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1. Hasbini A, Ozanne F, Ammarguellat H, Crequit J, Dolige T, Bouchaert E, Dutel JL, Durdux C: [Radio-chemotherapy combinations in non operable localized non small cell lung carcinoma: updates and perspectives]. Bull Cancer; 2002 Jun;89(6):599-611
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  • [Title] [Radio-chemotherapy combinations in non operable localized non small cell lung carcinoma: updates and perspectives].
  • [Transliterated title] Les associations de radio-chimiothérapie dans les carcinomes bronchiques non à petites cellules localisés inopérables: actualités et perspectives.
  • Optimal treatment of non operable localized non small cell lung carcinoma (NSCLC) continues to evolve.
  • Increasing overall survival must evolute through improving local tumoral control and eradication of probable occult metastasis.
  • Induction chemotherapy (CT) followed by RT has demonstrated its superiority over RT alone, modality which is widely utilised.
  • Results of all of these new therapeutic modalities still poor.
  • Implication of new CT drugs has conducted for an emergence of new studies finding to demonstrate more encouraging results.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / drug therapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials, Phase II as Topic. Clinical Trials, Phase III as Topic. Combined Modality Therapy / methods. Forecasting. Humans. Radiation-Sensitizing Agents / therapeutic use

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  • (PMID = 12135861.001).
  • [ISSN] 0007-4551
  • [Journal-full-title] Bulletin du cancer
  • [ISO-abbreviation] Bull Cancer
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] France
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Radiation-Sensitizing Agents
  • [Number-of-references] 103
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2. Xi L, Coello MC, Litle VR, Raja S, Gooding WE, Yousem SA, El-Hefnawy T, Landreneau RJ, Luketich JD, Godfrey TE: A combination of molecular markers accurately detects lymph node metastasis in non-small cell lung cancer patients. Clin Cancer Res; 2006 Apr 15;12(8):2484-91
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  • [Title] A combination of molecular markers accurately detects lymph node metastasis in non-small cell lung cancer patients.
  • Occult lymph node metastasis (micrometastasis) is a good prognostic indicator in non-small cell lung cancer (NSCLC) and could be used to direct adjuvant chemotherapy in stage I patients.
  • This study was designed to evaluate molecular markers for detection of occult lymph node metastasis in NSCLC, define the best marker or marker combination to distinguish positive from benign lymph nodes, and evaluate these markers in lymph nodes from pathologically node-negative (pN(0)) NSCLC patients.
  • Potential markers were identified through literature and database searches and all markers were analyzed by quantitative reverse transcription-PCR in a primary screen of six NSCLC specimens and 10 benign nodes.
  • Selected markers were further evaluated on 21 primary NSCLC specimens, 21 positive nodes, and 21 benign nodes, and the best individual markers and combinations were identified.
  • A combination of three markers was further validated on an independent set of 32 benign lymph nodes, 38 histologically positive lymph nodes, and 462 lymph nodes from 68 pN(0) NSCLC patients.
  • PVA and SFTPB are particularly powerful in tumors of squamous and adenocarcinoma histologies, respectively, whereas TACSTD1 is a good general marker for NSCLC metastasis.
  • The combination of these genes identified 32 of 462 (7%) lymph nodes from 20 of 68 (29%) patients as potentially positive for occult metastasis.

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  • (PMID = 16638856.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / CA094059-04; United States / NCI NIH HHS / CA / R01 CA094059-05; United States / NCI NIH HHS / CA / R01 CA094059; United States / NCI NIH HHS / CA / CA094059-03; United States / NCI NIH HHS / CA / R01 CA094059-01; United States / NCI NIH HHS / CA / R01 CA090665; United States / NCI NIH HHS / CA / R01 CA094059-03; United States / NCI NIH HHS / CA / R01CA90665; United States / NCI NIH HHS / CA / CA094059-02; United States / NCI NIH HHS / CA / CA094059-05; United States / NCI NIH HHS / CA / R01 CA094059-02; United States / NCI NIH HHS / CA / R01 CA094059-04; United States / NCI NIH HHS / CA / CA094059-01
  • [Publication-type] Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, Neoplasm; 0 / Biomarkers, Tumor; 0 / Cell Adhesion Molecules; 0 / DSG3 protein, human; 0 / Desmoglein 3; 0 / EPCAM protein, human; 0 / Pulmonary Surfactant-Associated Protein B
  • [Other-IDs] NLM/ NIHMS24707; NLM/ PMC1933488
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3. Spiro SG: Surgery for nonsmall cell lung cancer: can improvements be made? Eur Respir J Suppl; 2003 Jan;39:52s-56s
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  • [Title] Surgery for nonsmall cell lung cancer: can improvements be made?
  • Low-dose spiral computed tomography (CT) for the earlier detection of lung cancer is at the stage of producing hypothesis-generating studies.
  • The role of neo-adjuvant chemotherapy before surgery in nonsmall cell lung cancer looks less promising than suggested by earlier studies and the place of adjuvant chemotherapy following surgery appears to be unhelpful, although results of some large, randomised international studies are still awaited.
  • Positron emission tomography scanning offers a genuine opportunity to identify occult disease and improve staging prior to surgery and therefore save futile thoracotomies in approximately 20% of patients otherwise apparently suitable for resection.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / surgery. Pulmonary Surgical Procedures / methods
  • [MeSH-minor] Chemotherapy, Adjuvant / methods. Combined Modality Therapy. Humans. Mass Screening / methods. Neoplasm Staging. Radiotherapy, Adjuvant / methods. Randomized Controlled Trials as Topic. Tomography, Spiral Computed

