Obojective Non-small-cell lung cancer(NSCLC)is a common malignancy.pN2 NSCLC,with pathologically confirmed ipsilateral mediastinal/subcarinal nodes metastasis,has been known as a very heterogeneous subgroup in terms o...Obojective Non-small-cell lung cancer(NSCLC)is a common malignancy.pN2 NSCLC,with pathologically confirmed ipsilateral mediastinal/subcarinal nodes metastasis,has been known as a very heterogeneous subgroup in terms of its anatomical,biological and patient characteristics.Prognostic factors based on patient characteristics were not well determined yet in this subgroup,and there is currently no standard treatment recommendation for these heterogeneous pN2 subjects.Apparent disagreements and inconsistency exist in study reports concerning the prognostic significance of certain factors in pN2 NSCLC,especially regarding to the issue about whether skip N2 metastasis benefit from surgery.Methods We therefore performed this comprehensive summary of the published literatures to draw a more precise and less uncertain conclusion.After a comprehensive literature search,a total of 73 studies involving 23,773 subjects were included according to eligibility criteria.Results As expected,most of the investigated factors,such as old age,male,advanced pathological T stage,advanced clinical N stage,multiple N2 stations,extended surgical resection(pneumonectomy),and incomplete resection,but not post-operation treatment(eg.chemotherapy and radiotherapy)were significantly associated with poor survival.However,skip N2 metastasis was favourable prognostic factors in operable pN2 NSCLC subjects.Other factors(histological type and primary tumour side)were neutral in terms of association with overall survival.We highlighted a number of important prognostic factors for pN2 NSCLC patients.Particularly,patients with skip N2 disease benefit from surgery.Conclusion Our findings could be used as reference information for decision-making in clinical practice and future study design.展开更多
Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and...Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and c-MET;therefore,it exhibits both antitumor and anti-angiogenetic activities.A phase III trial has shown that anlotinib improved progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small cell lung cancer(NSCLC),who presented with progressive disease or intolerance after standard chemotherapy.This study aimed to analyze the characteristics of patients receiving anlotinib treatment to determine the dominant populations who are fit for the treatment.Methods:Data were collected from March 2015 to January 2017 from a randomized,double-blind,placebo-controlled,multicenter,phase III trial of anlotinib(ALTER0303).A total of 437 patients were enrolled and randomly allocated(2:1)to the anlotinib and placebo groups.Kaplan–Meier analysis and log-rank test were performed to compare PFS and OS.Cox proportional hazards model was adopted for multivariate prognostic analysis.Results:Multivariate analysis indicated that high post-therapeutic peripheral blood granulocyte/lymphocyte ratio and elevated alkaline phosphatase levels were independent risk factors for PFS.Meanwhile,elevated thyroid-stimulating hormone,blood glucose,and triglyceride levels;hypertension;and hand–foot syndrome were independent protective factors of PFS.High posttherapeutic peripheral blood granulocyte/lymphocyte ratio,an Eastern Cooperative Oncology Group(ECOG)score≥2,and the sum of the maximal target lesion length at baseline were independent risk factors of OS,and hypertriglyceridemia was an independent protective factor of OS.Conclusions:This study preliminarily explored the possible factors that affected PFS and OS after anlotinib treatment in patients with advanced refractory NSCLC,and the baseline characteristics of the therapeutically dominant populations were then identified.展开更多
Objective To investigate the effects of multidisciplinary and comprehensive Chinese medicine(CM)treatments on progression-free survival(PFS)and median survival time(MST)in patients with advanced non-small cell lung ca...Objective To investigate the effects of multidisciplinary and comprehensive Chinese medicine(CM)treatments on progression-free survival(PFS)and median survival time(MST)in patients with advanced non-small cell lung cancer(NSCLC)and identify factors that influence progression and prognosis.Methods Clinical data of 855 patients with advanced NSCLC who received multidisciplinary and comprehensive CM treatments at Longhua Hospital from January 2009 to December 2018 were retrospectively analyzed.Univariate analysis was performed by the Kaplan-Meier method and log-rank sequential inspection.Multivariate analysis of significant variables from the univariate analysis was performed with Cox regression modeling.Key factors correlated to progression and prognosis were screened out,and a Cox proportional hazard model was established to calculate the prognostic index.Results The PFS and MST of 855 advanced NSCLC patients were 9.0 and 26.0 months,respectively.The 1-,2-,3-,and 5-year survival rates were 79.2%,54%,36.2%,and 17.1%,respectively.Gender,pathologic type,and clinical stage were independent prognostic risk factors;surgical history,radiotherapy,treatment course of Chinese patent medicine,intravenous drip of Chinese herbal preparation,duration of oral administration of Chinese herbal decoction(CHD),and intervention measures were independent prognostic protective factors.Gender was an independent risk factor for progression,while operation history and oral CHD administration duration were independent protective factors(all P<0.05).Women with stage IIIb–IIIc lung adenocarcinoma had the best outcomes.Conclusions Female patients have lower progression risk and better prognoses than male patients,younger patients have higher progression risk but better long-term prognoses than the elderlys,and patients with lower performance status scores are at lower risk for progression and have better prognoses.Comprehensive CM treatments could significantly reduce progression risk,improve prognosis,and prolong survival time for patients with advanced NSCLC.This treatment mode offers additional advantages over supportive care alone.展开更多
基金grants from the National Basic Research Program of China(973 ProgramNo.2012CB720605)the Zhongnan Hospital of Wuhan University Science,Technology and Innovation Seed Fund(No.znpy2016046).
