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Hu X, Geetha RV, Surapaneni KM, Veeraraghavan VP, Chinnathambi A, Alahmadi TA, Manikandan V, Manokaran K. Lung cancer induced by Benzo(A)Pyrene: ChemoProtective effect of sinapic acid in swiss albino mice. Saudi J Biol Sci 2021; 28:7125-7133. [PMID: 34867015 PMCID: PMC8626324 DOI: 10.1016/j.sjbs.2021.08.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/02/2021] [Accepted: 08/01/2021] [Indexed: 01/02/2023] Open
Abstract
Cancer of lung is the utmost typical cause of death and the number of cases is increasing rapidly, which has emerged as a major leading health problem. A large amount of reports suggested that Benzo(a)pyrene [B(a)P] in cigarette smoke plays the major function in an initiation of cancer of lung. Cancer prevention or chemoprevention has become a compelling approach recently for treatment of lung cancer. So, discovering a fresh candidate with reduced toxicity for targeting lung cancer is vital and urgent. Sinapic acid which is a widely extracted in various vegetables and fruit exhibits rich anti-oxidant content, anti-inflammatory and anti-tumor activity. But, the chemopreventive action of sinapic acid against lung cancer initiated by B[a]P remain unclear. Following, an in-vivo B[a]P-stimulated lung cancer in swiss albino mice and an in-vitro human lung cancer cell (A549) model were established to examine the chemopreventive activities of sinapic acid. The levels of immunoglobulins (IgG and IgM), oxidative and inflammatory markers, and tumor markers level was studied using kits and standard methods. The results showed administration of sinapic acid ameliorates the exposure of B[a]P mediated lung cancer in swiss albino mice by a decline in IgG and IgM level, leukocyte count, neutrophil function tests, soluble immune complex, lipid peroxidation, pro-inflammatory cytokines, tumor markers (AHH, LDH, GGT, 5'NT and CEA) and enhanced phagocytic index, activity index and antioxidant defense enzymes. In addition, in-vitro studies showed potential cytotoxicity against human lung cancer and exhibited a potential cytotoxic (MTT assay) and apoptotic activity by elevation of ROS production and caspase activity (caspase-3 and caspase-9). Collectively, the results, clearly specifies sinapic acid can be utilized as an effective chemo preventative agent against lung carcinogenesis.
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Affiliation(s)
- Xinglong Hu
- Department of General Surgery, Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| | - Royapuram Veeraragavan Geetha
- Department of Microbiology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India
| | - Krishna Mohan Surapaneni
- Department of Biochemistry, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai 600 123, India
| | - Vishnu Priya Veeraraghavan
- Department of Biochemistry, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 600 077, India
| | - Arunachalam Chinnathambi
- Department of Botany and Microbiology, College of Science, King Saud University, PO Box -2455, Riyadh 11451, Saudi Arabia
| | - Tahani Awad Alahmadi
- Department of Pediatrics, College of Medicine and King Khalid University Hospital, King Saud University, Medical City, PO Box-2925, Riyadh 11461, Saudi Arabia
| | - Velu Manikandan
- Division of Biotechnology, College of Environmental and Bioresource Sciences, Jeonbuk National University, Iksan 54596, South Korea
| | - Kalaivani Manokaran
- Department of Medical Laboratory Technology, Manipal College of Health Professions, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka 576104, India
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Factors affecting survival after palliative radiotherapy in patients with lung cancer. Rep Pract Oncol Radiother 2021; 26:674-682. [PMID: 34760303 DOI: 10.5603/rpor.a2021.0079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 02/28/2021] [Indexed: 11/25/2022] Open
Abstract
Background Lung cancer is the most common cancer worldwide. It is estimated that 60% of patients with NSCLC at time of diagnosis have advanced disease. The aim of this study was to identify factors that play a major role in the survival of lung cancer patients treated with palliative radiotherapy. Materials and methods We retrospectively reviewed data of 280 lung cancer patients treated with palliative radiotherapy from January 2013 to December 2017. A multivariate analysis using the proportional hazards model of Cox was conducted. Also, Kaplan Meier curves were used to describe the distribution of survival times of the patients. The level of significance was set at 0.05. Results The mean age at diagnosis was 65.6 years. About 77.5% of patients were male and 22.5% were female. In our cohort > 95% had stage 4 lung cancer. Most cases were adenocarcinomas (72.5%) and ECOG-PS 0-1 (80.4%). Different sites were submitted to palliative treatment: 120 brain metastases, 96 bone metastases, 53 lung tumour, 8 lymph nodes and 3 lung metastases. Brain as first site of palliative radiotherapy (HR: 1.553, 95% CI: 1.167-2.067, p = 0.003) and ECOG-PS 2-3 compared with ECOG-PS 0-1 (HR: 2.253, 95% CI: 1.546-3.283, p ≤ 0.001) were associated with increased likelihood of lung cancer death. Patients who received biological therapy had 70.7% (p ≤ 0.001) reduction in lung cancer death risk. Conclusion Brain as the first metastatic site treated with radiotherapy and ECOG-PS 2-3 are associated with increased lung cancer death. Biological therapy was associated with decreased death risk.
