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de Oliveira TB, Fontes DMN, Montella TC, Lewgoy J, Dutra C, Miola TM. The Best Supportive Care in Stage III Non-Small-Cell Lung Cancer. Curr Oncol 2023; 31:183-202. [PMID: 38248097 PMCID: PMC10814676 DOI: 10.3390/curroncol31010012] [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: 11/15/2023] [Accepted: 11/27/2023] [Indexed: 01/23/2024] Open
Abstract
Lung cancer is a major cause of cancer deaths worldwide. Non-small-cell lung cancer (NSCLC) represents most lung cancer cases, and approximately one-third of patients present with stage III disease at diagnosis. As multiple treatment plans can be adopted for these patients depending on tumor size and nodal staging, stage III NSCLC management is challenging. Over the past decades, multidisciplinary teams (MDTs) have been implemented in healthcare services to coordinate actions among the different health care professionals involved in cancer care. The aim of this review was to discuss real-world evidence of the impact of MDTs on stage III NSCLC management, survival, and quality of life. Here, we performed a literature review to investigate the role of nutrition and navigational nursing in NSCLC care and the influence of MDTs in the choice of treatment plans, including immunotherapy consolidation, and in the management of chemotherapy and radiotherapy-related adverse events. We also performed a mapping review to identify gaps in the implementation of cancer care MDTs in healthcare services around the world.
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Affiliation(s)
| | | | | | - Jairo Lewgoy
- Medical Oncology Department, Hospital Mãe de Deus, Porto Alegre 90880-481, Brazil;
| | - Carolina Dutra
- Medical Oncology Department, Clínica Soma, Florianópolis 88020-210, Brazil;
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Yi Z, Zhang Y, Wang Y, Gao Y, Wang Y, Li X, Ru S, Guo N, Qiu J, Zhang M. Association between radiotherapy and risk of death from cardiovascular diseases in lung and bronchus cancer. Front Cardiovasc Med 2023; 9:1068957. [PMID: 36712270 PMCID: PMC9877540 DOI: 10.3389/fcvm.2022.1068957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023] Open
Abstract
Background Radiotherapy plays an important role in the treatment of lung cancer. However, radiation-related deaths from cardiovascular disease (CVD) are a concern in these patients, and few studies have examined CVD-related death associated with lung cancer. We aimed to evaluate the risk of CVD-related death after radiotherapy in patients with lung and bronchus cancer. Methods Data were extracted from the surveillance, epidemiology, and end results database. Propensity score matching (PSM) was applied to reduce possible bias between patients who received radiotherapy and those who did not. The Kaplan-Meier method was used to estimate cardiovascular-specific survival (CVSS), and the log-rank test was used to compare CVSS between the radiotherapy and no radiotherapy groups. Cox proportional hazards regression analysis was performed to estimate the hazard ratio (HR) of CVD-related death. Results A total of 225,570 patients with lung and bronchus cancer were included, and 201,282 patients remained after PSM. Radiotherapy was identified as an independent risk factor for CVSS among patients with lung and bronchus cancer before PSM (HR: 1.18, P < 0.001) and after PSM (HR: 1.18, P < 0.001). Patients treated with radiotherapy had a significantly worse CVSS than those who did not receive radiotherapy before PSM (25-year CVSS: 49.9 vs. 56.4%, P = 0.002) and after PSM (25-year CVSS: 48.4 vs. 56.7%, P < 0.001). Radiotherapy was associated with more deaths from heart disease before PSM (81.9 vs. 77.2%, P < 0.001) and after PSM (83.0 vs. 78.7%, P < 0.001). Conclusion Radiotherapy is associated with an increased risk of CVD-related death, especially death from heart disease, in patients with lung and bronchus cancer. More efforts are needed to monitor cardiovascular health after radiotherapy.
