Advances in Lung Cancer
ISSN / EISSN : 2169-2718 / 2169-2726
Current Publisher: Scientific Research Publishing, Inc. (10.4236)
Total articles ≅ 46
Latest articles in this journal
Advances in Lung Cancer, Volume 9, pp 24-29; doi:10.4236/alc.2020.92003
A NF1 (neurofibromatosis 1) patient developed multiple necrotic lung metastases from a sciatic malignant peripheral nerve sheath tumor (MPNST) invading the superficial femoral artery. The first diagnosis was metastases of a non-small-cell adenocarcinoma because the right calf MPNST was not clinically noticeable ant that the chest/abdomen PET/CT did not include the region of the legs. When the MPNST was diagnosed, new histological analysis on the metastases changed the diagnosis to that of epithelioid undifferentiated sarcoma. The article deals with the sometimes-delayed diagnosis in those NF1 patients with large palpable masses and chronic pain pre-existing the malignant transformation, and discusses the difficulty of the biopsy of necrotic metastases.
Advances in Lung Cancer, Volume 9, pp 1-15; doi:10.4236/alc.2020.91001
Lung cancer is one of the leading causes of death worldwide, accounting for an estimated 2.1 million cases in 2018. To analyze the risk factors behind the lung cancer survival, this paper employs two main models: Kaplan-Meier estimator and Cox proportional hazard model . Also, log-rank test and wald test are utilized to test whether a correlation exists or not, which is discussed in detail in later parts of the paper. The aim is to find out the most influential factors for the survival probability of lung cancer patients. To summarize the results, stage of cancer is always a significant factor for lung cancer survival, and time has to be taken into account when analyzing the survival rate of patients in our data sample, which is from TCGA. Future study on lung cancer is also required to make improvement for the treatment of lung cancer, as our data sample might not represent the overall condition of patients diagnosed with lung cancer; also, more appropriate and advanced models should be employed in order to reflect factors that can affect survival rate of patients with lung cancer in detail.
Advances in Lung Cancer, Volume 9, pp 41-54; doi:10.4236/alc.2020.93005
Introduction: Apart from smoking as the known risk factor for lung cancer, recent developments implicate occupational exposure to carcinogens, indoor air pollution and dietary factors as other causative agents. In our study, we have analyzed the clinical and pathological profile of lung cancer patients treated at our center over a period of 8 years. Aim: To find the demographic and clinicopathological profile of lung cancer patients admitted to the oncology unit. Methods: This retrospective record based analysis includes a cohort of 1248 patients diagnosed with lung cancer, at a tertiary cancer care center in Bangalore, South India. This study includes data of patients admitted during the period 2010 to 2018, retrieved from the Hospital’s emergency medical records (EMR). Their demographic profile, clinical correlates, radiological profile and diagnostic details were studied. Benign tumours, malignant pleural disease and sarcomatoid tumors were excluded from this study. Results: Adenocarcinoma (AC) was detected among 70.4% of patients, Squamous cell carcinoma (SCC) among 15.3% and Small cell lung cancer (SCLC) among 14.3% of lung cancer admissions. Male to female ratio was 2.95:1. It was found that the median age of lung cancer patients was 61 years. >60% of lung cancer patients were from the 51 - 70 year age-group. Across the three types of cancers among the patients in Stage 3B to 4 strata, >35% received palliative chemotherapy and >20% received palliative chemotherapy + radiation. Conclusion: In our study, AC is the most common histological subtype (>70%) of lung cancer. The outcome of lung cancer patients can be considerably impacted by addressing risk factors through preventive measures implemented in the community.
