of mTOR which regulates cell growth, proliferation and autophagy was significantly suppressed by PPVI. Accordingly, the PI3K/AKT and MEK/ERK pathways positively regulating mTOR were inhibited, and AMPK negatively regulating mTOR was activated. In addition, the downstream of mTOR, ULK1 at Ser 757 which downregulates autophagy was inhibited by PPVI. The apoptotic cell death induced by PPVI was confirmed, and it was significantly suppressed by the overexpression of AKT, ERK and mTOR, and the induced autophagic cell death which was depended on the Atg7 was decreased by the inhibitors, such as LY294002 (LY), Bafilomycin A1 (Baf), Compound C (CC) and SBI-0206965 (SBI). Furthermore, the mTOR signaling pathway was regulated by the increased ROS as the initial signal in A549 and H1299 cells. Finally, the anti-tumor growth activity of PPVI in vivo was validated in A549 bearing athymic nude mice. Taken together, our data have firstly demonstrated that PPVI is the main component in TTM that exerts the anti-proliferative effect by inducing apoptotic and autophagic cell death in NSCLC via the ROS-triggered mTOR signaling pathway, and PPVI may be a promising candidate for the treatment of NSCLC in future.
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Affiliation(s)
- Jin-Feng Teng
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China
| | - Da-Lian Qin
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China; Education Ministry Key Laboratory of Medical Electrophysiology, Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Southwest Medical University, Luzhou, 646000, China
| | - Qi-Bing Mei
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China
| | - Wen-Qiao Qiu
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China
| | - Rong Pan
- Department of Human Anatomy, School of Preclinical Medicine, Southwest Medical University, Luzhou, Sichuan, China
| | - Rui Xiong
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China
| | - Ya Zhao
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China
| | - Betty Yuen-Kwan Law
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Vincent Kam-Wai Wong
- State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Macau, China
| | - Yong Tang
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China
| | - Chong-Lin Yu
- Department of Human Anatomy, School of Preclinical Medicine, Southwest Medical University, Luzhou, Sichuan, China
| | - Feng Zhang
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China.
| | - Jian-Ming Wu
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China; Education Ministry Key Laboratory of Medical Electrophysiology, Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Southwest Medical University, Luzhou, 646000, China.
| | - An-Guo Wu
- School of Pharmacy, Southwest Medical University, Luzhou, 646000, China; Education Ministry Key Laboratory of Medical Electrophysiology, Sichuan Key Medical Laboratory of New Drug Discovery and Drugability Evaluation, Luzhou Key Laboratory of Activity Screening and Druggability Evaluation for Chinese Materia Medica, Southwest Medical University, Luzhou, 646000, China.
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8
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Abstract
Curative-intent lung cancer radiation therapy either alone (RT) or combined with immuno-chemotherapy is associated with potential risk of serious radiation-induced lung injury. This review provides a summary of the role of SPECT ventilation perfusion (V/Q) imaging as an emerging adjunct to lung cancer RT planning and treatment dosimetry. Denoted "functional lung avoidance RT" it is hypothesized that preferential dosimetric avoidance of physiologically functional lung may reduce the frequency of radiation-induced lung injury. SPECT V/Q imaging datasets available during the planning process allows the prioritization (or "personalization') of RT dose to minimize the volume of functional lung probabilistically exposed to injurious radiation dose. Selective escalation of target dose and adaptive planning and replanning is also enabled. The emergent importance of the tumor-lung microenvironment and its biologic relationship to local immune effectors in lung cancer provides further incentive to individualize RT planning and delivery. This review examines important normal tissue dosimetric constraints that are part of current standards-of-care and the new dosimetric parameters associated with functional lung avoidance RT. SPECT V/Q has been a valuable tool in investigating the feasibility and efficacy of functional lung avoidance RT but is yet to become main stream due to the lack of large clinical trials. It is encouraging however that functional lung avoidance is feasible in RT dose-target delineation and some of the more promising studies are discussed.
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Affiliation(s)
- Enid M Eslick
- Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, NSW, Australia; Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia
| | - Mark J Stevens
- Northern Sydney Cancer Centre, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Dale L Bailey
- Department of Nuclear Medicine, Royal North Shore Hospital, Sydney, NSW, Australia; Faculty of Health Sciences, University of Sydney, Sydney, NSW, Australia.