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  • (PMID = 12572702.001).
  • [ISSN] 0904-1850
  • [Journal-full-title] The European respiratory journal. Supplement
  • [ISO-abbreviation] Eur Respir J Suppl
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Denmark
  • [Number-of-references] 25
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4. Usuda J, Ichinose S, Ishizumi T, Hayashi H, Ohtani K, Maehara S, Ono S, Kajiwara N, Uchida O, Tsutsui H, Ohira T, Kato H, Ikeda N: Management of multiple primary lung cancer in patients with centrally located early cancer lesions. J Thorac Oncol; 2010 Jan;5(1):62-8
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  • [Title] Management of multiple primary lung cancer in patients with centrally located early cancer lesions.
  • BACKGROUND: Patients with centrally located early lung cancer (CLELC) are often heavy smokers with a considerably high risk of multiple primary lung cancer (MPLC) lesions; treatment strategies for such patients must preserve the cardiopulmonary function.
  • METHODS: Between July 2004 and July 2008, patients with CLELC underwent photodynamic therapy (PDT) using NPe6, second-generation photosensitizer at Tokyo Medical University Hospital.
  • Among these patients, we retrospectively analyzed MPLC, which was treated by surgery plus PDT or PDT alone and examined the effectiveness of PDT, and we propose a treatment strategy for patients with MPLC.
  • Among these 22 patients, 10 patients underwent surgery for primary lung cancer and underwent NPe6-PDT for the treatment of secondary primary CLELC, one patient underwent PDT for CLELC as a primary lesion followed by an operation for peripheral-type lung cancer as a secondary primary lesion, and 11 patients underwent PDT alone for MPLC lesions (28 lesions) that were roentgenographically occult lung cancers.
  • Among these 22 patients with MPLC including peripheral-type lung cancers, which were resected by surgery, all 39 CLELC lesions exhibited a complete response after PDT, and all patients were alive.
  • CONCLUSIONS: For patients with lung cancer with a long-term history of smoking, careful follow-up examinations after surgical resection are needed considering the incidence of metachronous primary lung cancers.
  • PDT can play an important role for the treatment strategy for MPLC.
  • [MeSH-major] Lung Neoplasms / drug therapy. Neoplasms, Multiple Primary / drug therapy. Neoplasms, Second Primary / drug therapy. Photochemotherapy. Photosensitizing Agents / therapeutic use. Porphyrins / therapeutic use
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adenocarcinoma / pathology. Adenocarcinoma / surgery. Aged. Aged, 80 and over. Carcinoma, Small Cell / drug therapy. Carcinoma, Small Cell / pathology. Carcinoma, Small Cell / surgery. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / surgery. Combined Modality Therapy. Female. Follow-Up Studies. Humans. Lasers. Male. Middle Aged. Neoplasm Staging. Pneumonectomy. Prognosis. Retrospective Studies. Smoking. Survival Rate. Tokyo

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  • (PMID = 19952800.001).
  • [ISSN] 1556-1380
  • [Journal-full-title] Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
  • [ISO-abbreviation] J Thorac Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Photosensitizing Agents; 0 / Porphyrins; P4ROX5ELT2 / Talaporfin
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5. Klein J, Král V, Neoral C, Bohanes T, Drác P, Grygárková I, Herman M: [Importance of neoadjuvant chemotherapy in the treatment of advanced bronchogenic carcinoma]. Rozhl Chir; 2003 Mar;82(3):152-6
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  • [Title] [Importance of neoadjuvant chemotherapy in the treatment of advanced bronchogenic carcinoma].
  • [Transliterated title] Význam neoadjuvantní chemoterapie v lécbĕ pokrocilého bronchogenního karcinomu.
  • BACKGROUND: The basic task of induction (neo-adjuvant) therapy is elimination of occult micrometastatic dissemination found in some cases already in localized stages of non-small cell pulmonary cancer (stage I-IIIA NSCLC).
  • A difficult problem remains the correct selection of patients who from the long-term aspect may profit from such a procedure.
  • MATERIAL AND METHODS: The authors evaluated perspectively aspects of oncological treatment and circumstances of surgical intervention after induction chemotherapy in 81 and 87 patients resp. in stage IIIA NSCLC evaluated before initiated neo-adjuvant chemotherapy.
  • In the group of 87 patients operated after induction therapy pneumonectomies predominated--41 (46%), only one operated patient died within 30 days after surgery (1.1%), complications were neither frequent nor serious.
  • CONCLUSIONS: Neo-adjuvant chemotherapy by modern cytostatics is usually well tolerated and creates satisfactory conditions for successful complete resection.
  • By this treatment it is probably possible to influence long-term results not only in stage IIIA but to reduce also the risk of a later more remote metastatic dissemination in some patients operated in lower stages of lung cancer.
  • Our present aim is to test parameters which will be able to predict possible failure of induction therapy, and seek factors predicting risk behaviour of the tumour also in lower stages (stage I and II TNM classification).
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Bronchogenic / drug therapy. Lung Neoplasms / drug therapy. Pneumonectomy
  • [MeSH-minor] Female. Humans. Male. Middle Aged. Neoadjuvant Therapy

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  • (PMID = 12728565.001).
  • [ISSN] 0035-9351
  • [Journal-full-title] Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
  • [ISO-abbreviation] Rozhl Chir
  • [Language] cze
  • [Publication-type] English Abstract; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] Czech Republic
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6. Besse B, Lasserre SF, Compton P, Huang J, Augustus S, Rohr UP: Bevacizumab safety in patients with central nervous system metastases. Clin Cancer Res; 2010 Jan 1;16(1):269-78

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  • Safety information for bevacizumab-treated patients with CNS metastases was reviewed to determine whether general exclusion of these patients from bevacizumab treatment is still justified.
  • In datasets A and B, known CNS metastasis was an exclusion criterion; patients with CNS metastasis had unrecognized CNS metastases at study entry or developed them during the trial.
  • RESULTS: In dataset A, occult brain metastases were identified in 187 of 8,443 patients (91 in bevacizumab arms and 96 in non-bevacizumab arms).
  • Three bevacizumab-treated patients (3.3%) developed grade 4 cerebral hemorrhage, whereas one control-arm patient (1.0%) developed grade 5 cerebral hemorrhage.
  • In dataset B, 321 of 4,382 patients had initially occult CNS metastases, in whom two grade 1 and one grade 3 cerebral hemorrhage (0.9%) were reported.
  • In 131 patients with treated CNS metastases in dataset C, one bevacizumab-treated patient (0.8%) developed grade 2 cerebral hemorrhage.
  • CONCLUSIONS: In this selected population, patients with CNS metastases are at similar risk of developing cerebral hemorrhage, independent of bevacizumab therapy.
  • Consequently, such patients with CNS metastases from advanced/metastatic breast cancer, non-small cell lung carcinoma, and renal and colorectal cancer should not be generally excluded from bevacizumab therapy or clinical trials.
  • [MeSH-major] Angiogenesis Inhibitors / adverse effects. Antibodies, Monoclonal / adverse effects. Central Nervous System Neoplasms / drug therapy. Central Nervous System Neoplasms / secondary. Cerebral Hemorrhage / chemically induced