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Quality of End-of-Life Care for People with Advanced Non-Small Cell Lung Cancer in Ontario: A Population-Based Study. ACTA ACUST UNITED AC 2021; 28:3297-3315. [PMID: 34590598 PMCID: PMC8406090 DOI: 10.3390/curroncol28050286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/13/2021] [Accepted: 08/23/2021] [Indexed: 11/17/2022]
Abstract
Ensuring high quality end of life (EOL) care is necessary for people with advanced non-small-cell lung cancer (NSCLC), given its high incidence, mortality and symptom burden. Aggressive EOL care can adversely affect the quality of life of NSCLC patients without providing meaningful oncologic benefit. Objectives: (1) To describe EOL health services quality indicators and timing of palliative care consultation provided to patients dying of NSCLC. (2) To examine associations between aggressive and supportive care and patient, disease and treatment characteristics. Methods: This retrospective population-based cohort study describes those who died of NSCLC in Ontario, Canada from 2009–2017. Socio-demographic, patient, disease and treatment characteristics as well as EOL health service quality and use of palliative care consultation were investigated. Multivariable logistic regression models examined factors associated with receiving aggressive or supportive care. Results: Aggressive care quality indicators were present in 50.3% and supportive care indicators in 60.3% of the cohort (N = 37,203). Aggressive care indicators decreased between 2009 and 2017 (57.4% to 45.3%) and increased for supportive care (54.2% to 67.5%). Benchmarks were not met by 2017 in 3 of 4 cases. Male sex and greater comorbidity were associated with more aggressive EOL care and less supportive care. Older age was negatively associated and rurality positively associated with aggressive care. No palliative care consultation occurred in 56.0%. Conclusions: While improvements in the use of supportive rather than aggressive care were noted, established Canadian benchmarks were not met. Moreover, there is variation in EOL quality between groups and use of earlier palliative care must improve.
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Polański J, Jankowska-Polańska B, Mazur G. Relationship Between Nutritional Status and Quality of Life in Patients with Lung Cancer. Cancer Manag Res 2021; 13:1407-1416. [PMID: 33603484 PMCID: PMC7886085 DOI: 10.2147/cmar.s287551] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction Malnutrition is often co-occur in patients with advanced cancer and are associated with poorer response to treatment therapy and decrease significantly the quality of life (QoL). There is little evidence regarding the relationship between nutritional status and QoL in this patient group. Purpose of the Study To assess the relationship between nutritional status and QoL in patients with lung cancer. Methods Our cross-sectional, descriptive study included 310 patients. Only standardized instruments were used to perform the study: Mini Nutritional Assessment (MNA) to assess nutritional status and The European Organization for Research and Treatment of Cancer Quality of Life Core-30 (EORTC-QLQ-C30) and Lung Cancer-13 (LC-13) to assess the QoL. Results The mean age in the study group was 63.77±9.43. 18.71% of patients were malnourished 44.19% at risk of malnutrition and 37.1% of patients had normal nutritional status. Clinical characteristics showed that 75% of respondents had been diagnosed with non-small-cell lung carcinoma, with an average duration of illness of 1–2 years. Nearly all patients received symptomatic treatment, and one in two had undergone surgery. At subsequent stages, QoL was analyzed in three groups depending on nutritional status risk. Malnourished patients had a lower quality of life and greater severity of cancer symptoms than those with a normal nutritional status (p<0.001). In regression analysis, nutritional status has a significant impact on all QLQ-C30 functional scales. Regression parameters are positive, indicating that better nutritional status is associated with better functioning in specific QLQ domains. Conclusion A considerable proportion of lung cancer patients are either malnourished or at risk of malnutrition. Malnutrition correlates negatively with QoL and increases symptom severity. Malnutrition is an independent determinant of lower QoL. Implications for Practice Nutritional assessment should be accompanied by QoL evaluation, so that nutritional interventions can be optimized based on a patient’s individual requirements.
