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Query: UMLS:C0684249 (lung carcinoma)
 23,830 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Co-morbidity has a major impact on survival in early and late-stage lung carcinoma. Patients maintained on dialysis are potentially at increased risk of cancer. However, since very few studies have examined the clinical course of lung cancer in patients with chronic kidney disease (CKD), we felt it was important to study the course of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) in this patient population. We performed a retrospective chart review of patients diagnosed with lung cancer and co-existent CKD. 107 patients (101 males and six females), with a mean age at diagnosis of 69 years (range: 39-86 years) were included in our study. Of these, 17 (15.9%) patients had SCLC while 87 (81.3%) had NSCLC. Dyspnea, weight loss, and chest pain were the most common symptoms at presentation in our patient population occurring in 25, 20, and 15% of patients, respectively. The median survival of all the patients in the study was 10 months (range: 0-116 months). Patients with SCLC had a median survival of 7 months. Patients with NSCLC had a median survival of 10 months. We found that the clinical course and survival in patients with lung cancer and CKD appear to be comparable to that of patients with lung cancer, but without kidney dysfunction. Hence though treatment of lung cancer does need to be individualized in the setting of CKD, it should not dissuade the clinician from treating the malignancy.
Lung Cancer 2004 Mar
PMID:Clinical course of lung cancer in patients with chronic kidney disease. 1516 87

Interventional bronchoscopy has evolved as an integral part of lung-cancer treatment but it is not always used to its full potential. The different methods can provide immediate relief of dyspnea and haemoptysis. Bleeding from central airway tumours can be stopped by coagulation preferably with the argon plasma coagulator. In cases of intraluminally growing tumour masses removal of the malignant tissue is accomplished with the Nd-YAG laser, electrocautery, argon plasma coagulation, cryotherapy or photodynamic therapy. Intramural tumour growth is most efficiently treated with high dose-rate endobronchial brachytherapy. Extrinsic compression or airway wall destruction require the placement of an airway stent. All methods can be combined and complement other palliation methods such as radiation or chemotherapy.
Lung Cancer 2004 Aug
PMID:Interventional endoscopic treatment. 1555 4

A 73-year-old man was admitted to our hospital with productive cough and dyspnea. His chest X-ray and CT scan showed a mass lesion on the lower lung field, pleural effusion on the left side, metastatic lesion in the right lung, and multiple metastases in the liver. The diagnosis was non-small cell carcinoma of the lung. Unfortunately, he had suffered from chronic nephritis; his creatinine level was 2.1, and his creatinine clearance was 29 ml/min. He received 4 courses of combined chemotherapy of carboplatin (AUC 5, day 1) and weekly paclitaxel (60 mg/ m2, day 1, 8, 15) every 4 weeks. His subjective symptoms as side effects were mild except for accidental melena due to colon diverticulum. Almost all lesions identified at admission were regressed by the chemotherapy. Although renal dysfunction often prevents patients with lung cancer from receiving systemic chemotherapies, in this case the combined chemotherapy of carboplatin and weekly paclitaxel proved to be a relatively safe and effective therapy for those patients with renal dysfunction.
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PMID:[A case of non-small cell lung carcinoma successfully treated with carboplatin and weekly paclitaxel under renal dysfunction]. 1557 Sep 41

The authors describe a case of 80-years old male hospitalized because of radiological and clinical signs suggestive of right-sided pneumonia. The main complaints of the patient were of productive cough with increasing amounts of watery sputum irregular fever up to 39 degrees C, progressive dyspnea, generalized weakness and loss of weight. Despite extensive use of antimicrobial and antituberculosis agents significant deterioration of patients general condition and the progression of X-ray picture were observed, inflammatory infiltration started to encompass the contralateral lung. Bronchial washing revealed the presence of atypical and neoplasmatic cells of adenous origin type. Since this finding contrasted with the pattern of radiological abnormality that did not show any tumor-like changes, another diagnostic approach was undertaken. Transthoracic fine needle aspiration biopsy revealed cells of non-small cell lung carcinoma. The diagnosis of bronchioalveolar carcinoma established on the basis of clinicoradiologic pattern was confirmed at autopsy. Increasing bronchorrhea was the most prominent symptom.
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PMID:[Bronchorrhea in a case of pneumonic type of bronchioloalveolar carcinoma]. 1567 72

This trial was designed to determine the 1-year survival rate, efficacy, progression-free survival (PFS), and toxicity with gemcitabine in patients with stage IIIB (with pleural effusion) or stage IV non-small-cell lung cancer (NSCLC) with Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2. Gemcitabine 1250 mg/m2 was administered intravenously on days 1 and 8 of each 21-day cycle. Treatment consisted of 6 cycles; patients who responded with complete response or partial response received < or = 2 additional cycles. Forty-two patients were enrolled at 31 community-based centers between March and November 2002. Most patients had stage IV disease (74%). The median age was 73 years (range, 58-84 years), and 19% had received prior palliative radiation therapy. Patients received a median of 3 cycles (range, 1-8 cycles). The median survival was 4.8 months (range, < 1 to 19.2 months), and the estimated 1-year survival was 20%. Median PFS was 2.5 months (range, < 1 to 19.2 months), and PFS at 1 year was 11.1%. Thirty-one patients died of disease progression, and 1 each died of myocardial infarction, brain herniation, pneumonia, and respiratory failure. Seven patients were not evaluable for response; 4 refused or received no treatment, treatment in 2 failed (myocardial infarction and pneumonia), and 1 was lost to follow-up. Among 35 evaluable patients, there were 5 partial responses (14%), 10 with stable disease (29%), and 20 with disease progression (57%). Drug-related grade > or = 3 toxicities included neutropenia (18%), anemia (8%), and dyspnea (2.6%). These results suggest that patients with NSCLC with an ECOG PS of 2 may benefit from single-agent chemotherapy gemcitabine. General toxicity, including myelotoxicity, was relatively low. Further studies comparing single-agent chemotherapy with combination chemotherapy for patients with a PS of 2 are warranted.
Clin Lung Cancer 2005 Jan
PMID:Results of a phase II trial of gemcitabine in patients with non-small-cell lung cancer and a performance status of 2. 1569 17

