scholarly journals Comparative efficacy of whole-brain radiotherapy with and without elemene liposomes in patients with multiple brain metastases from non-small-cell lung carcinoma

2016 ◽  
Vol 23 (4) ◽  
pp. 377 ◽  
Author(s):  
Y.N. Sun ◽  
Z.Y. Zhang ◽  
Y.C. Zheng ◽  
F. Chi ◽  
X.Y. Jin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Brain Metastases ◽  
Small Cell Lung Carcinoma ◽  
Whole Brain Radiotherapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Multiple Brain Metastases ◽  
Brain Radiotherapy

PurposeWe explored and compared the clinical effects of whole-brain radiotherapy (wbrt) with and without elemene liposomes in patients with multiple brain metastases from non-small-cell lung carcinoma (nsclc).MethodsWe retrospectively analyzed 62 patients with multiple brain metastases from nsclc who received wbrt (30 Gy in 10 fractions) at Shengjing Hospital of China Medical University from January 2012 to May 2013. In 30 patients, elemene liposomes (400 mg) were injected intravenously via a peripherally inserted central catheter for 21 consecutive days from the first day of radiotherapy. Overall survival (os) and nervous system progression-free survival (npfs) for the two groups were compared by Kaplan–Meier analysis. Factors influencing npfs were examined by Cox regression analysis. Chi-square or Fisher exact tests were used for group comparisons.Results The median os was 9.0 months in the wbrt plus elemene group and 7.8 months in the wbrt-alone group (p = 0.581); the equivalent median npfs durations were 5.2 months and 3.7 months (p = 0.005). Patient treatment plan was an independent factor associated with npfs (p = 0.002). Tumour response and disease-control rates in the wbrt plus elemene group were 26.67% and 76.67% respectively; they were 18.75% and 62.5% in the wbrt group (p = 0.452). Compared with the patients in the wbrt-alone group, significantly fewer patients in the wbrt plus elemene group developed headaches (p = 0.04); quality of life was also significantly higher in the wbrt plus elemene group both at 1 month and at 2 months (p = 0.021 and p = 0.001 respectively).Conclusions The addition of elemene liposomes to wbrt might prolong npfs in patients with multiple brain metastases from nsclc, while also reducing the incidence of headache and improving patient quality of life.

Association of pretreatment financial toxicity with time to treatment for patients with head and neck carcinoma and lung carcinoma.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 131-131
Author(s):  
Sharon Lam ◽  
Nicolas Schlecht ◽  
Gregory Rosenblatt ◽  
Vikas Mehta
Keyword(s):  
Quality Of Life ◽  
Lung Carcinoma ◽  
Small Cell Lung Carcinoma ◽  
Treatment Delay ◽  
Small Cell ◽  
Financial Toxicity ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Younger Age

131 Background: Financial toxicity (FT) describes objective and subjective burden of costs associated with medical care. Patients with head and neck cancer (HNC) and lung carcinoma are acutely impacted by FT, as these cancers disproportionately occur in populations that are poor, unemployed, and/or of minority backgrounds compared to patients with other cancers. Our group recently published results showing delay in time to treatment initiation (TTI) was associated with poorer survival in HNC patients. Another study reported that FT was associated with worse progression-free survival in non-small cell lung cancer patients. In this study, we sought to investigate the association between FT, TTI and clinical outcomes among HNC and lung carcinoma patients, as well as predictors of FT. Methods: A retrospective analysis of 140 patients diagnosed with either HNC or lung carcinoma between January 2007 and March 2018 with quality-of-life data collected prospectively at the time of radiation oncology treatment was conducted. Participants responded to a question about their experience on ‘financial difficulties’ with a 4-point Likert Scale within the European Organization for the Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) quality of life assessment. FT was low when patients indicated ‘1’ (not at all) or ‘2’ (a little), and high if patients indicated ‘3’ (quite a bit), and ‘4’ (very much). Chi-square test and Student’s t-test were used to compare characteristics of patients with and without FT. The association between FT and TTI and survival outcomes were analyzed using the Kaplan-Meier methods and Cox proportional-hazards regression models. Results: The study sample included 70 patients with HNC (mean [SD] age, 64.3 [12.0]; 62.7% male) and 70 patients with lung carcinoma (mean [SD] age, 69.1 [10.2]; 38.0% male). Over half (N = 80, 55.2%) reported experiencing financial toxicity (64% HNC vs. 45.7% lung carcinoma). Younger age (< 60 years), having Medicaid, and having small-cell lung carcinoma were associated with greater FT (p = 0.049, p = 0.042, p = 0.034, respectively). Patients who reported having poorer health and quality of life also experienced greater FT (p = 0.030, p = 0.016, respectively). HNC patients who experienced greater FT were less likely to experience treatment delay (p = 0.035). After adjusting for age, sex, ethnicity, tumor site, and tumor stage, FT was associated with worse survival outcomes in all patients (HR = 1.52, 95% CI 1.06-2.19). Conclusions: Greater FT was associated with younger age, having Medicaid, and having small-cell lung carcinoma. HNC patients who experienced greater FT were less likely to experience treatment delay, which suggests that delay may not be a causative factor for the worsened survival seen with patients who report FT.

scholarly journals Pre-cachexia and cachexia at diagnosis of stage III non-small-cell lung carcinoma: an exploratory study comparing two consensus-based frameworks

2012 ◽  
Vol 109 (12) ◽  
pp. 2231-2239 ◽  
Author(s):  
Barbara S. van der Meij ◽  
Coline P. Schoonbeek ◽  
Egbert F. Smit ◽  
Maurizio Muscaritoli ◽  
Paul A. M. van Leeuwen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prognostic Value ◽  
Cancer Cachexia ◽  
Small Cell Lung Carcinoma ◽  
Small Cell ◽  
Stage Iii ◽  
Small Cell Lung ◽  
Cell Lung Carcinoma ◽  
Stage Iii Nsclc

Despite the development of consensus-based frameworks to define cancer cachexia, the validity and usefulness of these frameworks are relatively unknown. The aim of the present study was to study the presence of pre-cachexia and cachexia in patients with stage III non-small-cell lung carcinoma (NSCLC) by using a cancer-specific framework and a general framework for cachexia, and to explore the prognostic value of pre-cachexia and cachexia. In forty patients at diagnosis of stage III NSCLC, weight loss, fat-free mass, handgrip strength, anorexia and serum biochemistry, assessed before the first chemotherapy, were used to define ‘cancer cachexia’ or ‘cachexia’. The cancer-specific framework also classified for pre-cachexia and refractory cachexia. Additionally, quality of life was assessed by the European Organisation for Research and Treatment of Cancer – Quality of Life Questionnaire C30. Groups were compared using independent t tests, ANOVA, Kaplan–Meier and Cox survival analyses. Based on the cancer-specific framework, pre-cachexia was present in nine patients (23 %) and cancer cachexia was present in seven patients (18 %). Cancer cachexia was associated with a reduced quality of life (P= 0·03) and shorter survival (hazard ratio (HR) = 2·9; P= 0·04). When using the general framework, cachexia was present in eleven patients (28 %), and was associated with a reduced quality of life (P= 0·08) and shorter survival (HR = 4·4; P= 0·001). In conclusion, pre-cachexia and cachexia are prevalent in this small population of patients at diagnosis of stage III NSCLC. For both frameworks, cachexia appears to be associated with a reduced quality of life and shorter survival. Further studies are warranted to more extensively explore the validity and prognostic value of these new frameworks in cancer patients.

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