• Title/Summary/Keyword: Advanced NSCLC

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One Case Report of Non-small Cell Lung Cancer Patients Treated with Allergen Removed Rhus Verniciflua Stokes(aRVS) (알러젠 제거 옻나무 추출물 투여로 삶의 질 개선과 생존기간 연장을 보인 비소세포성 폐암 환자 1례)

  • Yu, Seung-Min;Eo, Wan-Kyu;Yoon, Seoung-Woo
    • Journal of Korean Traditional Oncology
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    • v.13 no.1
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    • pp.63-69
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    • 2008
  • Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related mortality worldwide. Standard treatment such as chemotherapy, radiotherapy, and surgery have many limitations in the treatment of this disease. Therefore, new molecular-targeted therapies needed and being developed. Patients with advanced NSCLC have a short life expentancy; therefore, in addition to increasing their survival, improving their quality of life (QoL) is also an important treatment goal. In this case report, we introduce NSCLC patient treated with Allergen Removed Rhus Verniciflua Stokes(aRVS). In this case, survival time incresed as traditional korean medicine using aRVS. And the general condition of the patient became better. Further case study will be needed in order to determine the effects of aRVS on NSCLC.

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Screening for Patients with Non-small Cell Lung Cancer Who Could Survive Long Term Chemotherapy

  • Wu, Xue-Yan;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.2
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    • pp.647-652
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    • 2015
  • Background: Lung cancer was one of the most common cancers in both men and women all over the world. In this study, we aimed to clarify who could survive after long term chemotherapy in patients with advanced non-small cell lung cancer (NSCLC). Methods: We enrolled 186 patients with stage IV NSCLC after long term chemotherapy from Jun 2006 to Nov 2014 diagnosed in Jiangsu Cancer Hospital. Multiple variables like age, gender, smoking, histology of adenocarcinoma and squamous-cell cancer, number of metastatic sites, metastatic sites (e.g. lung, brain, bone, liver and pleura), hemoglobin, lymphocyte rate (LYR), Change of LYR during multiple therapies, hypertension, diabetes, chronic bronchitis, treatments (e.g.radiotherapy and targeted therapy) were selected. For consideration of factors influencing survival and response for patients with advanced NSCLC, logistic regression analysis and Cox regression analysis were used in an attempt to develop a screening module for patients with elevated survival after long term chemotherapy become possible. Results: Of the total of 186 patients enrolled, 69 survived less than 1 year (short-term group), 45 one to two years, and 72 longer than 3 years (long-term group). For logistic regression analysis, the short-term group was taken as control group and the long-term group as the case group. We found that age, histology of adenocarcinoma, metastatic site (e.g. lung and liver), treatments (e.g. targeted therapy and radiotherapy), LYR, a decreasing tendency of LYR and chronic bronchitis were individually associated with overall survival by Cox regression analysis. A multivariable Cox regression model showed that metastatic site (e.g. lung and liver), histology of adenocarcinoma, treatments (e.g. targeted therapy and radiotherapy) and chronic bronchitis were associated with overall survival. Thus metastatic site (e.g. lung and liver) and chronic bronchitis may be important risk factors for patients with advanced NSCLC. Gender, metastatic site (e.g. lung and liver), LYR and the decreasing tendency of LYR were significantly associated with long-term survival in the individual-variable logistic regression model (P<0.05). On multivariate logistic regression analysis, gender, metastatic site (e.g. lung and liver) and the decreasing tendency of LYR associated with long-term survival. Conclusions: In conclusion, female patients with stage IV adenocarcinoma of NSCLC who had decreasing tendency of LYR during the course therapy and had accepted multiple therapies e.g. more than third-line chemotherapy, radiotherapy and/or targeted therapy might be expected to live longer.