Advances in Lung Cancer, Volume 9, pp 30-40; doi:10.4236/alc.2020.92004
In recent years, the incidence of lung adenocarcinoma has been increasing, and now it has become the largest type of non-small cell lung cancer (NSCLC). Currently, treatment of advanced NSCLC consists of several modalities: systemic chemotherapy, local radiation therapy, and targeted therapy (including most recently immunotherapy). In the past decade, the discovery of new molecular subtypes, the search for tumor driver gene mutations, the development of targeted molecular targeted drugs, or targeted therapy to suppress tumor angiogenesis and regulate tumor immune response have been the main directions of NSCLC research and clinical diagnosis and treatment. At present, platinum-based chemotherapy is widely used in NSCLC patients clinically. Platinum-based chemotherapy drugs can effectively prolong the survival time of patients and improve their quality of life, but the incidence of adverse reactions is still high. Therefore, it is necessary to find a drug that can improve the efficacy of patients and reduce the adverse reactions of platinum chemotherapy drugs to NSCLC patients.
Advances in Lung Cancer, Volume 9, pp 17-23; doi:10.4236/alc.2020.92002
We report two cases of brain metastasis from a lung adenocarcinoma. Magnetic Resonance Imaging (MRI) appearance was closely correlated with the macroscopic and microscopic findings that showed multiples nodules of a well-differentiated papillary adenocarcinoma with secreting tubules, surrounded by mucoid fluid.
Advances in Lung Cancer, Volume 8, pp 1-14; doi:10.4236/alc.2019.81001
Objective: The objective of the study was to determine the survival of patients with small-cell lung cancer treated at tertiary hospitals in the East of Thailand. Materials and methods: The researchers conducted this retrospective study by reviewing medical records of patients with small-cell lung cancer treated at Chonburi Cancer Hospital and Prapokklao Hospital from January 2007 to December 2016 and monitored via follow-up until December 2018. Results: This study enrolled 54 patients with a median follow-up time of 8.5 months. The median age of patients was 63 years old. Most patients were male (83.3%) and had a history of smoking (90.7%), and 31.4% had clinical superior vena cava obstruction at initial treatment. The Eastern Cooperative Oncology Group performance status 0-1 was noted for 61.1% of the study population. Median survival time of patients with limited-stage and extensive-stage small cell lung cancer who received systemic chemotherapy and/or radiotherapy was 17.01 months (95% CI, 12.01 - 22.01) and 8.14 months (95% CI, 7.19 - 9.10), respectively, and that of patients receiving supportive care was 2.3 months (95% CI, 0.75 - 4.03). However, the median survival time of patients with extensive-stage small-cell lung cancer receiving only palliative chemotherapy was 5.9 months (95% CI, 0.32 - 17.51). Conclusions: The median survival time of patients with limited-stage small-cell lung cancer treated in the East of Thailand was comparable to those of landmark studies; however, the survival of patients with extensive-stage small-cell lung cancer was shorter than those of Phase III trials. A multidisciplinary team was necessary to improve the quality of patient care.
Advances in Lung Cancer, Volume 7, pp 9-20; doi:10.4236/alc.2018.72002
Background: Survivin is an inhibitor of apoptosis that may be a novel diagnostic and prognostic marker of cancer. Our study is to investigate the diagnostic and prognostic value of survivin for pleural effusions. Methods: Sixty-five pleural effusion patients were enrolled prospectively. Pleural effusion samples were examined for survivin level by ELISA. Pleural effusions were divided into three groups: Group I, malignant pleural effusion (MPE) (n = 36); Group II, tuberculous pleurisy (TPE) (n = 18); and Group III, transudative pleural effusion (n = 11). The accuracy of diagnosis and the correlation between survivin level and survival in malignant pleural effusions (MPE) were analyzed. Results: Survivin level was 320.50 ± 228.24 pg/ml in MPE, 328.35 ± 146.79 pg/ml in TPE and 318.87 ± 208.39 pg/ml in transudative pleural effusion respectively. ROC curves for MPE versus TPE were analyzed, area under the ROC curve was 0.419, and for the cutoff value of 254.85 pg/ml sensitivity was 44.4% and specificity 55.6%. Survivin had no discriminative power in differentiating exudative effusions of MPE from non-MPE (p = 0.648). There was no correlation between survivin level and age, sex. However, statistically significant difference was found between primary lung carcinoma (238.66 ± 48.19 pg/ml) and extra-pulmonary metastatic carcinomas (435.09 ± 320.62 pg/ml) according to survivin level (p = 0.033). Survivin levels can distinguish patients who had poor prognosis (median survival 96 days) and those who had good prognosis (median survival 206 days) in MPE. Conclusion: survivin levels detected with ELISA had no discriminative power in differentiating exudative effusions included MPE and TPE. However, over-expression of survivin correlates with poor prognosis in cancer patients. Our results suggest that survivin may be a potential prognostic marker in MPE.