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  • (PMID = 20028762.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Angiogenesis Inhibitors; 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 2S9ZZM9Q9V / Bevacizumab
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7. Prokakis Ch, Koletsis EN, Apostolakis E, Chatzimichalis A, Dougenis D: Preoperative chemotherapy in early-stage (stage IB-IIIA) resectable non small cell lung cancer. Is it justified? J BUON; 2008 Apr-Jun;13(2):161-8
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  • [Title] Preoperative chemotherapy in early-stage (stage IB-IIIA) resectable non small cell lung cancer. Is it justified?
  • Only 20-30% of patients with non small cell lung cancer (NSCLC) present with early-stage disease at the time of diagnosis and may benefit by surgical resection.
  • Occult micrometastatic disease already present in many patients with resectable NSCLC at the time of diagnosis and surgical treatment leads to local and distant disease recurrence.
  • The role of adjuvant chemotherapy has already been established in this field.
  • Within the past decade attention has been focused on the possible beneficial effects of preoperative chemotherapy considering that patients' compliance to the induction treatment can be very high with eventual eradication of micrometastatic disease and primary tumor downstaging.
  • In this review we present the currently available data on induction chemotherapy followed by surgery in early-stage (stages IB-IIIA) NSCLC with a fundamental question to be answered: is this approach justified in current clinical practice?
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy

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  • (PMID = 18555460.001).
  • [ISSN] 1107-0625
  • [Journal-full-title] Journal of B.U.ON. : official journal of the Balkan Union of Oncology
  • [ISO-abbreviation] J BUON
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Greece
  • [Number-of-references] 32
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8. Azouz SM, Walpole J, Amirifeli S, Taylor KN, Grinstaff MW, Colson YL: Prevention of local tumor growth with paclitaxel-loaded microspheres. J Thorac Cardiovasc Surg; 2008 May;135(5):1014-21
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  • OBJECTIVES: Lung cancer is associated with a significant rate of locoregional recurrence after surgical resection, particularly when nonanatomic wedge resections are performed.
  • The primary aim of this study was to assess the feasibility of a microsphere drug delivery system to locally deliver chemotherapy and prevent the establishment and growth of lung cancer cells and establish proof of concept for a potential future approach to target occult microscopic disease remaining at the surgical resection margin.
  • METHODS: Poly-(D,L-lactic-co-glycolic acid) (PLGA) microspheres loaded with the antineoplastic agent paclitaxel were prepared and tested for antitumor efficacy in an in vitro cell proliferation assay for tumor inhibition and induction of apoptosis.
  • The in vivo prevention of Lewis lung carcinoma cell establishment and growth in subcutaneous tissues of mice was also assessed by comparing 4 treatment groups: Lewis lung carcinoma cells alone, Lewis lung carcinoma cells combined with 100 x 10(6) unloaded (carrier alone) PLGA microspheres, and Lewis lung carcinoma cells combined with 50 x 10(6) or 100 x 10(6) paclitaxel-loaded PLGA microspheres.
  • After the coinjection of Lewis lung carcinoma cells with or without microspheres, in vivo tumor growth was monitored, and tumor weight was recorded on death.
  • Similarly, paclitaxel-loaded PLGA microspheres significantly inhibited tumor growth in vivo at both the 50 x 10(6) and 100 x 10(6) microsphere dose (0.497 +/- 0.183 and 0.187 +/- 0.083 g total tumor weight, respectively) compared with 2.91 +/- 0.411 g for Lewis lung carcinoma cells with unloaded microspheres and 3.37 +/- 0.433 g for untreated tumor (P < .001).
  • CONCLUSIONS: Paclitaxel-loaded PLGA microspheres induce tumor apoptosis and inhibit the establishment and growth of lung cancer cells both in vitro and in vivo without obvious systemic toxicity.
  • By using models consistent with localized microscopic tumor burdens, these results suggest that local delivery of paclitaxel through a microsphere system might lead to an effective future method of decreasing local tumor recurrence in non-small cell lung cancer when applied to the surgical margins at risk for microscopic tumor foci.
  • Such an approach might be particularly efficacious after wedge resection in the setting of poor pulmonary reserve or significant comorbidity, where local recurrence rates are increased and acceptable alternative treatment options are limited.
  • [MeSH-major] Antineoplastic Agents, Phytogenic / administration & dosage. Lung Neoplasms / prevention & control. Neoplasm Recurrence, Local / prevention & control. Paclitaxel / administration & dosage
  • [MeSH-minor] Animals. Apoptosis / drug effects. Cell Line, Tumor. Feasibility Studies. Female. Mice. Mice, Inbred C57BL. Microspheres

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  • (PMID = 18455578.001).
  • [ISSN] 1097-685X
  • [Journal-full-title] The Journal of thoracic and cardiovascular surgery
  • [ISO-abbreviation] J. Thorac. Cardiovasc. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents, Phytogenic; P88XT4IS4D / Paclitaxel
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9. Celikoglu F, Celikoglu SI, Goldberg EP: Intratumoural chemotherapy of lung cancer for diagnosis and treatment of draining lymph node metastasis. J Pharm Pharmacol; 2010 Mar;62(3):287-95
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  • [Title] Intratumoural chemotherapy of lung cancer for diagnosis and treatment of draining lymph node metastasis.
  • OBJECTIVES: Reviewed here is the potential effectiveness of cytotoxic drugs delivered by intratumoural injection into endobronchial tumours through a bronchoscope for the treatment of non-small cell lung cancer and the diagnosis of occult or obvious cancer cell metastasis to mediastinal lymph nodes.
  • KEY FINDINGS: Intratumoural lymphatic treatment may be achieved by injection of cisplatin or other cytotoxic drugs into the malignant tissue located in the lumen of the airways or in the peribronchial structures using a needle catheter through a flexible bronchoscope.
  • This procedure is termed endobronchial intratumoural chemotherapy and its use before systemic chemotherapy and/or radiotherapy or surgery may provide a prophylactic or therapeutic treatment for eradication of micrometastases or occult metastases that migrate to the regional lymph nodes draining the tumour area.
  • CONCLUSIONS: To better elucidate the mode of action of direct injection of cytotoxic drugs into tumours, we review the physiology of lymphatic drainage and sentinel lymph node function.
  • In this light, the potential efficacy of intratumoural chemotherapy for prophylaxis and locoregional therapy of cancer metastasis via the sentinel and regional lymph nodes is indicated.
  • Randomized multicenter clinical studies are needed to evaluate this new and safe procedure designed to improve the condition of non-small cell lung cancer patients and prolong their survival.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / secondary. Lung Neoplasms / drug therapy
  • [MeSH-minor] Bronchoscopes. Early Detection of Cancer / methods. Humans. Injections, Intralesional / methods. Lymphatic Metastasis / diagnosis. Lymphatic Metastasis / radionuclide imaging. Lymphatic System / physiology. Lymphatic System / physiopathology. Lymphoscintigraphy