Malignant pleural effusions with dyspnoea as their most common presenting symptom are a frequent clinical problem in patients with neoplastic disease. Lung carcinoma is the leading cause, followed by breast carcinoma and malignant lymphoma. The frequency of malignant mesothelioma is increasing in industrialized countries. In this overview, which is based on the ERS/ATS Statement 2001, the diagnostic approach, the differential diagnosis including causes of paramalignant effusions, as well as the therapeutic possibilities are described. Pleurodesis is the most important therapeutic modality, today preferably via thoracoscopic talc poudrage. Alternative local and systemic treatment options are discussed in detail. A special emphasis is put on the epidemiology, diagnosis, treatment, and prognosis of malignant effusions in patients with lung and breast carcinomas, and with lymphomas. Finally, open questions are listed which need future research, which will hopefully improve the treatment and prognosis of malignant pleural effusions.
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PMID:[Management of malignant pleural effusions]. 1572 26

Two Japanese females complained of cough and bronchorrhea for which chest radiographs showed infiltrate in the lungs. The patients were subsequently diagnosed as having bronchioloalveolar carcinoma by transbronchial lung biopsy. After receiving systemic chemotherapy, their symptoms were slightly improved. A few months later, their bronchorrhea and dyspnea worsened, and they were then treated with gefitinib, a selective epidermal growth factor receptor tyrosine kinase inhibitor. Bronchorrhea and dyspnea were improved within 24 h after treatment with gefitinib where the improvement was evident after 6 h for one patient and 24 h for the other patient. Thereafter, their radiological findings showed gradual improvement. Rapid relief of bronchorrhea preceded the improvement seen by the radiological findings. These observations suggest that gefitinib may inhibit mucin production as well as exert anti-proliferative activity against bronchioloalveolar carcinoma.
Lung Cancer 2005 Jul
PMID:Novel effects of gefitinib on mucin production in bronchioloalveolar carcinoma; two case reports. 1594 98

Despite advances in lung cancer treatment, the outlook for most patients remains grim. Many of them face a short survival time during which they may suffer physical and psychological problems related with the cancer and the treatment side-effects. There is a need for a high quality care to support patients and reduce symptoms as much as possible. This systematic review found that a specialised nursing programme to reduce breathlessness was effective and that after patients' treatment had finished, those cared by nurses did as well or even better than those cared by doctors.
Lung Cancer 2005 Nov
PMID:Non-invasive interventions for improving well-being and quality of life in patients with lung cancer--a systematic review of the evidence. 1613 86

Only about 15% of patients diagnosed with lung carcinoma each year are surgical candidates, either due to advanced disease or comorbidities. The past decade has seen the emergence of minimally invasive therapies using thermal energy sources: radiofrequency, cryoablation, focused ultrasound, laser, and microwave; radiofrequency ablation (RFA) is the best developed of these. Radiofrequency ablation is safe and technically highly successful in terms of initial ablation. Long-term local control or complete necrosis rates drop considerably when tumors are larger than 3 cm, although repeat ablations can be performed. Patients with lung metastases tend to fare better with RF lung ablation than those with primary lung carcinoma in terms of local control, but it is unclear if this is related to smaller tumor size at time of treatment, lesion size uniformity, and sphericity with lung metastases, or to differences in patterns of pathologic spread of disease. The effects of RFA on quality of life, particularly dyspnea and pain, as well as long-term outcome studies are generally lacking. Even so, the results regarding RF lung ablation are comparable to other therapies currently available, particularlyfor the conventionally unresectable or high-risk lung cancer population. With refinements in technology, patient selection, clinical applications, and methods of follow-up, RFA will continue to flourish as a potentially viable stand-alone or complementary therapy for both primary and secondary lung malignancies in standard and high-risk populations.
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PMID:Radiofrequency ablation in lung cancer: promising results in safety and efficacy. 1636 74

Although we have made steady improvements in the survival rates of patients with advanced-stage lung cancer, the majority of patients still experience distress and suffering. Although the symptom burden is greatest in patients in the end stages of life, many patients living with lung cancer suffer from troubling symptoms and side effects of therapy. Even long-term survivors with early-stage non-small-cell lung cancer (NSCLC) often experience respiratory symptoms, such as dyspnea and cough. Because of the high prevalence of NSCLC and the frequency with which it presents in an incurable stage, symptom management is a large component of the care of these patients. Dyspnea, cough, fatigue, anorexia/cachexia, and pain are the most common symptoms in patients with advanced-stage NSCLC. Cancer-directed therapy can improve some of these symptoms but often incompletely and temporarily. Therefore, comprehensive care of patients with advanced-stage NSCLC must include therapies targeted at these difficult and distressing symptoms.
Clin Lung Cancer 2006 Jan
PMID:Comprehensive symptom management in patients with advanced-stage non-small-cell lung cancer. 1651 77


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