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Affiliation(s)
- Jacek Polański
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wrocław Medical University, Wrocław, 50-367, Poland
| | | | - Grzegorz Mazur
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wrocław Medical University, Wrocław, 50-367, Poland
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Risk Factors for Short-Term Lung Cancer Survival. J Clin Med 2021; 10:jcm10030519. [PMID: 33535673 PMCID: PMC7867142 DOI: 10.3390/jcm10030519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/13/2021] [Accepted: 01/26/2021] [Indexed: 12/25/2022] Open
Abstract
Background: Lung cancer is typically diagnosed in an advanced phase of its natural history. Explanatory models based on epidemiological and clinical variables provide an approximation of patient survival less than one year using information extracted from the case history only, whereas models involving therapeutic variables must confirm that any treatment applied is worse than surgery in survival terms. Models for classifying less than one year survival for patients diagnosed with lung cancer which are able to identify risk factors and quantify their effect for prognosis are analyzed. Method: Two stepwise binary logistic regression models, based on a retrospective study of 521 cases of patients diagnosed with lung cancer in the Interventional Pneumology Unit at the Hospital “Virgen de las Nieves”, Granada, Spain. Results: The first model included variables age, history of pulmonary neoplasm, tumor location, dyspnea, dysphonia, and chest pain. The independent risk factors age greater than 70 years, a peripheral location, dyspnea and dysphonia were significant. For the second model, treatments were also significant. Conclusions: Age, history of pulmonary neoplasm, tumor location, dyspnea, dysphonia, and chest pain are predictors for survival in patients diagnosed with lung cancer at the time of diagnosis. The treatment applied is significant for classifying less than one year survival time which confirms that any treatment is markedly inferior to surgery in terms of survival. This allows to consider applications of more or less aggressive treatments, anticipation of palliative cares or comfort measures, inclusion in clinical trials, etc.
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Zhong B, Shen J, Zhang C, Zhou G, Yu Y, Qin E, Tang J, Wu D, Liang X. Plasma Heat Shock Protein 90 Alpha: A Valuable Predictor of Early Chemotherapy Effectiveness in Advanced Non-Small-Cell Lung Cancer. Med Sci Monit 2021; 27:e924778. [PMID: 33419959 PMCID: PMC7805245 DOI: 10.12659/msm.924778] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background Heat shock protein-90 alpha (HSP90α) is more abundant in non-small-cell lung cancer (NSCLC) patients than in control individuals. However, whether it can reflect chemotherapy efficacy remains unknown. This study aimed to investigate the association of HSP90α with chemotherapy in advanced NSCLC. Material/Methods We retrospectively evaluated data from patients admitted to the Department of Respiratory Medicine, Shaoxing People’s Hospital, from September 2016 to September 2018 with stage IIIB or IV NSCLC and administered 4 cycles of third-generation platinum-based combination chemotherapy (2 drugs simultaneously). Based on the RECIST1.1 criteria, complete remission (CR), partial response (PR), and stable disease (SD) in 60 cases were determined before and after chemotherapy. Before chemotherapy and after 1, 2, and 4 cycles of chemotherapy, plasma HSP90α levels were quantitated by ELISA. Chest CT was performed before and after 2 and 4 cycles of chemotherapy. Results After 1–4 cycles of chemotherapy, plasma HSP90α levels were significantly lower than pre-chemotherapy levels (P<0.05). The sums of the longest tumor diameters after 2 and 4 cycles of chemotherapy were decreased compared with pre-chemotherapy values (P<0.05). Plasma HSP90α levels and tumor size showed no significant correlation before and after chemotherapy (r=0.244, P=0.06). Conclusions Plasma HSP90α can be considered a valuable predictor of early chemotherapy effectiveness in advanced NSCLC, and is positively correlated with tumor remission after chemotherapy. However, plasma HSP90α level is not correlated with tumor diameter and pathological type.