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Affiliation(s)
- Zhong Yi
- Department of Geriatrics, Aerospace Center Hospital, Beijing, China
| | - Yu Zhang
- Institute of Laboratory Animal Sciences, Chinese Academy of Medical Sciences, Beijing, China,Comparative Medicine Center, Peking Union Medical College, Beijing, China,National Human Diseases Animal Model Resource Center, Beijing, China,National Health Committee (NHC) Key Laboratory of Human Disease Comparative Medicine, Beijing, China
| | - Yu Wang
- Department of Geriatrics, Aerospace Center Hospital, Beijing, China
| | - Yun Gao
- Department of Geriatrics, Aerospace Center Hospital, Beijing, China
| | - Yanhong Wang
- Department of Geriatrics, Aerospace Center Hospital, Beijing, China
| | - Xiangnan Li
- Department of Geriatrics, Aerospace Center Hospital, Beijing, China
| | - Songwei Ru
- Department of Geriatrics, Aerospace Center Hospital, Beijing, China
| | - Na Guo
- Department of Geriatrics, Aerospace Center Hospital, Beijing, China
| | - Jingxuan Qiu
- Department of Geriatrics, Aerospace Center Hospital, Beijing, China
| | - Meng Zhang
- Department of Cardiovascular, Aerospace Center Hospital, Beijing, China,*Correspondence: Meng Zhang,
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Van Dao T, Diep TB, Le Phuong T, Huggenberger R, Kumar A. Real-World Treatment Patterns and Clinical Outcomes in Patients With Stage III Non-Small-Cell Lung Cancer: Results of KINDLE-Vietnam Cohort. Front Oncol 2022; 12:842296. [PMID: 35677172 PMCID: PMC9169691 DOI: 10.3389/fonc.2022.842296] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 04/13/2022] [Indexed: 12/24/2022] Open
Abstract
Objective KINDLE-Vietnam was a part of a real-world KINDLE study with an aim to characterise treatment patterns and clinical outcomes of patients with stage III non-small cell lung cancer (NSCLC). Materials and Methods Retrospective data from patients diagnosed with stage III NSCLC (American Joint Committee on Cancer, 7th edition) between January 2013 and December 2017 with at least 9 months of follow-up were collected from 2 centres in Vietnam. Descriptive statistics were used to summarise demographics, disease characteristics and treatment modalities. Kaplan-Meier methodology evaluated survival estimates; 2-sided 95% confidence intervals (CIs) were computed. Inferential statistics were used to correlate clinical and treatment variables with median progression-free survival (mPFS) and median overall survival (mOS). Results A total of 150 patients (median age: 60 years [range 26-82]) were enrolled; 75.3% were male, 62.0% had smoking history, 56.4% had stage IIIB disease and 62.5% had adenocarcinoma. The majority of the cases (97.3%) were not discussed at a multidisciplinary team meeting. Overall, chemotherapy alone (43.3%), radiotherapy alone (17.0%), sequential chemoradiation (13.5%) and concurrent chemoradiation (12.8%) were preferred as initial therapy. Surgery-based treatment was administered in limited patients (stage IIIA, 10%; stage IIIB, 1.3%). Palliative therapy was the most commonly administered treatment upon relapse in the second-and third-line setting. The mPFS and mOS for the Vietnam cohort were 8.7 months (95% CI, 7.59-9.72) and 25.7 months (95% CI, 19.98-42.61), respectively. The mPFS and mOS for stage IIIA were 11.9 months (95% CI, 8.64-14.95) and 28.2 months (95% CI, 24.15-not-calculable) and for stage IIIB were 7.8 months (95% CI, 6.64-8.71) and 20.0 months (95% CI, 13.01-42.61). Conclusions KINDLE-Vietnam offers insights into the clinical findings of stage III NSCLC. There is a high unmet need for identifying patients in the early stages of NSCLC. Strategies for improving clinical outcomes in this patient population include physician education, multidisciplinary management and catering to increased access to novel agents like immunotherapy and targeted therapy.
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Affiliation(s)
- Tu Van Dao
- Cancer Research and Clinical Trials Center, Vietnam National Cancer Hospital, Hanoi, Vietnam.,Oncology Department, Hanoi Medical University, Hanoi, Vietnam
| | - Tuan Bao Diep
- Ho Chi Minh City Oncology Hospital, Ho Chi Minh City, Vietnam
| | - Tri Le Phuong
- Medical Affairs, AstraZeneca Vietnam, Ho Chi Minh, Vietnam
| | | | - Amit Kumar
- Medical Affairs, AstraZeneca India, Bangalore, India
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Hayashi K, Yamamoto N, Nakajima M, Nomoto A, Ishikawa H, Ogawa K, Tsuji H. Carbon-ion radiotherapy for octogenarians with locally advanced non-small-cell lung cancer. Jpn J Radiol 2021; 39:703-709. [PMID: 33608792 PMCID: PMC8255258 DOI: 10.1007/s11604-021-01101-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/03/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE The clinical significance of carbon-ion radiotherapy (CIRT) for octogenarians with locally advanced non-small-cell lung cancer (LA-NSCLC) remains unclear. We aimed to evaluate the clinical outcomes of CIRT alone for octogenarians with LA-NSCLC. MATERIALS AND METHODS We evaluated 32 patients who underwent CIRT alone between 1997 and 2015. The median age was 82.0 years (range, 80-88 years). In terms of clinical stage (UICC 7th edition), 7 (21.9%), 10 (31.3%), 11 (34.4%), and 4 (12.5%) patients had stage IIA, IIB, IIIA, and ΙΙΙB disease, respectively. The median CIRT dose was 72.0 Gy (relative biological effectiveness), and the median follow-up period was 33.1 months. RESULTS All patients successfully completed CIRT. Regarding grade ≥ 2 toxicities, 1 (3.1%), 3 (9.4%), and 4 (0.7%) patients developed grade 3 radiation pneumonitis, grade 2 radiation pneumonitis, and grade 2 dermatitis, respectively. No grade ≥ 4 toxicities were observed. The 2 year LC, PFS, and OS rates were 83.5%, 46.7%, and 68.0%, respectively. CONCLUSION CIRT alone is safe and effective for octogenarians with LA-NSCLC.