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  • (PMID = 20487210.001).
  • [ISSN] 2042-7158
  • [Journal-full-title] The Journal of pharmacy and pharmacology
  • [ISO-abbreviation] J. Pharm. Pharmacol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 61
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10. Perry MC, Kohman LJ, Bonner JA, Gu L, Wang X, Vokes EE, Green MR: A phase III study of surgical resection and paclitaxel/carboplatin chemotherapy with or without adjuvant radiation therapy for resected stage III non-small-cell lung cancer: Cancer and Leukemia Group B 9734. Clin Lung Cancer; 2007 Jan;8(4):268-72
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  • [Title] A phase III study of surgical resection and paclitaxel/carboplatin chemotherapy with or without adjuvant radiation therapy for resected stage III non-small-cell lung cancer: Cancer and Leukemia Group B 9734.
  • PURPOSE: Patients with completely resected stage IIIA (N2) non-small-cell lung cancer (NSCLC) are at substantial risk for locoregional and systemic recurrence.
  • Adjuvant chemotherapy has recently improved overall control for these patients.
  • We added adjuvant chemotherapy to control presumed micrometastatic disease and then randomized patients to receive radiation therapy (RT) or observation to determine the benefit of local radiation consolidation.
  • PATIENTS AND METHODS: Patient eligibility required histologically documented stage IIIA (radiographically occult N2) NSCLC that was completely resected, with no known residual disease, surgical staging per protocol requirements, Cancer and Leukemia Group B performance status of 0/1, no previous chemotherapy or RT, and minimal laboratory values.
  • Two to 4 weeks after chemotherapy, patients were randomized to receive RT as 5000 cGy in 25 fractions over 5 weeks or observation.
  • CONCLUSION: In this small study, consolidation RT after complete resection and adjuvant chemotherapy in stage IIIA NSCLC did not significantly improve outcome for this high-risk population.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Adult. Aged. Carboplatin / administration & dosage. Combined Modality Therapy. Female. Humans. Male. Middle Aged. Neoplasm Staging. Paclitaxel / administration & dosage

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  • (PMID = 17311692.001).
  • [ISSN] 1525-7304
  • [Journal-full-title] Clinical lung cancer
  • [ISO-abbreviation] Clin Lung Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] BG3F62OND5 / Carboplatin; P88XT4IS4D / Paclitaxel
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11. Al-Sarraf N, Aziz R, Gately K, Lucey J, Wilson L, McGovern E, Young V: Pattern and predictors of occult mediastinal lymph node involvement in non-small cell lung cancer patients with negative mediastinal uptake on positron emission tomography. Eur J Cardiothorac Surg; 2008 Jan;33(1):104-9
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  • [Title] Pattern and predictors of occult mediastinal lymph node involvement in non-small cell lung cancer patients with negative mediastinal uptake on positron emission tomography.
  • OBJECTIVE: We sought to assess the incidence, pattern and predictors of occult mediastinal lymph node involvement (N2) in non-small cell lung cancer patients with negative mediastinal uptake of 2-deoxy-2-[(18)F]-fluoro-d-glucose ((18)FDG) on integrated positron emission tomography-computerised tomography (PET-CT).
  • All patients had preoperative PET-CT prior to lung resection as an adjunct to a dedicated chest CT.
  • Diabetic patients, patients who received neoadjuvant chemotherapy and those with positive mediastinal nodes on PET-CT (N2/N3) were excluded from this study.
  • The population of interest was 153 non-small cell cancer patients (NSCLC), all of which had no FDG uptake in the mediastinum.
  • RESULTS: The incidence of occult N2 disease in NSCLC patients with negative mediastinal uptake of (18)FDG on PET-CT was 16% (25 of 153).
  • The highest incidence of occult N2 involvement was in American thoracic society (ATS) 7 (16 of 25 patients, 64%) followed by ATS 4 (seven patients of 25, 28%).
  • In univariate analysis, the following were significant predictors of occult N2 disease: centrally located tumours (P=0.049), right upper lobe tumours (P=0.04), enlarged lymph nodes (>1cm) on CT (P=0.048) and PET positive uptake in N1 nodes (P=0.006).
  • In multivariate analysis, the following were independent predictors of occult N2 disease: centrally located tumours, right upper lobe tumours and PET positive uptake in N1 nodes (P<0.05).
  • CONCLUSIONS: In NSCLC patients who are clinically staged as N2/N3 negative in the mediastinum by integrated PET-CT, 16% will have occult N2 disease following resection.
  • Patients with the following: centrally located tumours, right upper lobe tumours and positive N1 nodes on PET should have preoperative cervical mediastinoscopy to rule out N2 nodal involvement, especially in ATS stations 7 and 4 as the incidence of occult nodal metastasis in these nodes is high.
  • This study has potential implications in decision-making and planning best treatment approach.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / radionuclide imaging. Lung Neoplasms / radionuclide imaging. Lymph Nodes / radionuclide imaging. Mediastinoscopy / methods
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Cohort Studies. Female. Humans. Male. Mediastinum. Middle Aged. Neoplasm Staging. Positron-Emission Tomography / methods. Predictive Value of Tests. Treatment Outcome

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  • (PMID = 17977738.001).
  • [ISSN] 1010-7940
  • [Journal-full-title] European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery
  • [ISO-abbreviation] Eur J Cardiothorac Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Germany
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12. Socinski MA: Adjuvant therapy of resected non-small-cell lung cancer. Clin Lung Cancer; 2004 Nov;6(3):162-9
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  • [Title] Adjuvant therapy of resected non-small-cell lung cancer.
  • Surgical resection of early-stage non-small-cell lung cancer (NSCLC) remains the standard of care in patients fit for surgery.
  • Adjuvant postoperative thoracic radiation therapy (RT) clearly has an impact in reducing locoregional recurrence but has no clear impact on survival.
  • The Postoperative RT (PORT) metaanalysis raised concerns about PORT, particularly in stage I/II NSCLC, suggesting it may negatively impact survival.
  • This was not a concern in stage III NSCLC, in which the risk of locoregional recurrence is higher.
  • However, distant recurrence remains the dominant pattern in resected NSCLC, suggesting that the majority of patients with early-stage resected NSCLC harbor occult micrometastatic disease.
  • Historically, the role of adjuvant chemotherapy has been controversial, and its routine use was not supported by the published data, which consisted of a small number of underpowered trials using inadequately delivered, antiquated chemotherapy.
  • Like adjuvant PORT, chemotherapy combined with RT has not improved survival over PORT alone.
  • The use of adjuvant cisplatin-based therapy did not show a survival advantage in the Adjuvant Lung Project Italy study but did in the International Adjuvant Lung Trial, creating controversy in the routine implementation of adjuvant therapy in all patients.
  • Recently completed randomized trials by the Cancer and Leukemia Group B and the National Cancer Institute of Canada provide convincing evidence of a substantial benefit from adjuvant therapy in well-staged and completely resected stage I/II NSCLC.
  • Currently, the totality of the data supports a discussion with patients with resected NSCLC regarding the potential benefits of adjuvant therapy.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Chemotherapy, Adjuvant. Humans. Pneumonectomy. Radiotherapy, Adjuvant. Survival Analysis