Advances in Lung Cancer, Volume 7, pp 21-31; doi:10.4236/alc.2018.73003
Advances in Lung Cancer, Volume 7, pp 1-8; doi:10.4236/alc.2018.71001
Non-small cell lung cancer (NSCLC) is a heterogeneous group of malignancies including squamous cell carcinoma, adenocarcinoma, bronchioloalveolar carcinoma and large cell carcinoma. They are known to be of poor prognosis, despite a better understanding of bronchial oncogenesis. This descriptive retrospective study carried out over three years (January 2013 to December 31st, 2016) at the Oncology Department of the Treichville University Hospital in Abidjan was aimed to assess the efficacy of new treatments for NSCLC in Cote d’Ivoire and to specify their benefit in terms of quality of life, comfort and overall survival. This 77 patients study, found that NSCLC, the most frequent of which is squamous cell carcinoma, occurs in relatively young subjects, smokers (91%) diagnosed at a locally advanced or metastatic stage (89%). Cisplatin base multi-drug chemotherapy was mostly used (71%). Combined all treatments, there was a significant clinical gain. However, no complete response was observed. Hematological and digestive toxicities were seen in more than 30% of cases. Overall survival was of 9 months on average. This study is an advocate to optimize primary prevention policies for a cancer with poor prognosis despite the development of new treatments such as target therapies.
Advances in Lung Cancer, Volume 6, pp 13-35; doi:10.4236/alc.2017.62002
Background: Patient-reported outcomes (PROs) of quality of life (QOL) during chemotherapy involving lung cancer are very important for the medical staffs. Patients’ satisfaction and healthy changes were evaluated by the patient-self assessment. Materials and Methods: From July 2007 to April 2008, a total of 19 patients received chemotherapy. The QOL data were collected by using the QOL questionnaire for cancer patients treated with anticancer drugs (QOL-ACD) and the anti-aging QOL assessment (AA-QOL). The AA-QOL contained 51 items: 30 of physical and 21 of mental symptoms of the elderly and the aging population. The patients replied to the questions at two different times, i.e., at pre-chemotherapy (baseline) and at post-chemotherapy (2 weeks after the chemotherapy). Results: Regarding the hematological toxicities, for the grade 3/4 toxicities, there were 12 neutropenia (12/19, 63.2%) and 3 thrombocytopenia (3/19, 15.8%). For the grade 3 febrile neutropenia, there were 5 cases (5/19, 26.3%). Regarding the non-hematological toxicities, there was no grade 3 and grade 4 toxicities. Based on the outcomes of the QOL-ACD, the three items (“physical condition”, “social attitude”, and “overall QOL”) at post-chemotherapy became significantly worse compared to the baseline. Regarding the outcomes of the AA-QOL, 4 items of physical symptoms (“thirst”, “anorexia”, “early satiety”, and “diarrhea”) became significantly worse compared to the baseline. Regarding the mental symptoms, 2 items (“nothing to look forward in life” and “a sense of uselessness”) became significantly worse compared to the baseline. Conclusion: Regarding the PROs of the QOL during the chemotherapy term, both the physical and mental symptoms had become worse. To clarify the changes in the QOL during chemotherapy is very important for multidisciplinary teamwork, which should play the role of providing the appropriate cares and treatment as patient-support.