文摘Obojective Non-small-cell lung cancer(NSCLC)is a common malignancy.pN2 NSCLC,with pathologically confirmed ipsilateral mediastinal/subcarinal nodes metastasis,has been known as a very heterogeneous subgroup in terms of its anatomical,biological and patient characteristics.Prognostic factors based on patient characteristics were not well determined yet in this subgroup,and there is currently no standard treatment recommendation for these heterogeneous pN2 subjects.Apparent disagreements and inconsistency exist in study reports concerning the prognostic significance of certain factors in pN2 NSCLC,especially regarding to the issue about whether skip N2 metastasis benefit from surgery.Methods We therefore performed this comprehensive summary of the published literatures to draw a more precise and less uncertain conclusion.After a comprehensive literature search,a total of 73 studies involving 23,773 subjects were included according to eligibility criteria.Results As expected,most of the investigated factors,such as old age,male,advanced pathological T stage,advanced clinical N stage,multiple N2 stations,extended surgical resection(pneumonectomy),and incomplete resection,but not post-operation treatment(eg.chemotherapy and radiotherapy)were significantly associated with poor survival.However,skip N2 metastasis was favourable prognostic factors in operable pN2 NSCLC subjects.Other factors(histological type and primary tumour side)were neutral in terms of association with overall survival.We highlighted a number of important prognostic factors for pN2 NSCLC patients.Particularly,patients with skip N2 disease benefit from surgery.Conclusion Our findings could be used as reference information for decision-making in clinical practice and future study design.
文摘Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and c-MET;therefore,it exhibits both antitumor and anti-angiogenetic activities.A phase III trial has shown that anlotinib improved progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small cell lung cancer(NSCLC),who presented with progressive disease or intolerance after standard chemotherapy.This study aimed to analyze the characteristics of patients receiving anlotinib treatment to determine the dominant populations who are fit for the treatment.Methods:Data were collected from March 2015 to January 2017 from a randomized,double-blind,placebo-controlled,multicenter,phase III trial of anlotinib(ALTER0303).A total of 437 patients were enrolled and randomly allocated(2:1)to the anlotinib and placebo groups.Kaplan–Meier analysis and log-rank test were performed to compare PFS and OS.Cox proportional hazards model was adopted for multivariate prognostic analysis.Results:Multivariate analysis indicated that high post-therapeutic peripheral blood granulocyte/lymphocyte ratio and elevated alkaline phosphatase levels were independent risk factors for PFS.Meanwhile,elevated thyroid-stimulating hormone,blood glucose,and triglyceride levels;hypertension;and hand–foot syndrome were independent protective factors of PFS.High posttherapeutic peripheral blood granulocyte/lymphocyte ratio,an Eastern Cooperative Oncology Group(ECOG)score≥2,and the sum of the maximal target lesion length at baseline were independent risk factors of OS,and hypertriglyceridemia was an independent protective factor of OS.Conclusions:This study preliminarily explored the possible factors that affected PFS and OS after anlotinib treatment in patients with advanced refractory NSCLC,and the baseline characteristics of the therapeutically dominant populations were then identified.
基金Supported by National Thirteenth Five-Year Science and Technology Major Special Project for New Drug Innovation and Development(No.2017ZX09304001)Shanghai Three-Year Action Plan for Further Accelerating the Development of TCM[No.ZY(2018-2020)-CCCX-1016]+3 种基金Shanghai Emerging Interdisciplinary Funding Program of TCMConstruction of the most Important Clinical Medical Center and Key Disciplines in Shanghai(No.2017ZZ01010)Pudong New Area Health Select Committee Health and Family Planning Scientific Research Project Plan(No.PW2019E-1)Shanghai Key Clinical Specialty Project(No.shslczdzk03701)。
文摘Objective To investigate the effects of multidisciplinary and comprehensive Chinese medicine(CM)treatments on progression-free survival(PFS)and median survival time(MST)in patients with advanced non-small cell lung cancer(NSCLC)and identify factors that influence progression and prognosis.Methods Clinical data of 855 patients with advanced NSCLC who received multidisciplinary and comprehensive CM treatments at Longhua Hospital from January 2009 to December 2018 were retrospectively analyzed.Univariate analysis was performed by the Kaplan-Meier method and log-rank sequential inspection.Multivariate analysis of significant variables from the univariate analysis was performed with Cox regression modeling.Key factors correlated to progression and prognosis were screened out,and a Cox proportional hazard model was established to calculate the prognostic index.Results The PFS and MST of 855 advanced NSCLC patients were 9.0 and 26.0 months,respectively.The 1-,2-,3-,and 5-year survival rates were 79.2%,54%,36.2%,and 17.1%,respectively.Gender,pathologic type,and clinical stage were independent prognostic risk factors;surgical history,radiotherapy,treatment course of Chinese patent medicine,intravenous drip of Chinese herbal preparation,duration of oral administration of Chinese herbal decoction(CHD),and intervention measures were independent prognostic protective factors.Gender was an independent risk factor for progression,while operation history and oral CHD administration duration were independent protective factors(all P<0.05).Women with stage IIIb–IIIc lung adenocarcinoma had the best outcomes.Conclusions Female patients have lower progression risk and better prognoses than male patients,younger patients have higher progression risk but better long-term prognoses than the elderlys,and patients with lower performance status scores are at lower risk for progression and have better prognoses.Comprehensive CM treatments could significantly reduce progression risk,improve prognosis,and prolong survival time for patients with advanced NSCLC.This treatment mode offers additional advantages over supportive care alone.
