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The relationship between tyrosine kinase inhibitor therapy and overall survival in patients with non-small cell lung cancer carrying EGFR mutations

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Chinese Journal of Cancer 2013年第3期32卷 136-140页

作者： Hidekazu Suzuki Tomonori Hirashima Norio Okamoto Tadahiro Yamadori Motohiro Tamiya Naoko Morishita Takayuki Shiroyama Tomoyuki Otsuka Kanako Kitai Ichiro Kawase Department of thoracic malignancy Osaka Prefectural Medical Center for Respiratory and Allergic Diseases 3-7-1 Habikino Habikino-shiOsaka 583-8588 Japan.

For patients with epidermal growth factor receptor (EGFR) mutation-positive lung cancer, the relationship between the dose or duration of treatment with tyrosine kinase inhibitor (TKI) and overall survival remains unclear. Here, we analyzed clinical data of 39 patients who were diagnosed with EGFR mutation-positive non-small cell lung cancer and treated with TKI, but subsequently died. Several parameters were measured in this study: overall survival; first, second, and overall TKI therapy durations; first TKI intensity (actual dose/normal dose); and TKI rate (overall TKI therapy duration/overall survival). The response rate to TKI therapy was 50% , and the median survival was 553 days. After TKI therapy failed, 38.5% patients were re-challenged with TKI. We observed a moderate relationship [r = 0.534, 95% confidential interval (CI) = 0.263 to 0.727, P < 0.001] between overall TKI therapy duration and overall survival. However, we found no relationship between overall survival and first TKI intensity (r = 0.073, 95% CI = -0.380 to 0.247, P = 0.657) or TKI rate (r = 0.0345, 95% CI = -0.284 to 0.346, P = 0.835). Nonsmall cell lung cancer patients with mutation-positive tumors remained on TKI therapy for, on average, 33% of the overall survival time. These findings suggest that patients with EGFR mutation-positive tumors should not stick to using TKIs.

关键词：酪氨酸激酶抑制剂非小细胞肺癌治疗剂量肿瘤患者 EGFR 生存期突变表皮生长因子受体

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Clinical Course of Lung Cancer Patients with Subcutaneously Implanted Central Venous Access Device Ports from the Time of Receiving Chemotherapy to the Endpoint of Cancer

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Journal of Cancer Therapy 2016年第7期7卷 519-529页

作者： Tomonori Hirashima Teppei Tsumori Kenichi Sakai Makoto Fujishima Yukie Yamakawa Noriko Ryouta Masumi Sandoh Takayuki Shiroyama Motohiro Tamiya Naoko Morishita Hidekazu Suzuki Norio Okamoto Sho Goya Hironori Shigeoka departments of thoracic malignancy osaka prefectural medical center for respiratory and allergic diseases Osaka Japan departments of Palliative Medicine osaka prefectural medical center for respiratory and allergic diseases Osaka Japan Tsumori Clinic Osaka Japan departments of Gastroenterological and Breast Surgery osaka prefectural medical center for respiratory and allergic diseases Osaka Japan departments of Nursing osaka prefectural medical center for respiratory and allergic diseases Osaka Japan departments of Pharmacy osaka prefectural medical center for respiratory and allergic diseases Osaka Japan

Background: As the prognosis of lung cancer (LC) patients improves, subcutaneously implanted central venous access device ports (CV-ports) have frequently been used for continuing chemotherapy (CC) or palliative care (PC). In this study, we examined the clinical course of LC patients with subcutaneously implanted CV-ports from the time of receiving chemotherapy to the endpoint of cancer. Materials and Methods: We retrospectively reviewed the clinical data and treatment history of LC patients with subcutaneously implanted CV-ports between June 2008 and November 2013 using clinical records and a pharmacy database. Results: Of the 132 LC patients with subcutaneously implanted CV-ports, 79 (59.8%) had CV-ports for CC (the CC group) and 53 (40.2%) had CV-ports for PC (the PC group). After CV-port implantation, LC patients in the CC group received a median of two regimens with a median of 6 cycles. The median survival time of patients in the CC and PC groups was 457 and 44 days, respectively. In the CC group, the median survival time of small cell and non-small cell LC patients was 342 (95% confidence interval, 235 - 627) and 563 (95% confidence interval, 368 - 728) days, respectively. Nine patients (6.8%) had their CV-ports removed due to complications. Forty (30.3%) of the 132 enrolled patients were referred for at-home PC. The at-home death rate observed among these 40 patients was 30.0% (N = 12). Conclusion: CV-ports may contribute to seamless oncological care.

关键词： Clinical Course At-Home Death Rate Implanted Central Venous Access Device Port Lung Cancer Seamless Oncological Care

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