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Affiliation(s)
- Kazuhiko Hayashi
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Naoyoshi Yamamoto
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan.
| | - Mio Nakajima
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Akihiro Nomoto
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Hitoshi Ishikawa
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan
| | - Hiroshi Tsuji
- QST Hospital, National Institutes for Quantum and Radiological Sciences and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
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Kim MS, Park HY, Kho BG, Park CK, Oh IJ, Kim YC, Kim S, Yun JS, Song SY, Na KJ, Jeong JU, Yoon MS, Ahn SJ, Yoo SW, Kang SR, Kwon SY, Bom HS, Jang WY, Kim IY, Lee JE, Jeong WG, Kim YH, Lee T, Choi YD. Artificial intelligence and lung cancer treatment decision: agreement with recommendation of multidisciplinary tumor board. Transl Lung Cancer Res 2020; 9:507-514. [PMID: 32676314 PMCID: PMC7354125 DOI: 10.21037/tlcr.2020.04.11] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background IBM Watson for Oncology (WFO) is a cognitive computing system helping physicians quickly identify key information in a patient’s medical record, surface relevant evidence, and explore treatment options. This study assessed the possibility of using WFO for clinical treatment in lung cancer patients. Methods We evaluated the level of agreement between WFO and multidisciplinary team (MDT) for lung cancer. From January to December 2018, newly diagnosed lung cancer cases in Chonnam National University Hwasun Hospital were retrospectively examined using WFO version 18.4 according to four treatment categories (surgery, radiotherapy, chemoradiotherapy, and palliative care). Treatment recommendations were considered concordant if the MDT recommendations were designated ‘recommended’ by WFO. Concordance between MDT and WFO was analyzed by Cohen’s kappa value. Results In total, 405 (male 340, female 65) cases with different histology (adenocarcinoma 157, squamous cell carcinoma 132, small cell carcinoma 94, others 22 cases) were enrolled. Concordance between MDT and WFO occurred in 92.4% (k=0.881, P<0.001) of all cases, and concordance differed according to clinical stages. The strength of agreement was very good in stage IV non-small cell lung carcinoma (NSCLC) (100%, k=1.000) and extensive disease small cell lung carcinoma (SCLC) (100%, k=1.000). In stage I NSCLC, the agreement strength was good (92.4%, k=0.855). The concordance was moderate in stage III NSCLC (80.8%, k=0.622) and relatively low in stage II NSCLC (83.3%, k=0.556) and limited disease SCLC (84.6%, k=0.435). There were discordant cases in surgery (7/57, 12.3%), radiotherapy (2/12, 16.7%), and chemoradiotherapy (15/129, 11.6%), but no discordance in metastatic disease patients. Conclusions Treatment recommendations made by WFO and MDT were highly concordant for lung cancer cases especially in metastatic stage. However, WFO was just an assisting tool in stage I–III NSCLC and limited disease SCLC; so, patient-doctor relationship and shared decision making may be more important in this stage.
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Affiliation(s)
- Min-Seok Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ha-Young Park
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Bo-Gun Kho
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Cheol-Kyu Park
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - In-Jae Oh
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young-Chul Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seok Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ju-Sik Yun
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sang-Yun Song
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Kook-Joo Na
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Thoracic Surgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jae-Uk Jeong
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Mee Sun Yoon
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sung-Ja Ahn
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Radiation Oncology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Su Woong Yoo
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Sae-Ryung Kang
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong Young Kwon
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hee-Seung Bom
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Nuclear Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Woo-Youl Jang
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - In-Young Kim
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Neurosurgery, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jong-Eun Lee
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Won-Gi Jeong
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Taebum Lee
- Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Yoo-Duk Choi
- Lung and Esophageal Cancer Clinic, Chonnam National University, Hwasun Hospital, Hwasun, Republic of Korea.,Department of Pathology, Chonnam National University Medical School, Gwangju, Republic of Korea
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Bobbili P, Ryan K, DerSarkissian M, Dua A, Yee C, Duh MS, Gomez JE. Predictors of chemoradiotherapy versus single modality therapy and overall survival among patients with unresectable, stage III non-small cell lung cancer. PLoS One 2020; 15:e0230444. [PMID: 32187231 PMCID: PMC7080248 DOI: 10.1371/journal.pone.0230444] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 02/29/2020] [Indexed: 12/25/2022] Open
Abstract
Introduction Concurrent chemoradiotherapy (cCRT) was the standard of care for patients with unresectable stage III non-small cell lung cancer (NSCLC) prior to the PACIFIC trial, however, patients also received single modality therapy. This study identified predictors of therapy and differences in overall survival (OS). Methods This retrospective study included stage III NSCLC patients aged ≥65 years, with ≥1 claim for systemic therapy (ST) or radiotherapy (RT) within 90 days of diagnosis, identified in SEER-Medicare data (2009–2014). Patients who had overlapping claims for chemotherapy and RT ≤90 days from start of therapy were classified as having received cCRT. Patients who received sequential CRT or surgical resection of tumor were excluded. Predictors of cCRT were analyzed using logistic regression. OS was compared between therapies using adjusted Cox proportional hazards models. Results Of 3,799 patients identified, 21.7% received ST; 26.3% received RT; and 52.0% received cCRT. cCRT patients tended to be younger (p <0.001), White (p = 0.002), and have a good predicted performance status (p<0.001). Patients who saw all three specialist types (medical oncologist, radiation oncologist, and surgeon) had increased odds of receiving cCRT (p<0.001). ST and RT patients had higher mortality risk versus cCRT patients (hazard ratio [95% CI]: ST: 1.38 [1.26–1.51]; RT: 1.75 [1.61, 1.91]); p<0.001). Conclusions Several factors contributed to treatment selection, including patient age and health status, and whether the patient received multidisciplinary care. Given the survival benefit of receiving cCRT over single-modality therapy, physicians should discuss treatment within a multidisciplinary team, and be encouraged to pursue cCRT for patients with unresectable stage III NSCLC.