Assessment of Appropriateness of Standard for Insurance Coverage on Chemotherapy used in Non-small Cell Lung Cancer (NSCLC) (비소세포폐암에 사용되는 항암화학요법의 요양급여기준 적절성 평가)

  • Kim, Jeong-Yeon;Park, Eun-Ji;Bae, Min-Kyung;Yoon, Jeong-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.3
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    • pp.193-207
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    • 2011
  • Purpose: The purpose of this study is to assess appropriateness of current standard for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on chemotherapy used in the treatment of advanced non-small cell lung cancer (NSCLC), by reviewing a variety of clinical evidences, and thereby, if needed, to propose an updated evidence-based recommendations. Methods: We collected data from HIRA regarding on the insurance standard which includes the scope and conditions for coverage on systemic chemotherapy of NSCLC. We performed a search for clinical databases and examined the most current clinical evidence from clinical literature including various clinical practice guidelines. Based on the collected data the appropriateness of HIRA standard for insurance coverage of chemotherapy of NSCLC was assessed. Results: Collected data demonstrated that HIRA standard did not reflect the most current clinical practice and evidence. Some were inappropriately listed in HIRA formulary and accepted as a chemotherapy being covered by insurance, despite the lack of evidences of clinical efficacy or superiority over other chemotherapeutic agents or regimens. In addition, there seems to be a need for a modification on the standard for insurance coverage of certain newer chemotherapeutic agents based on the current accumulated data showing their clinical efficacy and benefits in the selected group of NSCLC patients. Therefore, we concluded that current HIRA standard for insurance coverage on chemotherapy of NSCLC needs to be revised and we proposed an updated recommendation based on these latest clinical evidences. Conclusion: The standard for insurance coverage of chemotherapy should be continually examined its appropriateness based on the most recent clinical evidences in a timely manner so as to provide the most effective and safe therapy to cancer patients.

Multidisciplinary Management of the Locally Advanced Unresectable Non-Small Cell Lung Cancer (수술 불가능한 국소 진행 비소세포성 폐암의 집합적 요법)

  • Cho, Kwan-Ho
    • Radiation Oncology Journal
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    • v.22 no.1
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    • pp.1-10
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    • 2004
  • Locally advanced (Stage III) non-small cell lung cancer (NSCLC) accounts for approximately one third of all cases of NSCLC. Few patients with locally advanced NSCLC present with disease amenable to curative surgical resection. Historically, these patients were treated with primary thoracic radiation therapy (RT) and had poor long term survival rates, due to both progression of local disease and development on distant metastases. Over the last two decades, the use of multidisciplinary approach has improved the outcome for patients with locally advanced NSCLC. Combined chemoradiotherapy is the most favored approach for treatment of locally advanced unresectable NSCLC. There are two basic treatment protocols for administering combined chemotherapy and radiation, sequential versus concurrent. The rationale for using chemotherapy is to eliminate subclinical metastatic disease while improving local control. Sequential use of chemotherapy followed by radiotherapy has improved median and long term survival compared to radiation therapy alone. This approach appears to decrease the risk of distant metastases,, but local failure rates remain the same as radiation alone. Concurrent chemoradiotherapy has been studied extensively. The potential advantages of this approach may include sensitization of tumor cells to radiation by the administration of chemotherapy, and reduced overall treatment time compared to sequential therapy; which is known to be important for improving local control in radiation biology. This approach Improves survival primarily as a result of improved local control. However, it doesn't seem to decrease the risk of distant metastases probably because concurrent chemoradiation requires dose reductions in chemotherapy due to increased risks of acute morbidity such as acute esophageal toxicity. Although multidisciplinary therapy has led to improved survival rates compared to radiation therapy alone and has become the new standard of care, the optimal therapy of locally advanced NSCLC continues to evolve. The current issues in the multidisciplinary management of locally advanced NSCLC will be reviewed in this report.

