RESUMEN
Background: Chinese patent medicine is widely used among patients with malignant tumors, and current studies have shown that long-term treatment with Chinese patent medicine is related to improved outcomes of patients. Huisheng Oral Liquid is a kind of Chinese patent medicine with the effects of curing dispersion-thirst and dissipating blood stasis. However, little is known about how it affects the survival rate of patients. Thus, patients with stage II-III NSCLC (non-small-cell lung cancer) were chosen to participate in a retrospective cohort study, which was conducted to preliminarily investigate the effects of using Chinese patent medicine and Huisheng Oral Liquid for different treatment durations on patients' 2-year survival rate and explore the prognostic factors affecting the 2-year survival rate of those patients. Purpose: This work compares the effect of different durations of treatment with Chinese patent medicine and Huisheng Oral Liquid on the 2-year survival rate of patients with stage II-III NSCLC and explores the prognostic factors of the patients' 2-year survival rate. Methods: This retrospective cohort study included patients with non-small cell lung cancer stage II-III according to the 2015 NCCN Guidelines: Non-Small Cell Lung Cancer. The Kaplan-Meier method was used to compare the 2-year survival rate of patients treated with different durations of Chinese medicine and Huisheng Oral Liquid. The relationship between different treatment durations and degree of improvement of 2-year survival rate was explored using the Cochran-Armitage trend test. The Cox proportional-hazards regression models were used to explore factors affecting the 2-year survival rate of patients. Results: A total of 614 patients with stage II-III NSCLC diagnosed from January 2015 to December 2018 were included in this study. Patients treated with Chinese patent medicine were divided into three groups by treatment durations: < 3 months, ≥ 3 months, and ≥6 months, and those treated with Huisheng Oral Liquid were divided into < 3 months and ≥3 and ≥6 months. The results showed that â the 2-year survival rate of patients treated with Chinese patent medicine for ≥3 months and ≥6 months was higher than that of patients treated for <3 months and the difference was statistically significant (p < 0.05). Further analysis of Huisheng Oral Liquid treatment revealed that â¡ the 2-year survival rate of patients treated with Huisheng Oral Liquid for ≥3 months was higher than that of patients treated for <3 months (p < 0.05). Because the total number of patients treated with Huisheng Oral Liquid for ≥6 months and the number of patients with improved outcomes were too small, there was no statistically significant difference in the 2-year survival rate between the two groups (p > 0.05). The results of the Cochran-Armitage trend test showed that the 2-year survival rate tended to increase with the duration of Huisheng Oral Liquid treatment (p < 0.05). ⢠The Cox proportional -hazards regression model revealed that among all 614 patients, surgery [HR = 0.48, 95% CI = (0.34, 0.68)], chemotherapy [HR = 0.46, 95% CI = (0.31,0.67)], and treatment with Huisheng Oral Liquid for ≥3 months were protective factors [HR = 0.48, 95%CI = (0.27,0.88)], whereas male gender [HR = 1.59, 95% CI = (1.01, 2.50)] and FIB ≥4 g/L [HR = 1.95, 95% CI = (1.37, 2.77)] were risk factors. Conclusion: Chinese patent medicine treatment for ≥3 months showed an improvement in the 2-year survival rate of patients with stage II-III NSCLC. Patients treated with Huisheng Oral liquid for ≥3 months also showed an improvement in the 2-year survival rate, and the 2-year survival rate tended to increase as the treatment duration increased. Finally, male and FIB ≥ 4 g/L were risk factors for prognosis.