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Affiliation(s)
- Priyanka Bobbili
- Analysis Group, Inc., Boston, Massachusetts, United States of America
- * E-mail:
| | - Kellie Ryan
- AstraZeneca, Gaithersburg, Maryland, United States of America
| | | | - Akanksha Dua
- Analysis Group, Inc., Boston, Massachusetts, United States of America
| | - Christopher Yee
- Analysis Group, Inc., Boston, Massachusetts, United States of America
| | - Mei Sheng Duh
- Analysis Group, Inc., Boston, Massachusetts, United States of America
| | - Jorge E. Gomez
- Icahn School of Medicine at Mt. Sinai, New York, New York, United States of America
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Ozdemir Y, Topkan E, Mertsoylu H, Selek U. Low Prognostic Nutritional Index Predicts Poor Clinical Outcomes in Patients with Stage IIIB Non-small-cell Lung Carcinoma Undergoing Chemoradiotherapy. Cancer Manag Res 2020; 12:1959-1967. [PMID: 32214853 PMCID: PMC7083637 DOI: 10.2147/cmar.s248034] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 03/06/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose To investigate the prognostic utility of the prognostic nutritional index (PNI) in stage IIIB non-small-cell lung carcinoma (NSCLC) patients undergoing concurrent chemoradiotherapy (CRT). Methods A total of 358 stage IIIB NSCLC patients who received a total dose of 60–66 Gy (2 Gy/fraction) radiotherapy and ≥1 cycle(s) of platinum-based chemotherapy were analyzed. The receiver operating curve analysis was utilized to identify the optimal PNI cut-off value demonstrating a significant connection with the overall survival (OS), locoregional progression-free survival (LRPFS), and progression-free survival (PFS). Results At a median follow-up time of 22.5 months (range: 2.4–123.5), 30.2% and 14% of the patients were still alive and free of disease progression, respectively.The median OS, LRPFS, and PFS were 25.2 [95% confidence interval (CI): 36.3–46.6 months], 15.4 (95% CI: 26.6–35.3 months), and 10.7 (95% CI: 36.8–69.9 months), individually, for the whole study accomplice. The ROC analysis revealed an optimum rounded cut-off that associated meaningfully with each of the OS [area under the curve (AUC): 84.1%; sensitivity: 75.9%;72.4% specificity], LRPFS (AUC: 92.4%; sensitivity: 87.9%; 85.1% specificity), and PFS (AUC: 80.1%; sensitivity: 73.7%; 71.6% specificity) at a value of 40.5. Comparative analyses revealed that the patients presenting with PNI≤40.5 had significantly inferior OS (16.8 vs 36.7; P<0.001), LRPFS (11.5 vs 19.5; P<0.001), and PFS (8.6 vs 13.6; P<0.001) outcomes compared to patients with PNI>40.5. In univariate analyses, lower T-stage (1–2 vs 3–4; P< 0.001), lower N-stage (N2 vs N3; P< 0.001), anemia status (absent vs present; P< 0.001), weight loss status (<5% vs ≥5%; P< 0.001), and PNI group (≤40.5 vs >40.5; P<0.001) were the factors found to be associated with OS, LRPFS and PFS results. The results of multivariate analysis exhibited that the PNI was independently associated with each of the OS (P<0.001), LRPFS (P<0.001), and PFS (P<0.001) outcomes. Conclusion The pretreatment PNI appears to be a robust novel prognostic factor that stratifies patients with stage IIIB NSCLC into two significantly distinct survival groups after CRT.