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Affiliation(s)
- Bo Zhong
- Department of Respiratory Medicine, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Juxin Shen
- Department of Respiratory Medicine, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Chunyi Zhang
- Department of Respiratory Medicine, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Guozhong Zhou
- Department of Clinical Laboratory, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Yuefang Yu
- Department of Respiratory Medicine, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
| | - E Qin
- Department of Respiratory Medicine, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Jixian Tang
- Department of Respiratory Medicine, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Dongping Wu
- Department of Oncology, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
| | - Xiaochao Liang
- Department of Respiratory Medicine, Shaoxing People's Hospital, Shaoxing, Zhejiang, China (mainland)
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Kaiser U, Vehling-Kaiser U, Kück F, Mechie NC, Hoffmann A, Kaiser F. Use of symptom-focused oncological cancer therapies in hospices: a retrospective analysis. BMC Palliat Care 2020; 19:140. [PMID: 32919468 PMCID: PMC7488695 DOI: 10.1186/s12904-020-00648-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 09/06/2020] [Indexed: 12/04/2022] Open
Abstract
Background There is controversy regarding the practical implementation of symptom-focused oncological cancer therapies to hospice residents. In this study, we aim to analyse the use and indication of supportive-oncological cancer therapies in hospices. Methods We conducted a retrospective survey of all residents of two hospice centres in the government district of Lower Bavaria, Germany. Hospice 1 (H1) was a member of an oncological–palliative medical network, and hospice 2 (H2) was independently organized. The evaluation period was the first 40 months after the opening of the respective hospice care centre. Demographical and epidemiological data as well as indications and type of supportive-oncological cancer therapies were recorded. A descriptive analysis and statistical tests were performed. Results Of the 706 residents, 645 had an underlying malignant disease. The average age was 72 years and the mean residence time was 28 days. The most frequent cancer types were gastrointestinal cancers, gynaecological cancers and bronchial carcinomas. Overall 39 residents (33 in H1 and 6 in H2, p < 0.01) received symptom-focused oncological cancer therapy. The average age of these residents was 68 years, and the mean residence time was 55 days. The most common therapeutic indications were dyspnoea and pain. The most common symptom-focused oncological cancer therapies were bisphosphonates, transfusions (erythrocyte- and platelet- concentrates), radiotherapy and anti-proliferative drugs (chemotherapy, anti-hormonal- and targeted- therapies). Patients with therapy lived significantly longer than patients without therapy (p < 0.01). Conclusions Symptom-focused oncological cancer therapies can be implemented in hospices; however, their implementation seems to require certain structural and organizational prerequisites as well as careful patient selection. As a palliative medical approach, the focus is to ameliorate the symptoms and not prolong life. Symptom-focused oncology treatment could be a further and important part for the therapy of hospice patients in the future.
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Affiliation(s)
- Ulrich Kaiser
- University Hospital Regensburg, Clinic and Polyclinic for Internal Medicine III, Regensburg, Germany
| | | | - Fabian Kück
- Department of Medical Statistics, University Medical Center Göttingen, Göttingen, Germany
| | - Nicolae-Catalin Mechie
- University Medicine Göttingen, Clinic for Gastroenterology and Gastrointestinal Oncology, Göttingen, Germany
| | | | - Florian Kaiser
- University Medicine Göttingen, Clinic for Haematology and Medical Oncology, Robert-Koch-Straße 40, 37075, Göttingen, Germany.
