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find Keyword "晚期非小细胞肺癌" 6 results
  • 电视胸腔镜辅助下射频消融治疗晚期非小细胞肺癌

    目的 探讨胸腔镜辅助下治疗晚期非小细胞肺癌的疗效及安全性,总结治疗经验。 方法 对18例原发性晚期肺癌和肺转移癌患者,在全身麻醉胸腔镜下行射频消融术,消融电极针在胸腔镜引导下穿刺进入肿瘤组织中心,消融范围超过病变区并延伸至正常组织0.5~1.0 cm,消融温度58~90 ℃,治疗时间12~24 min。 结果 住院期间全组患者无严重并发症发生,术后30 d复查肿瘤标记物CYFRA211值较术前降低(6.26±2.31 ng/ml vs. 14.62±3.65 ng/ml),差异有统计学意义(Plt;0.05);术后45 d复查CT,肿瘤最大截面长径27±12 mm,CT值31±9 Hu,较术前相应值46±18 mm,52±16Hu明显减小,差异有统计学意义(Plt;0.05)。全组患者6、12、18个月生存率分别为88.9%,77.8%和38.9%。 结论 胸腔镜辅助下射频消融治疗晚期非小细胞肺癌,疗效较确切,安全性好。

    Release date:2016-08-30 06:06 Export PDF Favorites Scan
  • Pemetrexed versus Docetaxel for Advanced Non-Small-Cell Lung Cancer: A Meta-analysis

    Objective For the dispute on the superiority of the pemetrexed compared with the docetaxel for treating advanced non-small-cell lung cancer (NSCLC), this study is conducted to evaluate the efficacy and safety of pemetrexed versus docetaxel for patients with NSCLC. Methods Such databases as The Cochrane Library, PubMed, EMBASE, SCI, CBM, CNKI, and VIP were searched to collect the randomized controlled trials (RCTs) about pemetrexed versus docetaxel for the treatment of NSCLC published before November of 2010. Two reviewers independently screened the studies, extracted the data and assessed the methodology quality. RevMan 5.0 software was used for meta-analyses. Results Five studies involving 847 patients were included. The results of meta-analyses showed that, in the aspect of efficacy, there was no significant difference between the two groups in the effective rate (OR=1.09, 95%CI 0.7 to 1.70), the disease control rate (OR=0.99, 95%CI 0.75 to 1.31), and the one-year survival rate (OR=1.11, 95%CI 0.56 to 2.18); in the aspect of safety, compared with docetaxel, pemetrexed could reduce the neutropenia (OR=0.09, 95%CI 0.05 to 0.15), the febrile neutropenia (OR=0.13, 95%CI 0.06 to 0.29) and the alopecia (OR=0.20, 95%CI 0.12 to 0.33), but no significant difference was found in haemoglobin (OR=1.45, 95%CI 0.23 to 9.06), thrombocytopenia (OR=1.46, 95%CI 0.59 to 3.59), nausea and vomiting (OR=1.23, 95%CI 0.53 to 2.83) and fatigue and debilitation (OR=0.73, 95%CI 0.40 to 1.30). Conclusion As the current evidence shows, pemetrexed has similar efficacy to docetaxel for advanced NSCLC patients, but it has fewer side effects of neutropenia, febrile neutropenia and alopecia.

    Release date:2016-09-07 11:06 Export PDF Favorites Scan
  • Oxaliplatin plus Vinorelbine in the Treatment of Advanced Non-small Cell Lung Cancer: A Systematic Review

    Objective To assess clinical efficacy and safety of Oxaliplatin plus Vinorelbine in the treatment of advanced non-small cell lung cancer (NSCLC). Methods We used the methods of Cochrane reviews, electronically searched the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 3, 2008), MEDLINE (1966 to April 2008), EMbase (1984 to Dec. 2006), Cancerlit (1996 to Dec. 2005), CBM (1978 to April 2008), CNKI (1994 to April 2008), VIP (1989 to April 2008), and handsearched 15 Chinese medical core journals, to collect randomized controlled trials (RCTs) of Oxaliplatin combined with Vinorelbine in the treatment of advanced NSCLC. RCTs were included according to the inclusion and exclusion criteria, the quality of included trials was evaluated and RevMan 4.2.8 software was used for metaanalyses after the extraction of the data. Results Seventeen RCTs involving 1 399 patients with advanced NSCLC were included. All of them reported the use of a random method, but with no detailed reports of allocation concealment and whether the blind method was used. The results of meta-analyses showed that NO program (vinorelbine + oxaliplatin) and NP program (vinorelbine + cisplatin) were similar in efficient rate (RR=0.97, 95%CI 0.85 to 1.10) and 1-year survival rate (RR=0.82, 95%CI 0.66 to 1.03). Compared with NP program, NO program induced lower III-IV degree of nausea and vomiting response (RR=0.20, 95%CI 0.14 to 0.28), III-IV degree of leukopenia reaction (RR=0.64, 95%CI 0.52 to 0.79), and I-II degree of renal damage RR=0.27, 95%CI 0.11 to 0.60) after chemotherapy. No study reported treatmentrelated death. Conclusion Oxaliplatin and Cisplatin plus Vinorelbine are similar in efficacy in the treatment of advanced NSCLC. Oxaliplatin plus Vinorelbine could be used as a chemotherapy of advanced NSCLC because of its better tolerance and more liability to be accepted by patients. However, highly-potential selection bias and measurement bias would affect the demonstration level of the outcome, so more high-quality double-blind RCTs are needed.