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Affiliation(s)
- Yurday Ozdemir
- Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey
| | - Erkan Topkan
- Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey
| | - Huseyin Mertsoylu
- Department of Medical Oncology, Baskent University Medical Faculty, Adana, Turkey
| | - Ugur Selek
- School of Medicine, Department of Radiation Oncology, Koc University, Istanbul, Turkey.,MD Anderson Cancer Center, Department of Radiation Oncology, The University of Texas, Houston, TX, USA
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Partovi S, Sin D, Gill A. Less of a good thing – the paradox of reduced multidisciplinary team decision-making. VASA 2019; 48:203-204. [DOI: 10.1024/0301-1526/a000782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Sasan Partovi
- Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio, USA
| | - David Sin
- School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Amanjit Gill
- Imaging Institute, Section of Interventional Radiology, Cleveland Clinic, Cleveland, Ohio, USA
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Tamburini N, Maniscalco P, Mazzara S, Maietti E, Santini A, Calia N, Stefanelli A, Frassoldati A, Santi I, Rinaldi R, Nigim F, Righi R, Pedrazzi S, Cavallesco G. Multidisciplinary management improves survival at 1 year after surgical treatment for non-small-cell lung cancer: a propensity score-matched study. Eur J Cardiothorac Surg 2019; 53:1199-1204. [PMID: 29293943 DOI: 10.1093/ejcts/ezx464] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/28/2017] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVES The management of patients affected by lung cancer requires the expertise of specialists from different disciplines. Although the advantages of multidisciplinary team discussions seem obvious, there are limited studies evaluating the influence of this approach on postoperative outcomes in non-small-cell lung cancer (NSCLC). The aim of this study is to examine the impact of a multidisciplinary approach on survival of patients undergoing surgery for NSCLC. METHODS A retrospective analysis was performed on consecutive patients who underwent surgery for NSCLC between January 2008 and December 2015. Data were compared between patients treated before the implementation of a multidisciplinary tumour board (MTB), between 2008 and 2012, and those who received treatment after the implementation of the MTB, between 2012 and 2015. Patients were matched one to one according to the discussion of the MTB and on the basis of a propensity score built using several patient characteristics. A propensity score-matched analysis was performed to compare patient outcomes. RESULTS A total of 246 patients were treated prior to the initiation of the MTB and 231 patients after the initiation of the MTB. Based on the propensity score, 2 well-matched groups of 170 patients were identified. Patients who were discussed at the MTB were noted to have better outcomes when compared with those who were not discussed at the MTB on different terms including complete staging evaluation, early tumour, node and metastasis (TNM) stages and 1-year survival rate. CONCLUSIONS Implementation of a multidisciplinary thoracic malignancy conference increased the 1-year survival rate of patients who underwent a surgical resection for NSCLC.
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Affiliation(s)
- Nicola Tamburini
- Department of Morfology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Pio Maniscalco
- Department of Morfology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Sara Mazzara
- Department of Morfology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Elisa Maietti
- Center for Clinical Epidemiology of the School of Medicine, University of Ferrara, Ferrara, Italy
| | - Alessandra Santini
- Department of Clinical Oncology, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Nunzio Calia
- Department of Respiratory Diseases, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Antonio Stefanelli
- Department of Radiation Oncology, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Antonio Frassoldati
- Department of Clinical Oncology, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Ivan Santi
- Department of Diagnostic Imaging, Section of Nuclear Medicine, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Rosa Rinaldi
- Department of Anatomic Pathology, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Fares Nigim
- Division of Neurosurgery, Department of Surgery, Harvard Medical School, Boston, MA, USA
| | - Riccardo Righi
- Department of Diagnostic Imaging, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Stefania Pedrazzi
- Department of Clinical Oncology, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
| | - Giorgio Cavallesco
- Department of Morfology, Experimental Medicine and Surgery, Section of General and Thoracic Surgery, Azienda Ospedaliero Universitaria di Ferrara Arcispedale Sant'Anna, Ferrara, Italy
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10
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Hayashi K, Yamamoto N, Nakajima M, Nomoto A, Tsuji H, Ogawa K, Kamada T. Clinical outcomes of carbon-ion radiotherapy for locally advanced non-small-cell lung cancer. Cancer Sci 2019; 110:734-741. [PMID: 30467928 PMCID: PMC6361552 DOI: 10.1111/cas.13890] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 12/21/2022] Open
Abstract
The efficacy and safety of carbon‐ion radiotherapy (CIRT) for locally advanced non‐small‐cell lung cancer (LA‐NSCLC) remain unclear. We reported the clinical outcomes of CIRT for LA‐NSCLC. Data for 141 eligible patients who received CIRT between 1995 and 2015 were retrospectively analyzed. Local control (LC), locoregional control (LRC), progression‐free survival (PFS) and overall survival (OS) were calculated using the Kaplan‐Meier method. The median age was 75.0 years. Overall, 21 (14.9%), 57 (40.4%), 43 (30.5%) and 20 (14.2%) patients had T1, T2, T3 and T4 disease, respectively. Moreover, 51 (36.2%), 45 (31.9%), 40 (28.4%) and 5 (3.5%) patients had N0, N1, N2 and N3 disease, respectively. Furthermore, 34 (24.1%), 42 (29.8%), 45 (31.9%) and 20 (14.2%) patients had stages IIA, IIB, IIIA and ΙΙΙB disease, respectively. Overall, 62 (44.0%), 60 (42.6%), 8 (5.7%) and 11 (7.8%) patients had adenocarcinoma, squamous cell carcinoma, large cell carcinoma, and others, respectively. The median dose was 72.0 Gy (relative biological effectiveness). No patient received concurrent chemotherapy. Median follow‐up periods were 29.3 (1.6‐207.7) and 40.0 (10.7‐207.7) months for all patients and survivors, respectively. Two‐year LC, PFS and OS rates were 80.3%, 40.2% and 58.7%, respectively. Overall, 1 (0.7%), 5 (3.5%) and 1 (0.7%) patient developed Grades 4 (mediastinal hemorrhage), 3 (radiation pneumonitis) and 3 (bronchial fistula) toxicities, respectively. Multivariate analysis showed adenocarcinoma and N2/3 classification as significant poor prognosticators of PFS. CIRT is an effective treatment with acceptable toxicity for LA‐NSCLC, especially for elderly patients or patients with severe comorbidities who cannot be treated with surgery or chemoradiotherapy.
