Related Articles

Feasibility of complete video-assisted thoracoscopic surgery following neoadjuvant therapy for locally advanced non-small cell lung cancer.

J Thorac Dis. 2013 Aug;5(Suppl 3):S267-73

Authors: Huang J, Xu X, Chen H, Yin W, Shao W, Xiong X, He J

Abstract
OBJECTIVE: To explore the feasibility of complete video-assisted thoracoscopic surgery (c-VATS) following neoadjuvant therapy (chemotherapy, targeted therapy and radiotherapy, either alone or in combination) for the treatment of patients with non-small cell lung cancer (NSCLC).
METHODS: The clinical data of 43 NSCLC patients undergoing c-VATS following neoadjuvant therapy were retrospectively analyzed, including the preoperative functional indicators, staging, concurrent diseases, surgical techniques, operation time, number of lymph nodes dissected and postoperative drainage time and quantity, postoperative hospital stay, postoperative complications, and survival.
RESULTS: From January 2006 to March 2012, a total of 43 patients with stage IIA-IIIB NSCLC were included in this study (IIIA: 27 cases, 62.8%; IIIB: 11 cases, 25.6%), including 32 males (74.4%) and 11 females (25.6%). Forty-two patients were operated successfully, 28 underwent pulmonary lobectomies (including 9 bronchial sleeve resections), 5 had double lobectomies, 5 had wedge resections, and 4 had total pneumonectomies. Seven patients were referred to undergo Hybrid VATS (7/42, 16.7%). The mean length of the operation was 160.48±16.52 min (range, 130-180 min); the intraoperative blood loss was 253.57±117.08 mL; the number of lymph nodes dissected was 16.88±10.93; the postoperative drainage time was 1-7 d (mean: 2.62±0.96 d); and the postoperative hospital stay was 3-7 d (mean: 5.45±1.30 d). The incidence of postoperative complications was 9.5% (4/42), and the perioperative mortality was 2.4% (1/42). The 1-, 2-, and 3-year overall survival rates were 94%, 79%, and 65%, respectively.
CONCLUSIONS: c-VATS following neoadjuvant therapy is safe and feasible for the treatment of locally advanced NSCLC.

PMID: 24040535 [PubMed]

Related Articles

Are erlotinib and gefitinib interchangeable, opposite or complementary for non-small cell lung cancer treatment? Biological, pharmacological and clinical aspects.

Crit Rev Oncol Hematol. 2013 Aug 28;

Authors: Bronte G, Rolfo C, Giovannetti E, Cicero G, Pauwels P, Passiglia F, Castiglia M, Rizzo S, Vullo FL, Fiorentino E, Van Meerbeeck J, Russo A

Abstract
Gefitinib and erlotinib are the two anti-epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) approved for treatment of advanced NSCLC patients. These drugs target one of the most important pathways in lung carcinogenesis and are able to exploit the phenomenon of 'oncogene addiction', with different efficacy according to EGFR gene mutational status in tumor samples. Gefitinib has been approved only for EGFR mutation bearing patients regardless the line of treatment, while erlotinib is also indicated in patients without EGFR mutation who undergo second- or third-line treatment. Some studies evaluated the main differences between these drugs both for direct comparison and to improve their sequential use. In particular, toxicity profile resulted partially different, and these observations may be explained by several molecular and pharmacokinetic features. Therefore, this review integrates preclinical data with clinical evidences of TKIs to guide the optimization of currently available treatments in advanced NSCLC patients.

PMID: 24041630 [PubMed - as supplied by publisher]

Related Articles

Prediction of Survival by [18F]Fluorodeoxyglucose Positron Emission Tomography in Patients With Locally Advanced Non-Small-Cell Lung Cancer Undergoing Definitive Chemoradiation Therapy: Results of the ACRIN 6668/RTOG 0235 Trial.