    Release date:2016-09-07 11:23 Export PDF Favorites Scan
  • Systemic Evaluation of Gefitinib in the Treatment of Non-small-cell Lung Cancer

    Objective To evaluate the efficacy of Gefitinib for patients with non-small-cell lung cancer (NSCLC). Methods We searched several databases, including MEDLINE (1991 to June 2008), The Cochrane Library (Issue 4, 2008) and CBMDisc (1978 to Feb. 2008). Randomized controlled trials (RCTs) were included in the meta-analyses, which were done using The Cochrane Collaboration’s RevMan 4.2 software. We also included retrospective case reports published in Chinese journals. Results Eight RCTs and 36 uncontrolled case reports were analyzed. The results of the RCTs showed that 250 mg/d Gefitinib had similar efficacy to 500 mg/d, but the side effect was significantly less for the lower dose. When used as a combined first-line treatment or a third-line treatment, Gefitinib was not superior to placebo on response rate, survival rate and life span. When used as second-line treatment, it did not prolong median survival, though it gave a higher response rate than placebo. Gefitinib caused many more side effects than placebo. Gefitinib exhibited similar efficacy to docetaxel in objective response rate [OR 1.18, 95%CI (0.84, 1.67), P=0.35], but was better for symptom and quality-of-life improvement [OR 1.58, 95%CI (1.33, 1.89), Plt;0.00001]. The overall uncontrolled clinical studies showed the following results: complete response rate was 2.2%, partial response rate was 25.8%, disease stable rate was 40.0% and progressive disease rate was 32.0%. The average median survival time was 8.9 months; the average time to progressive disease was 5.2 months, and the 1-year survival rate was 44.2%. The average median survival from EAP studies (6.9 months) was shorter than that for all the studies as well as the registered clinical trials (10.0 months). The average periods to progressive disease for registered clinical trials (3.2 months) and EAP studies (4.4 months) were somewhat shorter than that found for all studies combined, though response rate and 1-year survival rate were similar. Since there was no controlled clinical study, it was hard to conclude from the results whether Gefitinib brought any clinical benefit to NSCLC patients in China. Conclusion  Gifitinib is not suitable as a combined first-line treatment or a third-line treatment for NSCLC. The clinical favor from gefitinib in the second-line treatment remains uncertain. There is not enough evidence to show whether Chinese people are more sensitive to Gefitinib, and its use in the second-line treatment of NSCLC needs to be tested further.

    Release date:2016-09-07 02:09 Export PDF Favorites Scan
  • Docetaxel as a Second-line Treatment for Patients with Advanced Non Small Cell Lung Cancer: A Systematic Review

    Objective To assess the efficacy, safety and dosage regimen of docetaxel in patients with non small cell lung cancer (NSCLC). Methods We searched The Cochrane Library, MEDLINE, EMBASE, CBM, CNKI, VIP and etc to collect controlled trials which involved docetaxel as the second-line treatment of NSCLC. Two reviewers evaluated the quality of included trials independently. The Cochrane Collaboration’s software RevMan 4.2 was used for meta-analyses. Results Eight randomized controlled trials were included, all of which didn’t mention the blinding methods. Compared with best supportive care (BSC), the docetaxel group showed longer time to progression (10.6 vs. 6.7 weeks, Plt;0.001) and longer median survival (7.0 vs. 4.6 months, P=0.047), as well as greater 1-year survival (37% vs. 11%, P=0.003). Patients treated with docetaxel showed higher incidence of hematologic toxicity than those treated with BSC. Meta-analyses of different docetaxel dosage regimens (1-week vs. 3-week) showed that there were no statistical differences in terms of disease control rate, response rate or 1-year survival; but the incidence of hematologic toxicity of 1-week regimen was lower than that of 3-week regimen, and no statistical difference was noted in the incidence of non-hematologic toxicity between the two regimens. Conclusion  Docetaxel as the second-line chemotherapy for NSCLC significantly improved survival compared with BSC. Two dosage regimens of docetaxel had no difference in efficacy, but some differences in hematologic toxicity. Thus, if serious hematologic toxicity occurs, the 3-week treatment regimen of docetaxel could be replaced by 1-week treatment regimen.

    Release date:2016-09-07 02:11 Export PDF Favorites Scan
  • Progress in the targeted therapy for advanced non-small cell lung cancer

    Systemic therapy is the main treatment for advanced non-small cell lung cancer, but the effect of chemotherapy alone is not good. In recent years, with the discovery of the pathogenic targets of non-small cell lung cancer, new treatment methods such as targeted drugs and immune checkpoint inhibitors are available, which greatly improve the survival time and quality of life of patients with advanced non-small cell lung cancer. Genetic testing is recommended for all patients with advanced non-small cells lung cancer to obtain more precise and individualized treatment. This article focuses on different types of gene mutations and the corresponding molecular targeted drugs in advanced non-small cell lung cancer, in order to better guide clinical treatment.

    Release date:2021-02-08 08:00 Export PDF Favorites Scan
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