RESUMEN
AIM: To compare survival outcomes in patients with non-small cell lung cancer (NSCLC) treated with modern-era drugs (antifolates, antiangiogenics, tyrosine kinase and anaplastic lymphoma kinase inhibitors, immunotherapy) with treatment initiation in 2011-12 and 2015-16, respectively. PATIENTS AND METHODS: Prospective data from Czech TULUNG Registry (960 patients from 2011-12 and 512 patients from 2015-16) were analyzed. Kaplan-Meier analysis was used to estimate overall survival (OS) and progression-free survival (PFS); Cox proportional hazards model to assess factors associated with 2-year survival. RESULTS: Survival at 2 years was more frequent in cohort 2015-16 compared to cohort 2011-12 (43.2% vs. 24% for adenocarcinoma; p<0.001 and 28.7% vs. 11.8% for squamous-cell lung carcinoma; p=0.002). Assignment to cohort 2015-16 and treatment multilinearity (two or more lines in sequence) were associated with higher probability of 2-year survival (hazard ratio=0.666 and hazard ratio=0.597; p<0.001). Comparison of 2-year survivors from both cohorts showed no differences. CONCLUSION: Survival at 2 years probability in stage IIIB-IV NSCLC doubled between 2011-12 and 2015-16; advanced-stage NSCLC may be considered a chronic disease in a large proportion of patients.
Asunto(s)
Adenocarcinoma del Pulmón/mortalidad , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Carcinoma de Células Escamosas/mortalidad , Neoplasias Pulmonares/mortalidad , Sistema de Registros/estadística & datos numéricos , Adenocarcinoma del Pulmón/epidemiología , Adenocarcinoma del Pulmón/patología , Adenocarcinoma del Pulmón/terapia , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Pulmón de Células no Pequeñas/epidemiología , Carcinoma de Pulmón de Células no Pequeñas/patología , Carcinoma de Pulmón de Células no Pequeñas/terapia , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Enfermedad Crónica , Estudios de Cohortes , Terapia Combinada , República Checa/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/patología , Neoplasias Pulmonares/terapia , Masculino , Persona de Mediana Edad , Pronóstico , Tasa de SupervivenciaRESUMEN
Objective: Applying radiomics and dosimetry features to establish machine learning models, which is used to predict the 2-year survival of esophageal patients with radiotherapy. Methods: Retrospective analysis of 579 esophageal cancer patients who underwent radiotherapy from January 2013 to December 2017 in Tianjin Medical University Cancer Institute and Hospital. Radiomics and dosimetry features were extracted from the GTV of the radiotherapy plan for patients with esophageal cancer. The maximum correlation and minimum redundancy and manual methods were used to reduce the feature vector. A total of 14 radiomics and 14 dosimetry features were selected, then normalized to the range [0,1]. The machine learning models such as support vector machines (SVM), Logistic regression (LR), and random forest (RF) were used to train and test the radiomics and dosimetry features, respectively, then to predict the 2-year survival of esophageal cancer patients treated with radiotherapy. Results: When only the radiomics features were used to predict the 2-year survival after radiotherapy, the accuracy of SVM, LR and RF models were 84.98%, 85.92% and 84.51%, respectively. Furthermore, when the combined features of radiomics and dosimetry were used for prediction, the accuracy of the SVM, LR and RF models were 86.32%, 83.02% and 90.01%, respectively. Using the radiomics and dosimetry features, the predictive accuracy of SVM and RF models are effectively improved. Conclusions: For the SVM and RF models, the radiomics and dosimetry features can effectively improve the accuracy of predicting 2-year survival for esophageal cancer patients after radiation therapy.
