Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We reviewed our initial institutional experience with the use of stereotactic hypofractionated radiation therapy (SFRT) in patients with stage I non-small cell lung cancer (NSCLC). Thirty patients with inoperable stage I non-small cell lung cancer due to a severe chronic obstructive pulmonary disease (COPD) and/or chronic heart disease (Eastern Cooperative Oncology Group (ECOG) performance status of 0-2) were treated between December 2000 and October 2003 with SFRT in curative intent. Infiltration of locoregional lymph nodes and distant metastases were ruled out by computerized tomography (CT) scan of the brain, thorax, and abdomen, and by whole body FDG-positron emission tomography scan in all patients. Total RT doses ranged from 24.0 to 37.5 Gy, given in 3-5 fractions to the 60% isodose encompassing the planning target volume. Immobilization was carried out by a vacuum couch and a low-pressure foil. The clinical target volume was the tumor as it appeared in lung windowing on lung CT scan. Organ movements (caused by breathing; range, 6-22 mm) and reproducibility of patient positioning in the couch (range, 3-12 mm) were calculated by sequential CT and orthogonal films. The individual values were taken into account as a safety margin for the definition of the planning target volume (PTV). The median follow-up of living patients is 18 months (range, 6-38 months). As maximum response, there were 10 (33%) complete responses (CRs) and 14 (47%) partial responses (PRs), resulting in a total response rate of 80%. Stable disease was observed in 6 (20%) patients, while no patient experienced progressive disease. During follow-up, 2 (7%) local recurrences were observed (after 17 and 18 months, respectively). Of 5 (17%) patients who developed distant metastasis, 1 patient developed it in liver (3 months), another one in brain (6 months), and another one in the lung (36 months), while 2 patients developed it in mediastinal lymph nodes (after 8, and 11 months, respectively) only. Of 9 (30%) patients who have died, only 3 (10%) died of cancer, while 6 (20%) died of cancer-unrelated or unknown causes. Acute side effects were mild and affected 9 (33%) patients during the RT course (fatigue being the most frequent one in 6 patients). There were 22 acute events occurring in 19 (63%) patients during the first 3 months post-SFRT, the most frequent one being pneumonitis observed in 14 (46%) patients. However, there was only one (3%) grade 3 acute toxicity and no patient experienced greater than grade 3 toxicity during this study. One (3%) patient experienced rib fracture as the late event. SFRT is a feasible and safe treatment method in inoperable patients with stage I NSCLC having reduced lung capacity. Longer follow-up is necessary to get robust data on late toxicity as well as survival.
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PMID:Stereotactic hypofractionated radiation therapy for stage I non-small cell lung cancer. 1577 77

There are few studies on the cause of death in patients with stage I non-small cell lung cancer after surgery. Our aim is to study the trend of cause of death and risk factors affecting prognosis in the patients. We retrospectively reviewed patients in Surveillance, Epidemiology and End results database from 2004 to 2015. The change trend between cause of death and follow-up time was studied by calculating the proportion of cause of death at different periods and analyzing the cumulative risk. COX risk regression model was performed by univariate and multivariate analyses for survival analysis. Finally, 23,652 patients were enrolled. In the whole cohort, lung cancer accounted for 18.68% of deaths, followed by other causes (9.57%), heart disease (5.12%) and COPD (3.89%). With the increasing of follow-up time, the cumulative incidence of lung cancer was always the highest, but the growth rate in the late follow-up period was slower than that caused by heart disease and COPD. The proportion of death due to lung cancer decreased from 53.1%-73.1% in 0-30 months after follow-up to 7.8%-41.4% in 90 months after follow-up, while the proportion of deaths due to heart disease and COPD increased. Age was an independent risk factor for lung cancer-, heart disease- and COPD-specific survival, while lobectomy resection was a protective factor, even in patients older than 70 years old. In conclusion, during the follow-up period, lung cancer was still the main cause of death, but the proportion of patients died of heart disease and COPD increased gradually, especially in elderly. Furthermore, age was an important independent factor affecting prognosis, particularly for heart disease- and COPD-related mortality. The application of wedge resection in elderly patients needs further exploration.
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PMID:The Change Trend of Cause of Death in Patients With Stage I Non-Small Cell Lung Cancer After Surgery in US: A Long-Term Follow-Up Study Based on SEER Database. 3307 Jun 29