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  • (PMID = 15555217.001).
  • [ISSN] 1525-7304
  • [Journal-full-title] Clinical lung cancer
  • [ISO-abbreviation] Clin Lung Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 52
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13. Oshita F, Sekiyama A, Suzuki R, Ikehara M, Yamada K, Saito H, Noda K, Miyagi Y: Detection of occult tumor cells in peripheral blood from patients with small cell lung cancer by promoter methylation and silencing of the retinoic acid receptor-beta. Oncol Rep; 2003 Jan-Feb;10(1):105-8
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  • [Title] Detection of occult tumor cells in peripheral blood from patients with small cell lung cancer by promoter methylation and silencing of the retinoic acid receptor-beta.
  • In order to investigate the possibility of detecting occult tumor cells of small cell lung cancer (SCLC), we used the methylation-specific PCR assay to detect methylation of retinoic acid receptor-beta (RARbeta) in peripheral mononuclear cells (PMNC).
  • The methylation-specific PCR assay can detect one tumor cell per 10(3) normal cells.
  • They received an initial full-dose of combination chemotherapy for SCLC between October 1995 and June 2000.
  • PMNC were obtained before each patient underwent chemotherapy.
  • In conclusion, occult tumor cells can be detected in the peripheral blood of patients with SCLC using methylation of RARbeta, and long-term survival appears to be better in LD-SCLC patients with occult tumor cells in their blood.
  • [MeSH-major] Carcinoma, Small Cell / blood. DNA Methylation. Lung Neoplasms / blood. Neoplastic Cells, Circulating / pathology. Promoter Regions, Genetic. Receptors, Retinoic Acid / genetics
  • [MeSH-minor] Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. DNA Primers / chemistry. DNA, Neoplasm / analysis. Female. Gene Expression Regulation, Neoplastic. Humans. Male. Middle Aged. Polymerase Chain Reaction. Prognosis. Survival Rate. Tumor Cells, Cultured

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  • (PMID = 12469153.001).
  • [ISSN] 1021-335X
  • [Journal-full-title] Oncology reports
  • [ISO-abbreviation] Oncol. Rep.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Greece
  • [Chemical-registry-number] 0 / DNA Primers; 0 / DNA, Neoplasm; 0 / Receptors, Retinoic Acid; 0 / retinoic acid receptor beta
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14. Socinski MA, Rosenman JG: Chemotherapeutic issues in the management of unresectable stage III non-small cell lung cancer. Semin Oncol; 2005 Apr;32(2 Suppl 3):S18-24
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  • [Title] Chemotherapeutic issues in the management of unresectable stage III non-small cell lung cancer.
  • The standard of care in unresectable stage IIIA/B non-small cell lung cancer is combined-modality therapy using both chemotherapy and thoracic radiation therapy.
  • The concurrent approach used in the phase III trials evaluating the question of sequence has been the use of full-dose systemic chemotherapy rather than a low-dose radio-enhancing strategy.
  • A number of clinical trials have established the use of both induction and consolidation chemotherapy; however, the optimal approach remains unclear.
  • What is clear is that this population of patients needs aggressive therapy directed at achieving locoregional control as well as control of occult micrometastatic disease that is present in the majority of cases.
  • As treatment strategies have become more aggressive, survival outcomes have improved, although the differences have been modest at best, and the risk of severe toxicity has increased.
  • Future aggressive approaches must enhance both locoregional and distant control of occult disease, with acceptable rates of both acute and long-term toxicities.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / drug therapy. Lung Neoplasms / drug therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Clinical Trials as Topic. Combined Modality Therapy. Humans


15. Bessho A, Tabata M, Kiura K, Takata I, Nagata T, Fujimoto N, Kunisada K, Ueoka H, Harada M: Detection of occult tumor cells in peripheral blood from patients with small cell lung cancer by reverse transcriptase-polymerase chain reaction. Anticancer Res; 2000 Mar-Apr;20(2B):1149-54
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Detection of occult tumor cells in peripheral blood from patients with small cell lung cancer by reverse transcriptase-polymerase chain reaction.
  • In this study, we determined whether mRNA of bombesin receptors is detectable in PB or peripheral blood progenitor cell (PBPC) samples from patients with small cell lung cancer.
  • Among three bombesin-like peptide receptors, we used the neuromedin B receptor (NMB-R) gene as a target, because of the most frequent expression on SCLC cell lines.
  • The lower limit of detection was one tumor cell in one million normal PB cells and there was no detection in normal PB or BM cells unlike a cytokeratin 19 gene.
  • The NMB-R gene was detected in 14 (31.8%) of 44 PB samples from patients with SCLC at diagnosis and 2 (15.4%) of 13 samples of PBPC collected during a recovery phase after chemotherapy followed by administration of G-CSF (filgrastim).
  • [MeSH-major] Biomarkers, Tumor / analysis. Bone Marrow / pathology. Carcinoma, Small Cell / pathology. Lung Neoplasms / pathology. Receptors, Bombesin / analysis. Reverse Transcriptase Polymerase Chain Reaction / methods
  • [MeSH-minor] Aged. Female. Filgrastim. Granulocyte Colony-Stimulating Factor / therapeutic use. Humans. Male. Middle Aged. Neoplasm, Residual. Recombinant Proteins. Sensitivity and Specificity. Survival Analysis. Tumor Cells, Cultured

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  • (PMID = 10810412.001).
  • [ISSN] 0250-7005
  • [Journal-full-title] Anticancer research
  • [ISO-abbreviation] Anticancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] GREECE
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 0 / Receptors, Bombesin; 0 / Recombinant Proteins; 143011-72-7 / Granulocyte Colony-Stimulating Factor; PVI5M0M1GW / Filgrastim
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16. Blackstock AW, Govindan R: Definitive chemoradiation for the treatment of locally advanced non small-cell lung cancer. J Clin Oncol; 2007 Sep 10;25(26):4146-52
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Definitive chemoradiation for the treatment of locally advanced non small-cell lung cancer.
  • A third of patients with newly diagnosed non-small-cell lung cancer (NSCLC) have locally advanced disease not amenable for curative resection.
  • Addition of chemotherapy to thoracic radiation improves survival in patients with locally advanced NSCLC when compared with thoracic radiation alone.
  • Over the past two decades, we have made slow but steady progress in improving the outcomes of therapy in this subset of patients.
  • The widespread use of positron emission tomography (identifying those with occult distant metastatic disease and sparing them combined-modality therapy), improved radiation techniques, and better supportive care resulting in improved chemotherapy delivery have resulted in improved outcomes.
  • There is considerable interest in studying the role of higher doses of thoracic radiation (74 Gy) in this disease, and this is the subject of an ongoing intergroup study.
  • Despite some recent setbacks, molecularly targeted therapies need to be studied carefully in combination with chemoradiotherapy.
  • There is an urgent need to develop regimens that incorporate chemotherapy agents that can be administered at doses that are systemically active and yet tolerable.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Animals. Combined Modality Therapy. Humans