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Affiliation(s)
- Kazuhiko Hayashi
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan.,Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Naoyoshi Yamamoto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Mio Nakajima
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Akihiro Nomoto
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Hiroshi Tsuji
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
| | - Kazuhiko Ogawa
- Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Tadashi Kamada
- Hospital of the National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Sciences and Technology, Chiba, Japan
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11
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Shrimali RK, Nallathambi C, Saha A, Das A, Prasath S, Mahata A, Arun B, Mallick I, Achari R, Dabkara D, Thambudorai R, Chatterjee S. Radical radiotherapy or chemoradiotherapy for inoperable, locally advanced, non-small cell lung cancer: Analysis of patient profile, treatment approaches, and outcomes for 213 patients at a tertiary cancer center. Indian J Cancer 2019; 55:125-133. [PMID: 30604722 DOI: 10.4103/ijc.ijc_469_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Radical radiotherapy (RT) with curative intent, with or without chemotherapy, is the standard treatment for inoperable, locally advanced nonsmall cell lung cancer (NSCLC). MATERIALS AND METHODS We retrospectively reviewed the data for all 288 patients who presented with inoperable, locally advanced NSCLC at our institution, between May 2011 and December 2016. RESULTS RT alone or sequential chemoradiotherapy (SCRT) or concurrent chemoradiotherapy (CCRT) was used for 213 patients. Median age was 64 years (range: 27-88 years). Stage-III was the biggest stage group with 189 (88.7%) patients. Most patients with performance status (PS) 0 or 1 received CCRT, whereas most patients with PS 2 received RT alone (P < 0.001). CCRT, SCRT, and RT alone were used for 120 (56.3%), 24 (11.3%), and 69 (32.4%) patients, respectively. A third of all patients (32.4%) required either volumetric-modulated arc radiotherapy (VMAT) or tomotherapy. Median follow-up was 16 months. The median progression-free survival and median overall survival (OS) were 11 and 20 months, respectively. One-year OS and 2-year OS were 67.9% and 40.7%, respectively. Patients treated using CCRT lived significantly longer with a median survival of 28 months, compared with 13 months using SCRT and RT alone (P < 0.001). On multivariate analysis, OS was significantly affected by age, stage group, treatment approach, and response to treatment. CONCLUSION RT including CCRT is feasible, safe, and well tolerated in our patient population and results in survival benefits comparable with published literature. CCRT should be considered for all patients with inoperable, locally advanced NSCLC, who are fit and have good PS.
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Affiliation(s)
- Raj Kumar Shrimali
- Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Chandran Nallathambi
- Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Animesh Saha
- Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Avipsa Das
- Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Sriram Prasath
- Department of Radiotherapy Physics, Tata Medical Center, Kolkata, West Bengal, India
| | - Anurupa Mahata
- Department of Radiotherapy Physics, Tata Medical Center, Kolkata, West Bengal, India
| | - B Arun
- Department of Radiotherapy Physics, Tata Medical Center, Kolkata, West Bengal, India
| | - Indranil Mallick
- Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Rimpa Achari
- Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Deepak Dabkara
- Department of Medical Oncology, Tata Medical Center, Kolkata, West Bengal, India
| | - Robin Thambudorai
- Department of Thoracic Surgery, Tata Medical Center, Kolkata, West Bengal, India
| | - Sanjoy Chatterjee
- Department of Radiation Oncology, Tata Medical Center, Kolkata, West Bengal, India
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12
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Hong JH, Kim YS, Lee SW, Lee SJ, Kang JH, Hong SH, Hong JY, Cheon G. High-Dose Thoracic Re-irradiation of Lung Cancer Using Highly Conformal Radiotherapy Is Effective with Acceptable Toxicity. Cancer Res Treat 2018; 51:1156-1166. [PMID: 30514067 PMCID: PMC6639224 DOI: 10.4143/crt.2018.472] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 11/28/2018] [Indexed: 12/25/2022] Open
Abstract
Purpose Thoracic re-irradiation (re-RT) of lung cancer has been challenged by the tolerance doses of normal tissues. We retrospectively analyzed local control, overall survival (OS) and toxicity after thoracic re-RT using highly conformal radiotherapy, such as intensity modulated radiotherapy and stereotactic body radiotherapy. Materials and Methods Thirty-one patients who received high-dose thoracic re-RT were analyzed. Doses were recalculated to determine biologically equivalent doses. The median interval to re-RT was 15.1 months (range, 4.4 to 56.3 months), the median initial dose was 79.2 Gy10 (range, 51.75 to 150 Gy10), and the median re-RT dose was 68.8 Gy10 (range, 43.2 to 132 Gy10). Results Eighteen (58.1%) and eleven (35.5%) patients showed loco-regional recurrence and distant metastasis, respectively, after 17.4 months of median follow-up. The 1-year and 2-year local control rates were 60.2% and 43.7%, respectively. The median loco-regional recurrence-free-survival (LRFS) was 15.4 months, and the median OS was 20.4 months. The cumulative and re-RT biologically equivalent dose for α/β=10 (BED10) doses were the most significant prognostic factors. Cumulative BED10 ≥145 Gy10 and re-RT BED10≥68.7 Gy10 were significantly associated with longer OS (p=0.029 and p=0.012, respectively) and LRFS (p=0.003 and p=0.000, respectively). The most frequent acute toxicity was grade 1-2 pulmonary toxicity (41.9%). No acute grade 3 or higher toxicities occurred. Conclusion Our results show that high-dose thoracic re-RT of lung cancer can be safely delivered using highly conformal radiotherapy with favorable survival and acceptable toxicity. An optimal strategy to select patients who would benefit from re-RT is crucial in extending the indications and improving the efficacy with a sufficiently high dose.