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Proanthocyanidin-Rich Fractions from Red Rice Extract Enhance TNF-α-Induced Cell Death and Suppress Invasion of Human Lung Adenocarcinoma Cell A549. Molecules 2019; 24:molecules24183393. [PMID: 31540489 PMCID: PMC6767152 DOI: 10.3390/molecules24183393] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 09/10/2019] [Accepted: 09/17/2019] [Indexed: 01/08/2023] Open
Abstract
Tumor necrosis factor-alpha (TNF-α) plays a key role in promoting tumor progression, such as stimulation of cell proliferation and metastasis via activation of NF-κB and AP-1. The proanthocyanidin-rich fraction obtained from red rice (PRFR) has been reported for its anti-tumor effects in cancer cells. This study investigated the molecular mechanisms associated with PRFR on cell survival and metastasis of TNF-α-induced A549 human lung adenocarcinoma. Notably, PRFR enhanced TNF-α-induced A549 cell death when compared with PRFP alone and caused a G0-G1 cell cycle arrest. Although, PRFR alone enhanced cell apoptosis, the combination treatment induced the cells that had been enhanced with PRFR and TNF-α to apoptosis that was less than PRFR alone and displayed a partial effect on caspase-8 activation and PARP cleavage. By using the autophagy inhibitor; 3-MA attenuated the effect of how PRFR enhanced TNF-α-induced cell death. This indicates that PRFR not only enhanced TNF-α-induced A549 cell death by apoptotic pathway, but also by induction autophagy. Moreover, PRFR also inhibited TNF-α-induced A549 cell invasion. This effect was associated with PRFR suppressed the TNF-α-induced level of expression for survival, proliferation, and invasive proteins. This was due to reduce of MAPKs, Akt, NF-κB, and AP-1 activation. Taken together, our results suggest that TNF-α-induced A549 cell survival and invasion are attenuated by PRFR through the suppression of the MAPKs, Akt, AP-1, and NF-κB signaling pathways.
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Chemistry and pharmacological diversity of quinoxaline motifs as anticancer agents. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2019; 69:177-196. [PMID: 31259731 DOI: 10.2478/acph-2019-0013] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/26/2018] [Indexed: 01/19/2023]
Abstract
Surpassing heart diseases, cancer is taking the lead as the deadliest disease because of its fast rate of spreading in all parts of the world. Tireless commitment to searching for novel therapeutic medicines is a worthwhile adventure in synthetic chemistry because of the drug resistance predicament and regular outbreak of new diseases due to abnormal cell growth and proliferation. Medicinal chemistry researchers and pharmacists have unveiled quinoxaline templates as precursors of importance and valuable intermediates in drug discovery because they have been established to possess diverse pharmacological potentials. Hence, this review highlights the current versatile routes to accessing functionalized quinoxaline motifs and harnessing their documented therapeutic potentials for anticancer drug development.
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Abstract
PURPOSE OF REVIEW Despite recent advances in the care of patients with advanced non-small cell lung cancer (NSCLC), significant morbidity and mortality remains. Symptoms caused by the cancer and its treatments can be profoundly debilitating. Palliative care aims to reduce this burden. In this review, we discuss the definition, purpose, benefits, and optimal timing of palliative care in advanced NSCLC. RECENT FINDINGS Several studies evaluating the value of early palliative care for patients with advanced NSCLC and other advanced malignancies have identified benefits for patients, caregivers, and health systems. For patients with advanced NSCLC, introduction of palliative care early in the disease course improves quality of life and even overall survival. Early institution of palliative care should become standard of care for patients with advanced NSCLC.
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Affiliation(s)
| | - Scott K Dessain
- Lankenau Institute for Medical Research, 100 East Lancaster Avenue, Wynnewood, PA, 19096, USA
| | - Tracey L Evans
- Lankenau Cancer Center, PA, Wynnewood, USA.
- Lankenau Institute for Medical Research, 100 East Lancaster Avenue, Wynnewood, PA, 19096, USA.