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  • (PMID = 17827465.001).
  • [ISSN] 1527-7755
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 38
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17. Hensing TA, Detterbeck F, Socinski MA: The role of induction therapy in the management of resectable non-small cell lung cancer. Cancer Control; 2000 Jan-Feb;7(1):45-55
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of induction therapy in the management of resectable non-small cell lung cancer.
  • BACKGROUND: Combined-modality therapy has become standard for many patients with non-small cell lung cancer.
  • Although surgical resection offers the best chance for long-term survival, the limited number of resectable patients and the presence of occult micrometastatic disease has limited the effectiveness of this modality alone.
  • METHODS: The authors reviewed several trials involving the use of induction chemotherapy in managing resectable non-small cell lung cancer.
  • Unfortunately, heterogeneous patient populations and treatment regimens limit the ability to draw firm conclusions from these trials alone.
  • While the phase III experience has been limited, long-term follow-up is now available suggesting that induction therapy may have a beneficial impact on survival, especially for those patients who can be sufficiently downstaged.
  • CONCLUSIONS: Results from ongoing randomized trials studying the impact of induction therapy on well-defined patient populations will be necessary before the optimal regimen and patient population can be identified.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Non-Small-Cell Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / surgery. Lung Neoplasms / drug therapy. Lung Neoplasms / surgery
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Male. Neoplasm Staging. Prognosis. Randomized Controlled Trials as Topic. Remission Induction. Survival Rate. Treatment Outcome

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  • [CommentIn] Cancer Control. 2000 Jan-Feb;7(1):13-4 [10777341.001]
  • (PMID = 10740660.001).
  • [ISSN] 1073-2748
  • [Journal-full-title] Cancer control : journal of the Moffitt Cancer Center
  • [ISO-abbreviation] Cancer Control
  • [Language] eng
  • [Grant] United States / NHLBI NIH HHS / HL / HL07149-22
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.; Review
  • [Publication-country] UNITED STATES
  • [Number-of-references] 53
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18. Robinson LA, Ruckdeschel JC, Wagner H Jr, Stevens CW, American College of Chest Physicians: Treatment of non-small cell lung cancer-stage IIIA: ACCP evidence-based clinical practice guidelines (2nd edition). Chest; 2007 Sep;132(3 Suppl):243S-265S
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Treatment of non-small cell lung cancer-stage IIIA: ACCP evidence-based clinical practice guidelines (2nd edition).
  • STUDY OBJECTIVES: Stage IIIA non-small cell lung cancer represents a relatively heterogeneous group of patients with metastatic disease to the ipsilateral mediastinal (N2) lymph nodes and also includes T3N1 patients.
  • Presentations of disease range from apparently resectable tumors with occult microscopic nodal metastases to unresectable, bulky multistation nodal disease.
  • This review explores the published clinical trials to make treatment recommendations in this controversial subset of lung cancer.
  • MEASUREMENT AND RESULTS: The evidence derived from the literature now appears to support routine adjuvant chemotherapy after complete resection of stage IIIA lung cancer encountered unexpectedly at surgery.
  • However, using neoadjuvant therapy followed by surgery for known stage IIIA lung cancer as a routine therapeutic option is not supported by current published randomized trials.
  • Combination chemoradiotherapy, especially delivered concurrently, is still the preferred treatment for prospectively recognized stage IIIA lung cancer with all degrees of mediastinal lymph node involvement.
  • CONCLUSIONS: Multimodality therapy of some type appears to be preferable in all subsets of stage IIIA patients.
  • However, because of the relative lack of consistent randomized trial data in this subset, the following evidence-based treatment guidelines lack compelling evidence in most scenarios.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Controlled Clinical Trials as Topic. Humans. Lymphatic Metastasis. Neoadjuvant Therapy. Neoplasm Staging. Radiotherapy, Adjuvant. Treatment Outcome


19. Sun LM, Leung SW, Wang CJ, Chen HC, Fang FM, Huang EY, Hsu HC, Yeh SA, Hsiung CY, Huang DT: Concomitant boost radiation therapy for inoperable non-small-cell lung cancer: preliminary report of a prospective randomized study. Int J Radiat Oncol Biol Phys; 2000 May 1;47(2):413-8
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  • [Title] Concomitant boost radiation therapy for inoperable non-small-cell lung cancer: preliminary report of a prospective randomized study.
  • PURPOSE: The radiation therapy results for patients with inoperable non-small-cell lung cancer (NSCLC) have been disappointing.
  • This trial was carried out to prospectively assess the radiation response and acute toxicity of CBT in comparison to the conventional treatment technique (CTT).
  • Patients were randomized to receive either CBT (43 patients) or CTT (54 patients) radiation therapy.
  • These patients either refused chemotherapy or were judged as unsuitable for chemotherapy.
  • Patients in the CBT group received 46.8 Gy in 26 fractions using large fields that encompassed the gross and occult disease.
  • A concomitant boost of 18.2 Gy (0.7 Gy per fraction) was delivered to the gross disease using small fields with 1.5-cm margins.
  • The small fields were treated concurrently with the large fields and the total dose to the tumor area was 65 Gy in 26 fractions.
  • Patients in the CTT group received 70.8 Gy in 38 fractions.
  • The response rate was analyzed and compared by treatment group, gender, age, stage, histology, initial Karnofsky performance score (KPS), severity of acute toxicity, and maximum body weight loss (MBWL) during treatment course.
  • RESULTS: The demographic parameters such as sex, age, and stage were evenly distributed in each treatment group.
  • Overall median treatment times were 39 days for the CBT group of patients and 62 days for the CTT group.
  • No treatment-related mortality was found.
  • There were 2 patients in the CTT group with acute RTOG Grade 3 lung toxicity, and no Grade 3 lung or esophageal toxicity was observed in CBT group.
  • CONCLUSION: This study demonstrates that concomitant boost radiation therapy is tolerable, and produces a superior response rate than conventional radiation therapy for patients with inoperable NSCLC.
  • The length of treatment was reduced from 38 to 26 treatment days, almost a 30% reduction.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / radiotherapy. Lung Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Analysis of Variance. Carcinoma, Squamous Cell / pathology. Carcinoma, Squamous Cell / radiotherapy. Female. Follow-Up Studies. Humans. Linear Models. Male. Middle Aged. Prospective Studies. Relative Biological Effectiveness. Weight Loss