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Affiliation(s)
- Ji Hyun Hong
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeon-Sil Kim
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sea-Won Lee
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - So Jung Lee
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin Hyung Kang
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Suk Hee Hong
- Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ju-Young Hong
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - GeumSeong Cheon
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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13
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Lange C, Alghamdi WA, Al-Shaer MH, Brighenti S, Diacon AH, DiNardo AR, Grobbel HP, Gröschel MI, von Groote-Bidlingmaier F, Hauptmann M, Heyckendorf J, Köhler N, Kohl TA, Merker M, Niemann S, Peloquin CA, Reimann M, Schaible UE, Schaub D, Schleusener V, Thye T, Schön T. Perspectives for personalized therapy for patients with multidrug-resistant tuberculosis. J Intern Med 2018; 284:163-188. [PMID: 29806961 DOI: 10.1111/joim.12780] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
According to the World Health Organization (WHO), tuberculosis is the leading cause of death attributed to a single microbial pathogen worldwide. In addition to the large number of patients affected by tuberculosis, the emergence of Mycobacterium tuberculosis drug-resistance is complicating tuberculosis control in many high-burden countries. During the past 5 years, the global number of patients identified with multidrug-resistant tuberculosis (MDR-TB), defined as bacillary resistance at least against rifampicin and isoniazid, the two most active drugs in a treatment regimen, has increased by more than 20% annually. Today we experience a historical peak in the number of patients affected by MDR-TB. The management of MDR-TB is characterized by delayed diagnosis, uncertainty of the extent of bacillary drug-resistance, imprecise standardized drug regimens and dosages, very long duration of therapy and high frequency of adverse events which all translate into a poor prognosis for many of the affected patients. Major scientific and technological advances in recent years provide new perspectives through treatment regimens tailor-made to individual needs. Where available, such personalized treatment has major implications on the treatment outcomes of patients with MDR-TB. The challenge now is to bring these adances to those patients that need them most.
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Affiliation(s)
- C Lange
- Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
- Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - W A Alghamdi
- Department of Pharmacotherapy and Translational Research, Infectious Disease Pharmacokinetics Laboratory, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - M H Al-Shaer
- Department of Pharmacotherapy and Translational Research, Infectious Disease Pharmacokinetics Laboratory, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - S Brighenti
- Department of Medicine, Center for Infectious Medicine (CIM), Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
| | - A H Diacon
- Task Applied Science, Bellville, South Africa
- Division of Physiology, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - A R DiNardo
- Section of Global and Immigrant Health, Baylor College of Medicine, Houston, TX, USA
| | - H P Grobbel
- Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
| | - M I Gröschel
- Department of Pumonary Diseases & Tuberculosis, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Molecular and Experimental Mycobacteriology, National Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany
| | | | - M Hauptmann
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- Cellular Microbiology, Research Center Borstel, Borstel, Germany
| | - J Heyckendorf
- Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
| | - N Köhler
- Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
| | - T A Kohl
- Molecular and Experimental Mycobacteriology, National Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany
| | - M Merker
- Molecular and Experimental Mycobacteriology, National Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany
| | - S Niemann
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- Molecular and Experimental Mycobacteriology, National Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany
| | - C A Peloquin
- Department of Pharmacotherapy and Translational Research, Infectious Disease Pharmacokinetics Laboratory, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - M Reimann
- Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
| | - U E Schaible
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- Cellular Microbiology, Research Center Borstel, Borstel, Germany
- Biochemical Microbiology & Immunochemistry, University of Lübeck, Lübeck, Germany
- LRA INFECTIONS'21, Borstel, Germany
| | - D Schaub
- Clinical Infectious Diseases, Research Center Borstel, Borstel, Germany
- Tuberculosis Unit, German Center for Infection Research (DZIF), Borstel, Germany
- International Health/Infectious Diseases, University of Lübeck, Lübeck, Germany
| | - V Schleusener
- Molecular and Experimental Mycobacteriology, National Reference Center for Mycobacteria, Research Center Borstel, Borstel, Germany
| | - T Thye
- Department of Infectious Disease Epidemiology, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - T Schön
- Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
- Department of Clinical Microbiology and Infectious Diseases, Kalmar County Hospital, Linköping University, Linköping, Sweden
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14
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Eser PÖ, Jänne PA. TGFβ pathway inhibition in the treatment of non-small cell lung cancer. Pharmacol Ther 2018; 184:112-130. [DOI: 10.1016/j.pharmthera.2017.11.004] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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15