Thalidomide Combined with Chemotherapy in Treating Patients with Advanced lung Cancer

  • Li, Li;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2583-2585
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    • 2016
  • Objectives: To evaluate efficacy and toxicity in patients with advanced lung cancer, including non-small cell and small cell variants (NSCLC and SCLC), treated with thalidomide plus chemotherapy. Methods: Fourteen patients with advanced lung cancer were scheduled to receive chemotherapy combined with thalidomide. All patients in this study received thalidomide (100 mg orally per night before sleeping, produced by Changzhou Pharmaceutical Factory Co.Ltd) after the start of chemotherapy for at least 14 days. Chemotherapy was administered according to the condition of patients. After at least 14 days of treatment, efficacy and toxicity were evaluated. Results: There were 6 female and 8 male patients with advanced lung cancer recruited into this study, including 2 with SCLC and 12 with NSCLC. The median age was 56.7 (44-65) years. Progressive disease was observed in 12 patients (12/14), and stable disease in 2 (2/14). Grade 1 to 2 myelosuppression was observed in 4/14 patients, and Grade 1 to 2 elevation of hepatic enzymes was recorded in 5/14 patients. Adverse effects on the gastrointestinal tract were documented in 2/14 patients, all beingGrade 1. No Grade 3-4 toxicity was recorded. No treatment related deaths occurred. Conclusions: Our results demonstrate that thalidomide combined with chemotherapy is mildly effective and safe for treating patients with advanced lung cancer. However, further evaluation of this combination is warranted.

Case Series of Advanced Non-Small Cell Lung Cancer Patients Treated with Hang-Am Plus (진행성 비소세포성 폐암환자에 대한 항암플러스의 치료효능 : 연속증례보고)

  • Zheng, Hong-Mei;Yoon, Jeung-Won;Lee, Yeon-Weol;Cho, Chong-Kwan;Oh, Dal-Seok;Yoo, Hwa-Seung
    • The Journal of Internal Korean Medicine
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    • v.32 no.1
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    • pp.113-120
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    • 2011
  • Objectives : A case series was conducted to investigate the therapeutic effects of Hang-Am Plus (HAP) on the tumor response and HRQoL (Health Related Quality of Life) in advanced non-small cell lung cancer (NSCLC) patients. Methods : Three patients were given 1,000-2,000 mg of HAP, three times a day (daily total dosage of 3,000-6,000 mg/day) for 12 weeks. Results : After the 3 month administration with HAP, three patients showed stable disease (SD) condition according to the chest computed tomography (CT), and two of the patients reported a decrease in pain levels. Conclusions : The observed NSCLC cases suggest treatment with HAP may be related to the observed tumor growth inhibition and pain reduction.

Case Series of Advanced Non-small Cell Lung Cancer Patients Treated with Hang-Am-Plus (항암플러스 투여로 호전된 진행성 비소세포성 폐암 연속환자증례)

  • Kim, Kyung-Soon;Jung, Tae-Young;Yoo, Hwa-Seung;Lee, Yeon-Weol;Cho, Chong-Kwan
    • The Journal of Internal Korean Medicine
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    • v.30 no.4
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    • pp.893-900
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    • 2009
  • Objective : To investigate the therapeutic effects of Hang-Am-Plus (HAP) on advanced non-small cell lung cancer (NSCLC) patients. Method : We prescribed HAP three times a day (3,000-6,000 mg/ day) during the treatment period (8 - 24 months). Computed tomography (CT) was performed to evaluate the therapeutic efficacy. Results : Four patients who were diagnosed with NSCLC were recommended chemotherap y, but refused it because of old age, side effects, or treatment failure, and instead sought oriental medicinal therapy. They were treated around 12 months. The patients showed stable disease (SD) state for 5 months, 3 months, 19 months and 3 months, respectively. Conclusion : These four cases may give us the possibility that HAP offers potential benefits for non-small cell lung cancer patients.

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A case of the elderly advanced Non-small Cell Lung Cancer Patient Treated with Allergen Removed Rhus Verniciflua Stokes extract (알러젠 제거 옻나무 추출물을 투여한 고령의 진행성 비소세포폐암 환자 1례)

  • Park, Hyeong-Jun;An, Ji-Hye;Lee, Jin-Soo;Jung, Yee-Hong;Lee, Sang-Hun;Cheon, Seong-Ha;Jung, Hyun-Sik;Kim, Kyung-Suk;Choi, Won-Cheol
    • Journal of Korean Traditional Oncology
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    • v.15 no.1
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    • pp.71-77
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    • 2010
  • This case report documents a case in which the administration of an herbal product, an extract of the lacquer tree, Rhus verniciflua Stokes was related with a prolonged survival in a elderly advanced non-small cell lung cancer(NSCLC) patient. A 79-year-old man who had been diagnosed with advanced NSCLC refused conventional therapy and treatment with the allergen-removed Rhus verniciflua Stokes(aRVS) had continued from September 2007 to July 2010. He had survived for 35 months after the administration of aRVS and maintained good performance status with European Cooperative Oncology Group performance status(ECOG PS) of 1. This case suggests that aRVS be alternative treatment for the elderly advanced NSCLC patients.