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  • (PMID = 10802368.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial
  • [Publication-country] UNITED STATES
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20. Rocco G: Results of cutting-edge surgery in stage IIIA-N2 nonsmall cell lung cancer. Curr Opin Oncol; 2009 Mar;21(2):105-9
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  • [Title] Results of cutting-edge surgery in stage IIIA-N2 nonsmall cell lung cancer.
  • PURPOSE OF REVIEW: To describe the state-of-the-art of the surgical management of stage IIIA-N2 nonsmall cell lung cancer.
  • RECENT FINDINGS: When completely resected, occult N2 found at thoracotomy, skip metastases, and single-level N2 in selected locations are reported to portend acceptable survival rates.
  • Conversely, preoperatively proven ipsilateral mediastinal nodal involvement requires a multidisciplinary approach on the basis of neoadjuvant chemotherapy or chemoradiation.
  • The impact of postoperative morbidity after induction treatment is still being evaluated.
  • In this setting, differences in treatment sequence and combination (chemotherapy alone or chemoradiation) may influence postsurgical outcome.
  • Patients' selection revolves around the modern concepts of oncologic operability and surgical resectability intended as assessment of survival benefit and ability to completely resect all residual tumor after neoadjuvant therapy.
  • [MeSH-major] Carcinoma, Non-Small-Cell Lung / therapy. Lung Neoplasms / therapy. Pulmonary Surgical Procedures
  • [MeSH-minor] Humans. Neoadjuvant Therapy. Neoplasm Staging. Postoperative Complications / therapy. Treatment Outcome

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  • (PMID = 19532010.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 41
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21. Lee P, de Bree R, Brokx HA, Leemans CR, Postmus PE, Sutedja TG: Primary lung cancer after treatment of head and neck cancer without lymph node metastasis: is there a role for autofluorescence bronchoscopy? Lung Cancer; 2008 Dec;62(3):309-15
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  • [Title] Primary lung cancer after treatment of head and neck cancer without lymph node metastasis: is there a role for autofluorescence bronchoscopy?
  • BACKGROUND: Head and neck cancer (HNC) is the 5th most common cancer worldwide.
  • As good locoregional tumor control can be achieved with current treatment strategies, patients who develop second primary tumors from field cancerization have poorer prognosis.
  • OBJECTIVES: To determine if autofluorescence bronchoscopy (AF) played a role in the detection of second primary lung cancer (SPLC), and impact of SPLC on survival of patients with HNC and no cervical lymph node metastasis (N0).
  • METHODS: Patients with HNC(N0) referred for symptoms and/or radiology suspicious for lung cancer were assessed with AF.
  • Data on patient demographics, smoking, cancer characteristics, and outcome were prospectively collected.
  • Median age was 70 years, all were current or former smokers of 35 pack years, and 25 had chronic obstructive lung disease.
  • Forty-two SPLC were found; 12 (29%) affected the tracheobronchial tree and 30 (71%) involved the lung parenchyma.
  • Median time to metachronous SPLC was 22 months.
  • Five radiographically occult lung cancers detected by AF were successfully treated with endobronchial therapy.
  • Lung cancer mortality was 24%.
  • HNC patients who developed synchronous and metachronous SPLCs had significantly shorter survival (51 and 144 months) compared to those without (240 months) (p=0.0005).
  • Close surveillance with AF and CT for SPLC combined with aggressive treatment of early stage lung cancer might be a strategy to improve outcome.
  • [MeSH-major] Bronchoscopy. Carcinoma, Non-Small-Cell Lung / diagnosis. Head and Neck Neoplasms / pathology. Neoplasms, Second Primary / diagnosis
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenocarcinoma / drug therapy. Adenocarcinoma, Bronchiolo-Alveolar / diagnosis. Adenocarcinoma, Bronchiolo-Alveolar / drug therapy. Adult. Aged. Carcinoma, Large Cell / diagnosis. Carcinoma, Large Cell / drug therapy. Female. Fluorescence. Humans. Lung Neoplasms / diagnosis. Lung Neoplasms / drug therapy. Lymphatic Metastasis. Male. Middle Aged. Prognosis. Prospective Studies. Small Cell Lung Carcinoma / diagnosis. Small Cell Lung Carcinoma / drug therapy. Smoking. Survival Rate. Treatment Outcome

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  • [CommentIn] Lung Cancer. 2009 Aug;65(2):255 [19410330.001]
  • (PMID = 18486989.001).
  • [ISSN] 0169-5002
  • [Journal-full-title] Lung cancer (Amsterdam, Netherlands)
  • [ISO-abbreviation] Lung Cancer
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Ireland
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22. Stummvoll GH, Aringer M, Machold KP, Smolen JS, Raderer M: Cancer polyarthritis resembling rheumatoid arthritis as a first sign of hidden neoplasms. Report of two cases and review of the literature. Scand J Rheumatol; 2001;30(1):40-4
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  • [Title] Cancer polyarthritis resembling rheumatoid arthritis as a first sign of hidden neoplasms. Report of two cases and review of the literature.
  • Recent onset arthritis reminiscent of rheumatoid arthritis (RA) may be an early manifestation of an occult malignancy.
  • In this report, we present two patients with cancer-associated polyarthritis.
  • Both suffered from symmetric polyarthritis when initially visiting their physicians and did not achieve relief when treated with non-steroidal anti-rheumatic drugs (NSAIDs).
  • One patient suffered from small cell lung cancer (SCLC), while the other was diagnosed with adenocarcinoma of the colon.
  • In both, the arthritis spontaneously disappeared after successful treatment of the malignancy, i.e. chemotherapy and tumor resection, respectively.
  • We discuss these cases in view of the existing literature, since awareness of the entity of cancer polyarthritis is necessary for its timely treatment and may potentially be life-saving.
  • [MeSH-minor] Adenocarcinoma / pathology. Aged. Carcinoma, Small Cell / pathology. Colonic Neoplasms / pathology. Diagnosis, Differential. Humans. Lung Neoplasms / pathology. Male. Middle Aged. Neoplasms, Unknown Primary