RESUMEN
Multidrug resistance is a major cause of death in patients with ovarian cancer. To improve patient survival, we developed a novel, noninvasive and convenient tool, the 75-gram oral glucose (75gOG)-stimulated CA125 test, to monitor cancer chemoresistance in real time. Our in vitro proof-of-principal experiments revealed that post-75gOG glucose and insulin peaks can synergistically increase cancer-derived CA125 levels, and the increase in CA125 secretion (ΔCA125) is correlated with the overactivation of the insulin receptor (IR)-PI3K-Akt axis and increases (ΔIC50 s) in cisplatin/taxol IC50 s. Correspondingly, among the 93 patients enrolled, post-75gOG CA125 over-release (i.e., enhanced ΔCA125) behavior was associated with overexpression of the IR-PI3K-Akt pathway and its downstream components, namely, IR, pAkt, pS6 and GLUT4, in cancer specimens. Furthermore, both pre- and postsurgical 75gOG CA125 tests demonstrated that CA125 over-release showed excellent prediction efficacy on the chemoresistance potential of ovarian cancer; notably, the former indicated the need for an optimal debulking surgery, and the latter suggested the use of IR-PI3K-Akt inhibitors. Both test results possess independent prognostic significance for the 2-year progression-free survival (PFS) and overall survival (OS) of patients. The odds ratios and corresponding 95% confidence intervals (95% CIs) were 2.680 (95% CI: 1.393-5.156) for patients with CA125 over-release behavior evidenced by a presurgical 75gOG CA125 test or 3.822 (95% CI: 1.942-7.522) for that evidenced by a postsurgical test in PFS; and 3.320 (95% CI: 1.508-7.309) for patients with CA125 over-release behavior evidenced by a presurgical test or 5.212 (95% CI: 2.241-12.121) for that evidenced by a postsurgical test in OS.
Asunto(s)
Antineoplásicos/uso terapéutico , Antígeno Ca-125/metabolismo , Resistencia a Múltiples Medicamentos , Resistencia a Antineoplásicos , Prueba de Tolerancia a la Glucosa , Neoplasias Ováricas/tratamiento farmacológico , Biomarcadores/metabolismo , Glucemia/metabolismo , Línea Celular Tumoral , Femenino , Humanos , Concentración 50 Inhibidora , Insulina/administración & dosificación , Insulina/sangre , Neoplasias Ováricas/sangre , Pronóstico , Prueba de Estudio ConceptualRESUMEN
C-met is a receptor normally expressed on epithelial cells and dysregulated in human breast cancers. Mammary tumours are the most common tumour in female dogs. The aims of this study were to detect the expression of c-met in canine mammary tumours (CMTs) and evaluate the correlations between c-met expression and clinicopathological features. A total of 240 specimens of canine mammary tissues composed of 30 normal glands, 30 hyperplastic ones, 90 benign tumours and 90 carcinomas obtained from 127 bitches were examined by immunohistochemical staining. Positive c-met immunoreactivity was demonstrated in the cytoplasm of mammary epithelial cells at variable levels, and in malignant CMTs, higher c-met expression was found in carcinomas whose grade, stage and mitotic index were low, and metastasis was absent. The median survival time was shorter in dogs with malignant CMTs with a maximum diameter ≥5 cm, regional lymph node or distant metastasis, and a high histologic grade. However, the 2-year survival rate was higher in dogs with malignant CMTs of higher c-met expression than those of low c-met expression (80.1% vs 57%). C-met expression could be used as a valuable positive prognostic factor for the clinical outcomes of dogs with malignant CMTs.