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Zhao C, Li Y, Zhang W, Zhao D, Ma L, Ma P, Yang F, Wang Y, Shu Y, Qiu W. IL‑17 induces NSCLC A549 cell proliferation via the upregulation of HMGA1, resulting in an increased cyclin D1 expression. Int J Oncol 2018; 52:1579-1592. [PMID: 29512693 DOI: 10.3892/ijo.2018.4307] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/16/2018] [Indexed: 11/06/2022] Open
Abstract
Non-small cell lung cancer (NSCLC) is considered to be an inflammation-associated carcinoma. Although interleukin‑17 (IL‑17) production contributes to the proliferation and growth of NSCLC, the mechanisms underlying IL‑17-induced NSCLC cell proliferation have not been fully elucidated. In the present study, by using ELISA and immunohistochemical analyses, we first found that the expression levels of IL‑17, IL‑17 receptor (IL‑17R), high-mobility group A1 (HMGA1) and cyclin D1 were elevated in the samples of patients with NSCLC. Subsequently, by RT-qPCR, western blot analysis and cell proliferation assay in vitro, we revealed that stimulation with recombinant human IL‑17 (namely IL‑17A) markedly induced the expression of HMGA1 and cyclin D1 in the A549 cells (a human lung adenocarcinoma cell line) and promoted cell proliferation. Furthermore, luciferase reporter and ChIP assays confirmed that upregulated HMGA1 directly bound to the cyclin D1 gene promoter and activated its transcription. Notably, the response element of HMGA1 binding to the cyclin D1 promoter was disclosed for the first time, at least to the best of our knowledge. Taken together, our findings indicate that the IL‑17/HMGA1/cyclin D1 axis plays an important role in NSCLC cell proliferation and may provide new insight into NSCLC pathogenesis and may thus aid in the development of novel therapeutic targets for NSCLC.
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Affiliation(s)
- Chenhui Zhao
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China
| | - Yongting Li
- Department of Immunology, Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China
| | - Weiming Zhang
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China
| | - Dan Zhao
- Department of Immunology, Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China
| | - Ling Ma
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China
| | - Pei Ma
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China
| | - Fengming Yang
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China
| | - Yingwei Wang
- Department of Immunology, Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China
| | - Yongqian Shu
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210009, P.R. China
| | - Wen Qiu
- Department of Immunology, Nanjing Medical University, Nanjing, Jiangsu 211166, P.R. China
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16
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Choi HS, Jeong BK, Jeong H, Lee YH, Ha IB, Song JH, Kang KM. Application of the new 8th TNM staging system for non-small cell lung cancer: treated with curative concurrent chemoradiotherapy. Radiat Oncol 2017; 12:122. [PMID: 28732516 PMCID: PMC5521086 DOI: 10.1186/s13014-017-0848-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Accepted: 06/26/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The eighth tumor, node, metastasis (TNM) staging system (8-TNM) for non-small cell lung cancer (NSCLC) was newly released in 2015. This system had limitation because most patients included in the analysis were treated with surgery. Therefore, it might be difficult to reflect prognosis of patients treated with curative concurrent chemoradiotherapy (CCRT). Purpose of this study was to investigate clinical impact of the newly published 8-TNM compared to the current seventh TNM staging system (7-TNM) for locally advanced NSCLC patients treated with CCRT. METHODS New 8-TNM was applied to 64 patients with locally advanced NSCLC who were treated with CCRT from 2010 to 2015. Changes in T category and stage group by 8-TNM were recorded and patterns of change were evaluated. Survival was analyzed according to T category, N category, and stage group in each staging system, respectively. RESULTS Among the total of 64 patients, 38 (59.4%) patients showed change in T category while 22 (34.4%) patients showed change in stage group using 8-TNM compared to 7-TNM. Survival curves were significantly separated in the 8-TNM stage group (p = 0.001) than those in the 7-TNM (p > 0.05). Especially, survival of newly introduced stage IIIC by 8-TNM was significantly lower than that of others. On the other hand, there was no significant survival difference between T categories in each staging system. CONCLUSIONS Subdivision of stage III into IIIA, IIIB, and IIIC by 8-TNM for patients treated with CCRT better reflected prognosis than 7-TNM. However, subdivision of T category according to tumor size in 8-TNM might be less significant.
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Affiliation(s)
- Hoon Sik Choi
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 13 Samjungja-ro, Changwon, 51472, Republic of Korea
| | - Bae Kwon Jeong
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju, 52727, Republic of Korea.,Institute of Health Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Hojin Jeong
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju, 52727, Republic of Korea.,Institute of Health Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Yun Hee Lee
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju, 52727, Republic of Korea.,Institute of Health Science, Gyeongsang National University, Jinju, Republic of Korea
| | - In Bong Ha
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju, 52727, Republic of Korea
| | - Jin Ho Song
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, 13 Samjungja-ro, Changwon, 51472, Republic of Korea. .,Institute of Health Science, Gyeongsang National University, Jinju, Republic of Korea.
| | - Ki Mun Kang
- Department of Radiation Oncology, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, 79 Gangnam-ro, Jinju, 52727, Republic of Korea. .,Institute of Health Science, Gyeongsang National University, Jinju, Republic of Korea.
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