23. Griset AP, Walpole J, Liu R, Gaffey A, Colson YL, Grinstaff MW: Expansile nanoparticles: synthesis, characterization, and in vivo efficacy of an acid-responsive polymeric drug delivery system. J Am Chem Soc; 2009 Feb 25;131(7):2469-71
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  • [Title] Expansile nanoparticles: synthesis, characterization, and in vivo efficacy of an acid-responsive polymeric drug delivery system.
  • Nanoparticles are finding increased uses in drug delivery applications as a means to increase treatment efficacy and improve patient care.
  • As our clinical interest lies in the prevention of lung tumor recurrence following resection, the nanoparticles were evaluated in a model mimicking microscopic disease, akin to residual occult tumor that can remain at the resection margin following surgery.
  • Expansile nanoparticles loaded with paclitaxel, a poorly water-soluble anticancer drug, prevent establishment of lung cancer in vivo and are superior to the conventional drug delivery method for paclitaxel using Cremophor EL/ethanol.
  • [MeSH-major] Drug Delivery Systems / methods. Nanoparticles / chemistry. Polymers / chemistry
  • [MeSH-minor] Animals. Carcinoma, Lewis Lung / drug therapy. Carcinoma, Non-Small-Cell Lung / drug therapy. Cell Line, Tumor. Drug Screening Assays, Antitumor. Hydrogen-Ion Concentration. Hydrophobic and Hydrophilic Interactions. Lung Neoplasms / drug therapy. Mice. Paclitaxel / administration & dosage. Paclitaxel / chemistry

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  • (PMID = 19182897.001).
  • [ISSN] 1520-5126
  • [Journal-full-title] Journal of the American Chemical Society
  • [ISO-abbreviation] J. Am. Chem. Soc.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Polymers; P88XT4IS4D / Paclitaxel
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24. Terzolo M, Reimondo G, Alì A, Bovio S, Daffara F, Paccotti P, Angeli A: Ectopic ACTH syndrome: molecular bases and clinical heterogeneity. Ann Oncol; 2001;12 Suppl 2:S83-7
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  • There are roughly two types of ectopic ACTH syndrome (EAS).
  • one associated with overt malignancies and one with occult neoplasms.
  • The prototype of the first condition is Cushing's syndrome sustained by small-cell lung cancer (SCLC), while bronchial carcinoid tumors are the most common occult sources of ACTH.
  • These patients have a poor prognosis because SCLC associated with the EAS is more resistant to chemotherapy and the severe hypercortisolism is responsible for a high rate of life-threatening complications during treatment.
  • However, the differentiation between the pituitary, or eutopic, from the non-pituitary, or ectopic, source of ACTH secretion may be extremely difficult in some cases despite the wide diagnostic armamentarium available.

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  • (PMID = 11762358.001).
  • [ISSN] 0923-7534
  • [Journal-full-title] Annals of oncology : official journal of the European Society for Medical Oncology
  • [ISO-abbreviation] Ann. Oncol.
  • [Language] ENG
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 66796-54-1 / Pro-Opiomelanocortin
  • [Number-of-references] 25
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25. Béhé M, Behr TM: Cholecystokinin-B (CCK-B)/gastrin receptor targeting peptides for staging and therapy of medullary thyroid cancer and other CCK-B receptor expressing malignancies. Biopolymers; 2002;66(6):399-418
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cholecystokinin-B (CCK-B)/gastrin receptor targeting peptides for staging and therapy of medullary thyroid cancer and other CCK-B receptor expressing malignancies.
  • Nuclear medicine is engaged with the detection of pathological processes with the help of radionuclides.
  • An interesting approach is to target antigens, symporters, or receptors with diagnostic and therapeutic radionuclides.
  • Different peptide receptors like somatostatin, bombesin/GRP or VIP are (over)expressed on cancer cells, and are therefore an ideal target for the diagnosis and therapy in nuclear medicine with radiolabeled peptides.
  • The staging of metastatic medullary thyroid cancer (MTC) with the conventional radiological procedures is sometimes difficult.
  • This reaction of the tumor cells to the pentagastrin stimulation test suggests a widespread expression of the corresponding receptor type on human MTC.
  • Indeed, autoradiographic studies demonstrated cholecystokinin (CCK)-B/gastrin receptors not only in over 90% of MTCs, but in a high percentage of small cell lung cancers, stromal ovarian, and potentially a variety of other tumors, including gastrointestinal adenocarcinomas, neuroendocrine tumors, and malignant glioma.
  • The aim of our recent work was to develop and systematically optimize suitable radioligands for targeting CCK-B receptors in vivo and to investigate their role in the staging and therapy of MTC and other CCK-B receptor expressing malignancies.
  • Their stability and affinity were studied and optimized in vitro and in vivo; their biodistribution and therapeutic efficacy were tested in preclinical models.
  • Radiometal-labeled derivatives of minigastrin showed excellent targeting of CCK-B receptor expressing tissues in animals and healthy human volunteers.
  • Preclinical therapy experiments in MTC-bearing animals showed significant antitumor efficacy.
  • In a subsequent clinical study, 75 MTC patients with metastatic MTC were investigated; 43 suffered of known, 32 of occult disease.
  • The normal organ uptake was essentially confined to the stomach (and to a lower extent, to the gallbladder and, in premenopausal women, to normal breast tissue) as a result of CCK-B receptor specific binding, and to the kidneys as excretory organs.
  • All tumor manifestations known from conventional imaging were visualized as early as 1 h p.i., with increasing tumor-to-background ratios over time; at least one lesion was detected in 29/32 patients with occult disease (patient-based sensitivity 91%).
  • Eight patients with advanced metastatic disease were injected in a dose-escalation study with potentially therapeutic activities of a (90)Y-labeled minigastrin derivative at 4-6-weekly intervals (30-50 mCi/m(2) per injection for a maximum of four injections).
  • These data suggest that CCK-B receptor ligands may be a useful new class of receptor binding peptides for diagnosis and therapy of a variety of (CCK-B receptor expressing) tumor types.
  • Initial therapeutic results are promising, but nephrotoxicity is a major concern to be solved.
  • [MeSH-major] Peptides / metabolism. Peptides / therapeutic use. Radiopharmaceuticals. Receptors, Cholecystokinin / metabolism. Thyroid Neoplasms / classification. Thyroid Neoplasms / drug therapy

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  • [Copyright] Copyright 2003 Wiley Periodicals, Inc.
  • (PMID = 12658727.001).
  • [ISSN] 0006-3525
  • [Journal-full-title] Biopolymers
  • [ISO-abbreviation] Biopolymers
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Gastrins; 0 / Ligands; 0 / Peptides; 0 / Radiopharmaceuticals; 0 / Receptor, Cholecystokinin B; 0 / Receptors, Cholecystokinin; 0 / Receptors, Somatostatin; 60748-07-4 / minigastrin; 7A314HQM0I / Pentetic Acid
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