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9
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Zhang B, Tao F, Zhang H. Metastasis-associated protein 2 promotes the metastasis of non-small cell lung carcinoma by regulating the ERK/AKT and VEGF signaling pathways. Mol Med Rep 2018; 17:4899-4908. [PMID: 29393472 PMCID: PMC5865949 DOI: 10.3892/mmr.2018.8535] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 05/23/2017] [Indexed: 01/05/2023] Open
Abstract
Non-small cell lung carcinoma (NSCLC) is the most common cause of cancer‑associated mortality in the world and accounts for ~85% of human lung cancers. Metastasis‑associated protein 2 (MTA2) is a component of the histone deacetylase complex and serves a role in tumor progression; however, the mechanism through which MTA2 is involved in the progression of NSCLC remains unclear. The aim of the present study was to investigate the expression and function of MTA2 and the MTA2‑mediated signaling pathway in NSCLC cells. Expression of MTA2 and its target genes was analyzed in MTA2‑overexpressing and anti‑MTA2 antibody (AbMTA2)‑treated NSCLC cells, as well as growth, migration, invasion and apoptotic‑resistance. The inhibitory effects on tumor formation were analyzed using AbMTA2‑treated NSCLC cells and in a mouse model. Histological assessment was conducted to analyze the expressions levels of extracellular signal‑regulated kinase (ERK), RAC‑α serine/threonine protein kinase (AKT) and vascular endothelial growth factor (VEGF) in experimental tumors. Results of the present study demonstrated that MTA2 was overexpressed in NSCLC cells. The growth, migration and invasion of NSCLC cells were markedly inhibited by AbMTA2. In addition, it was observed that the ERK/AKT and VEGF signaling pathways were both upregulated in MTA2‑overexpressing NSCLC cells, and downregulated following silencing of MTA2 activation. ERK and AKT phosphorylation levels were downregulated in NSCLC cells and tumors following MTA2 silencing. The in vivo study demonstrated that tumor growth was markedly inhibited following siRNA‑MTA2 treatment. In conclusion, the results of the present study suggested that MTA2 silencing may significantly inhibit the growth and aggressiveness of NSCLC cells. Results from the present study indicated that the mechanism underlying the MTA2‑mediated invasive potential of NSCLC cells involved the ERK/AKT and VEGF signaling pathways, which may be a potential therapeutic target for the treatment of NSCLC.
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Affiliation(s)
- Bin Zhang
- Department of Respiratory Disease, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 120070, P.R. China
| | - Feng Tao
- Department of Respiratory Disease, The First Hospital of Jiaxing, Jiaxing, Zhejiang 320090, P.R. China
| | - Hao Zhang
- Department of Respiratory Disease, The Second Affiliated Hospital, Zhejiang University College of Medicine, Hangzhou, Zhejiang 120070, P.R. China
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10
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Bousnina M, Zribi H, Zairi S, Soumer K, Ouerghi S, Kilani T. Surgical management of a simultaneous aortic valve replacement and pneumonectomy. Indian J Thorac Cardiovasc Surg 2017; 34:420-424. [PMID: 33060907 DOI: 10.1007/s12055-017-0616-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 10/23/2017] [Accepted: 10/25/2017] [Indexed: 11/24/2022] Open
Abstract
Combined heart surgery and lung resection remains a controversial issue. The treatment of two major conditions in the same operative time may be attempted in certain cases. We report the case of a 68-year-old man who presented for dyspnea on exertion. The chest computerized tomography scan showed an infiltrating tumor which involved the right interlobar artery. A pneumonectomy was indicated and the preoperative echocardiography detected a calcified aortic valve with severe stenosis and significant pressure gradient. The patient had combined pneumonectomy and aortic valve replacement through median sternotomy and was discharged 18 days after surgery. Cardiac valve replacement is feasible in conjunction with pulmonary resection. However morbidity is increased in case of associated pneumonectomy.
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Affiliation(s)
- Mouna Bousnina
- Department of thoracic and cardiovascular surgery, Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,University of Medicine, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia
| | - Hazem Zribi
- Department of thoracic and cardiovascular surgery, Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,University of Medicine, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia
| | - Sarra Zairi
- Department of thoracic and cardiovascular surgery, Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,University of Medicine, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia
| | - Khedija Soumer
- Department of thoracic and cardiovascular surgery, Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,University of Medicine, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia
| | - Sonia Ouerghi
- Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,University of Medicine, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia.,Department of Anesthesia and Reanimation, Abderrahman Mami Hospital, 2080 Ariana, Tunisia
| | - Tarek Kilani
- Department of thoracic and cardiovascular surgery, Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,Abderrahman Mami Hospital, 2080 Ariana, Tunisia.,University of Medicine, Tunis, Tunisia.,Tunis El Manar University, Tunis, Tunisia
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