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Clinical Observation and Prognostic Analysis of Pemetrexed plus Platinum as First-line Treatment in Patients with Advanced Non-small Cell Lung Cancer

  • Wang, Ji-Ying;Cai, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6267-6271
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    • 2013
  • Objective: To determine clinical efficacy, safety and prognostic factors of pemetrexed plus platinum as first-line treatment in patients with advanced non-small cell lung cancer (NSCLC). Materials and Methods: Clinical characteristics, short-term efficacy, survival and adverse reactions of 47 advanced non-squamous NSCLC patients who had received pemetrexed plus platinum as first-line treatment in Shanghai Pulmonary Hospital from January 2009 to June 2011 were retrospectively analyzed. The Chi-squared test was applied to statistically analyze the overall response rate (ORR), disease control rate (DCR) and toxicity reactions in both groups, while survival data wereanalyzed by Kaplan-Meier and logrank methods, and the COX proportional hazards model was adopted for a series of multi-factor analyses. Results: Only two patients were lost to follow-up. The ORR, DCR, medium progression-free survival time (PFS) and medium overall survival (OS) were 31.9%, 74.5%, 5 months and 15.2 months, while 1- and 2-year survival rates were 63.8% (30/47) and 19.2% (9/47), respectively. Single-factor analysis showed that tumor pathological patterns and efficacy were in association with medium PFS (P<0.05), whereas tumor pathological patterns, smoking history and efficacy were closely connected with medium OS (P<0.05). Multi-factor analyses demonstrated that pathological patterns and efficacy were independent factors influencing OS (P<0.05). The rate of toxicity reactions in degree III/IV was low, including hematologic toxicity marked by decline in white blood cell count and decrease in the platelet count (PLT), and non-hematologic toxicity manifested by gastrointestinal reactions, such as nausea and vomiting. Conclusions: Pemetrexed plus platinum as first-line treatment has excellent efficacy and slight adverse reactions with favorable drug-tolerance in patients with advanced non-squamous NSCLC.

Outcomes of Second-Line Chemotherapy for Advanced Non-Small Cell Lung Cancer in One Institution

  • Lee, Seok Jeong;Kang, Hyun Ju;Kim, Seo Woo;Ryu, Yon Ju;Lee, Jin Hwa;Kim, Yookyung;Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.1
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    • pp.13-17
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    • 2014
  • Background: This study analyzed the negative prognostic factors in patients who received second-line chemotherapy for advanced inoperable non-small cell lung cancer (NSCLC). Methods: We retrospectively reviewed the records of 137 patients with inoperable stage III-IV NSCLC who received second-line chemotherapy. The effects of clinical parameters on survival were analyzed and the hazard ratios (HR) for mortality were identified by a Cox regression analysis. Results: Sex, age older than 65 years, smoking history, cell type, T-stage, best response to first-line chemotherapy and first-line chemotherapy regimen were significant negative predictors in univariate analysis. The multivariate analysis showed that patients older than 65 years (HR, 1.530; 95% confidence interval [CI], 1.020-2.297), advanced T stage (T4 vs. T1; HR, 2.273; 95% CI, 1.010-5.114) and non-responders who showed progression with first-line chemotherapy (HR, 1.530; 95% CI, 1.063-2.203) had higher HR for death. Conclusion: The age factor, T stage and responsiveness to first-line chemotherapy were important factors in predicting the outcome of patients with advanced NSCLC who received second-line chemotherapy. The results may help to predict outcomes for these patients in the future.