J Clin Oncol. 2013 Sep 16;

Authors: Machtay M, Duan F, Siegel BA, Snyder BS, Gorelick JJ, Reddin JS, Munden R, Johnson DW, Wilf LH, Denittis A, Sherwin N, Ho Cho K, Kim SK, Videtic G, Neumann DR, Komaki R, Macapinlac H, Bradley JD, Alavi A

Abstract
PURPOSE: In this prospective National Cancer Institute-funded American College of Radiology Imaging Network/Radiation Therapy Oncology Group cooperative group trial, we hypothesized that standardized uptake value (SUV) on post-treatment [(18)F]fluorodeoxyglucose positron emission tomography (FDG-PET) correlates with survival in stage III non-small-cell lung cancer (NSCLC).
PATIENTS AND METHODS: Patients received conventional concurrent platinum-based chemoradiotherapy without surgery; postradiotherapy consolidation chemotherapy was allowed. Post-treatment FDG-PET was performed at approximately 14 weeks after radiotherapy. SUVs were analyzed both as peak SUV (SUVpeak) and maximum SUV (SUVmax; both institutional and central review readings), with institutional SUVpeak as the primary end point. Relationships between the continuous and categorical (cutoff) SUVs and survival were analyzed using Cox proportional hazards multivariate models.
RESULTS: Of 250 enrolled patients (226 were evaluable for pretreatment SUV), 173 patients were evaluable for post-treatment SUV analyses. The 2-year survival rate for the entire population was 42.5%. Pretreatment SUVpeak and SUVmax (mean, 10.3 and 13.1, respectively) were not associated with survival. Mean post-treatment SUVpeak and SUVmax were 3.2 and 4.0, respectively. Post-treatment SUVpeak was associated with survival in a continuous variable model (hazard ratio, 1.087; 95% CI, 1.014 to 1.166; P = .020). When analyzed as a prespecified binary value (≤ v > 3.5), there was no association with survival. However, in exploratory analyses, significant results for survival were found using an SUVpeak cutoff of 5.0 (P = .041) or 7.0 (P < .001). All results were similar when SUVmax was used in univariate and multivariate models in place of SUVpeak.
CONCLUSION: Higher post-treatment tumor SUV (SUVpeak or SUVmax) is associated with worse survival in stage III NSCLC, although a clear cutoff value for routine clinical use as a prognostic factor is uncertain at this time.

PMID: 24043740 [PubMed - as supplied by publisher]

Related Articles

Prediction of new-onset asthma and nasal allergy by skin prick test and RAST in a cohort of adults.

Eur Respir J. 2013 Sep 13;

Authors: Gallmeier K, Becker E, Kirsten A, Wölke G, Manuwald O, Meyer H, Magnussen H, Nowak D, Heinrich J

Abstract
Limited information exists regarding the incidence and predictors of asthma and nasal allergy in adulthood. We determined the incidence rate of asthma and nasal allergy in adults and assessed the predictive value of skin prick tests (SPT) and radioallergosorbent tests (RAST) on these two outcomes.Two German centres involved in the European Community Respiratory Health Survey conducted a follow-up assessment in 2012 of the baseline participants (1185 adults aged 21 to 47 assessed in 1990). The predictive value of SPT and RAST on new-onset asthma and nasal allergy was assessed by cox regression and by calculating the positive/negative predictive value (PPV/NPV).During the 20 years between baseline and follow-up, 3.1 and 4.4 per 1000 person-years new-onset asthma and nasal allergy cases were recorded, respectively. The hazard ratios for SPT of any specific and of all aeroallergens combined were slightly higher than those of RAST for asthma and nasal allergy. The NPVs of both SPT and RAST were very high and similar (0.94-0.96) whereas the PPVs were low (0.09-0.20).Positive SPT results showed a better association with new onset asthma and nasal allergy than positive RAST to any specific aeroallergens or to all combined.

PMID: 24036244 [PubMed - as supplied by publisher]