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Mohan V, Koul A. Anticancer potential of Tinospora cordifolia and arabinogalactan against benzo(a)pyrene induced pulmonary tumorigenesis: a study in relevance to various biomarkers. JOURNAL OF HERBMED PHARMACOLOGY 2018. [DOI: 10.15171/jhp.2018.35] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Gao Y, Gao F, Ma JL, Zhang XZ, Li Y, Song LP, Zhao DL. Analysis of the characteristics and prognosis of advanced non-small-cell lung cancer in older patients. Patient Prefer Adherence 2015; 9:1189-94. [PMID: 26316724 PMCID: PMC4548719 DOI: 10.2147/ppa.s87069] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE Lung cancer is still the leading cause of cancer-related deaths worldwide. However, most elderly patients with advanced non-small-cell lung cancer (NSCLC) have been undertreated and the outcome related to age is controversial. A retrospective analysis was conducted for advanced NSCLC in order to investigate the characteristics and prognosis of older patients. METHODS Medical records were collected from 165 patients with NSCLC (stages IIIA-IIIB) who had been treated with concurrent chemoradiotherapy (CRT) or radiotherapy from January 2009 to January 2011. The cases were divided into two age groups 1) patients ≥70 years old; 2) patients <70 years old. There were 73 patients in group I, 92 in group II. Patient characteristics, treatment toxicities, and prognosis were evaluated. RESULTS Of the 165 patients analyzed, 34 patients (34/73) in group I received concurrent CRT while 47 (47/92) in group II completed that treatment. No significant difference was observed in the reason for patients who discontinued CRT in two groups (P>0.05). In the patients with adenocarcinoma, more cases were found in group II than that in group I; the more squamous cell carcinoma and the more smokers with squamous cell carcinoma were seen in older group (P<0.05). With a median follow-up of 20.5 months, the 1-year survival for group I and II were 49.3% and 40.2% respectively (P=0.243). Two-year survival for the two groups was 20.5% and 16.3% (P=0.483); 3-year survival was 9.6% and 9.8% (P=0.967). There was no significant difference between two groups statistically in survival by univariate analysis (P>0.05). The therapy-related toxicities in group I seem to be similar to the group II (P>0.05). CONCLUSION More adenocarcinoma patients were found in youthful lung cancer and the more smokers with squamous cell carcinoma were seen in older group. Age is not the important factor for the selection and allocation of treatment in advanced NSCLC. The same prognosis and toxicities had been shown in older and young. Age may not be an independent increased risk of death in advanced NSCLC.
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Affiliation(s)
- Ying Gao
- Department of Radiotherapy Oncology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
- Correspondence: Ying Gao; Dong-li Zhao, Department of Radiotherapy Oncology, First Affiliated Hospital of Xi’an Jiaotong University, 277 Yan Ta West Road, Xi’an 710061, People’s Republic of China, Tel +86 29 8532 4029, Email ;
| | - Fei Gao
- Department of Neurology, First Affiliated Hospital of Xi’an Medical University, Xi’an, People’s Republic of China
| | - Jin-lu Ma
- Department of Radiotherapy Oncology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Xiao-zhi Zhang
- Department of Radiotherapy Oncology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Yi Li
- Department of Radiotherapy Oncology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Li-ping Song
- Department of Radiotherapy Oncology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
| | - Dong-li Zhao
- Department of Radiotherapy Oncology, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, People’s Republic of China
- Correspondence: Ying Gao; Dong-li Zhao, Department of Radiotherapy Oncology, First Affiliated Hospital of Xi’an Jiaotong University, 277 Yan Ta West Road, Xi’an 710061, People’s Republic of China, Tel +86 29 8532 4029, Email ;
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Incidence of chemotherapy discontinuation and characteristics of elderly patients with non-small cell lung cancer treated with platinum-based doublets. Contemp Oncol (Pozn) 2014; 18:340-3. [PMID: 25477757 PMCID: PMC4248059 DOI: 10.5114/wo.2014.45293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 08/13/2014] [Accepted: 08/14/2014] [Indexed: 11/17/2022] Open
Abstract
Aim of the study To compare patient's characteristics, clinical data, and rates of chemotherapy discontinuation in advanced NSCLC (non-small cell lung cancer) patients treated with platinum-based association chemotherapy (elderly vs. younger counterparts). To evaluate if there are certain factors that can predict discontinuation of chemotherapy. Material and methods A retrospective analysis of all cases of advanced NSCLC treated with either cisplatin-gemcitabine or cisplatin-vinorelbine at the Regional Institute of Oncology Iaşi between January 2012 and December 2013 was performed. Patients were divided into two groups: over 70 years old and under 70 years old. Patient's characteristics and clinical data (including whether or not the patient discontinued treatment) were recorded for each case. Results The elderly patients had more comorbidities (p = 0.003), were prescribed a larger number of pills (p = 0.02), and had longer periods of hospitalisation (p = 0.005). No difference in toxicity was noted between the two groups. Five patients chose to discontinue chemotherapy in the elderly group. Only two patients made the same choice (p = 0.02) in the younger group. Correlation analysis revealed that refusal of further chemotherapy was associated with the length of hospital stay, number of pills per day, and smoking status. Conclusions Geriatricians should minimise iatrogeny and polypharmacy by optimising long-term treatment. This will increase the chance that elderly patients will not discontinue chemotherapy. Hospital stay should be reduced to a minimum. As life span increases so does the number of elderly patients with cancer; it is vital to understand and prevent the causes of chemotherapy discontinuation in order to achieve optimal therapeutic results.
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