Asunto(s)
Enfermedades de los Perros/diagnóstico , Neoplasias Mamarias Animales/diagnóstico , Proteínas Proto-Oncogénicas c-met/metabolismo , Animales , Enfermedades de los Perros/metabolismo , Enfermedades de los Perros/mortalidad , Enfermedades de los Perros/patología , Perros , Femenino , Regulación Neoplásica de la Expresión Génica , Glándulas Mamarias Animales/metabolismo , Glándulas Mamarias Animales/patología , Neoplasias Mamarias Animales/metabolismo , Neoplasias Mamarias Animales/mortalidad , Neoplasias Mamarias Animales/patología , PronósticoRESUMEN
Objective To assess the factors associated with the restoration of spontaneous circulation (ROSC) and 2-year survival prognosis in patients with cardiac arrest (CA) after acute myocardial infarction (AMI),and after ROSC,the effects of various factors on midian survival time and on 2-year survival.Methods In a registry study from January 2005 to January 2015,all consecutive AMI-induced CA patients treated with cardiopulmonary resuscitation (CPR) admitted to our hospital were enrolled.The survivors were followed-up for 2 years.Univariate analysis was applied to evaluate factors associated with rate of ROSC and 2-year survival.Multivariable logistic regression analysis was applied to evaluate statistically significant factors in the univariate analysis.Medians with inter-quartile ranges were used to describe 2-year survival time affected by various factors after ROSC.Kaplan-Meier survival curve analysis was used to evaluate the effect of factors on 2-year survival.Results A total of 254 cases with CA after AMI were enrolled,including 129 cases of ROSC and 71 cases of 2-year survival.Univariate analysis showed age ≥ 70 years,CA occurred during 22:00-8:00,the duration time ofCPR ≥ 15 min and adrenaline dosage ＞ 5 mg were unfavorable predictors of ROSC;while,left ventricular ejection fraction (LVEF) ≥ 40％ before CA,shockable rhythm and percutaneous coronary intervention (PCI) therapy were favorable predictors.Besides,age ≥ 70 years,intubation during CPR,adrenaline dosage ＞ 5 mg and cardiogenic shock were unfavorable predictors of 2-year survival;While,male,normal daily activity before CA and PCI treatment were favorable predictors.Multivariable analysis showed age,the duration of CPR,adrenaline dosage,LVEF before CA,the rhythm during CPR and PCI therapy were independent predictors of ROSC.Age and PCI therapy were independent predictors of 2-year survival.Among patients,the survival time was affected by various factors after ROSC,and the factors with minimum 25％ and small median value were associated with cardiac rupture,cancer,adrenaline dosage ＞ 5 mg and cardiogenic shock.The factor with maximum 25％ value was PCI treatment (216 days).Kaplan-Meier survival analysis suggested that age ≥ 70 years was an unfavorable factor of 2-years survival (Log-rank test,P=0.007);while,PCI treatment was a favorable factor (Log-rank test,P＜0.01).PCI-related prognosis analysis showed that the effectiveness of PCI was related to the timing of PCI,the number of infarctrelated artery and the difference in culprit lesion.Conclusions The age ≥ 70 years was disadvantageous to both ROSC and 2-year survival.PCI treatment was favorable to both ROSC and 2-year survival.
RESUMEN
BACKGROUND: Despite a dismal prognosis, variability exists regarding the survival-time in patients with glioblastoma-multiforme (GBM), which may be explained by genetic variation. A possible candidate-gene for such variation is Aquaporin-1 (AQP1), since Aquaporin-1-expression influences the pathogenesis and outcome of various malignancies. Functional genetic variants in the promoter of AQP1, modifying Aquaporin-1-expression, could be associated with altered survival in patients with GBM. METHODS: We sequenced the human AQP1-promoter to detect novel sequence variants, which might impact on Aquaporin-1-expression and tested the hypothesis, that functional single nucleotide polymorphisms are associated with different survival-times of patients suffering from GBM. RESULTS: Sequencing the AQP1-promoter revealed a novel -783G/C-polymorphism. Reporter-assays showed that substitution of G for C was associated both with increased transcriptional-activation of the AQP1-promoter by serum and with increased AQP1 mRNA expression. Finally, we assessed in a cohort of 155 Caucasian patients with GBM whether the functional single-nucleotide-783G/C-polymorphism is associated with survival-time. Cox-regression analyses revealed the AQP1 -783G/C genotype status as an independent prognostic-factor when jointly considering other predictors of survival. Homozygous CC subjects had a significantly worse outcome compared to GC/GG genotypes (hazard ratio: 3.09; 95% CI, 1.43-6.65; P = 0.004). CONCLUSIONS: Our findings suggest the novel AQP1 polymorphism as a survival prognosticator in patients suffering from GBM that could help to identify a subgroup of patients at high risk for death. Further studies are necessary to reveal the exact molecular mechanisms.