Naikang Zhou

Survival benefit of neoadjuvant chemotherapy in non-small cell lung cancer: an updated meta-analysis of 13 randomized control trials

Introduction: The survival effectiveness of neoadjuvant chemotherapy in non-small cell lung cancer (NSCLC) is still unclear based on the study of most up-to-date literatures. This article contributes to this problem by conducting an updated meta-analysis. Methods: Based on Burdett et als (J Thorac Oncol 2006;1:611–621) systematic review, this meta-analysis was conducted. Articles were searched electrically. The possible survival benefit of neoadjuvant chemotherapy was assessed by hazard ratio (HR) in terms of overall survival. A subgroup meta-analysis with only stage III NSCLC was also conducted. The software of Review Manager was used for data management. Results: Thirteen randomized control trials, 6 of which were new ones, were included into this meta-analysis. The overall survival of NSCLC patients in neoadjuvant chemotherapy arm were improved significantly, comparing with those in surgery-alone arm (combined HR = 0.84; 95% confidence interval, 0.77–0.92; p = 0.0001). When only patients with stage III NSCLC were considered, the result was similar (combined HR = 0.84; 95% confidence interval, 0.75–0.95; p = 0.005). Conclusion: Neoadjuvant chemotherapy, as an addition of surgery, would significantly improve the overall survival of operable NSCLC patients, including patients with stage III NSCLC.

Lung cancer presenting as thin-walled cysts: An analysis of 15 cases and review of literature.

Lung cancer presenting as cysts is a rare entity in clinical practice. Differential diagnosis is difficult in the benign‐like cyst.

The use of multislice spiral CT to predict the resectability of central lung cancer: Correlation with pathologic and surgical findings

ObjectiveTo assess the accuracy of multi-slice spiral CT (MSCT) with imaging reconstruction in judging central pulmonary vascular involvement from central lung cancer, and to explore its ability to predict the resectability of lung cancer.MethodsMSCTs were conducted on 48 patients who were diagnosed preoperatively with central lung cancer. Images of pulmonary arteries and veins that might affect lobectomy or pneumonectomy were reconstructed by means of imaging processing techniques. Then the relationship of the tumor to the vessels was assessed prospectively on both axial CT images and axial CT images plus reconstructed images(CT-RI) in comparison to subsequent pathologic and surgical findings.ResultsMSCTs were obtained on all 48 patients whom 42 underwent thoracotomy, lobectomy or pneumonectomy. Compared with the axial CT images, CT -Rl was more accurate in judging the relationship of the central pulmonary vessels to the tumor based on subsequent pathologic 78 vessels studied and surgical findings (186 vessels studied) (0.01 <P<0.05). The sensitivity and positive predictive value of unresectability of the vessels were all remarkably higher with CT-RI (P<0.01 ).ConclusionMSCT with imaging reconstruction can improve the recognition of neoplastic invasion of central pulmonary vessels. It can be used to predict preoperatively the resectability of central lung cancer and to plan surgery.

[Treatment of central-type lung cancer with intrapericardial pneumonectomy].

BACKGROUND To summarize the clinical results of intrapericardial ligation of pulmonary vessels in the treatment of central-type lung cancer. METHODS Retrospective study was employed in this study. RESULTS From 1978 to 1997, 91 patients with central-type lung cancer underwent pneumonectomy by dealing with major pulmonary vessels inside the pericardium. The 1-, 3-, 5-year surival rates were 79. 0%, 37. 3%, 23. 8% respectively. Indications, operative techniques, complications and prognostic factors were discussed in this paper. CONCLUSIONS Pneumonectomy with intrapericardial management of the pulmonary vessels is a safe and reliable procedure, which increases resection rate of lung cancer and improves the survival of patients with lung cancer . The prognostic factors for this technique are TNM staging , pathological types, resection site, postoperative radiotherapy and chemotherapy.

[Spectroscopic differentiation between normal bronchial and lung cancer tissues by laser-induced fluorescence (LIF) with intravenous injection of hematoporphyrin monomethyl ether (HMME)].

BACKGROUND To study the feasibility of laser-induced fluorescence ( LIF) spectroscopy with intravenous injection of a new agent, hematoporphyrin monomethyl ether (HMME) , in the diagnosis of lung cancer. METHODS Fifteen patients with lung cancer were administrated HMME 2. 5 mg/ kg intravenously three hours before lobectomy. Surgical specimens were collected for examination of LIF spectrum. TheLIF spectra of normal bronchial and lung cancer tissues were measured with a detecting system which consists of an YAG laser ( wavelength 355 nm) and an optical multichannel analyzer ( OMA) . The patholog ical examination was performed in each specimen. RESULTS The fluorescence intensity of the lung cancer tissues ( 31 446±5 017) was much lower than that of the normal bronchial tissues ( 75 430±8 908) ( P < 0. 001) . There was a flat spectrum in the normal bronchial tissues at the wavelength from 580 to 600 nm ( I580nm / I600nm = 1. 081 ±0. 090) , but the cancer tissue spectrum showed a smoothly descending profile ( I580nm/ I600nm = 1. 260±0. 157) . A remarkable characteristic peak ( drug peak) located at the 623. 4 nm±1. 6 nm in the lung cancer spectrum. Using the criterion of I580nm/ I600nm , the sensitivity, specificity, and accuracy of the diagnosis for lung cancer were 80. 0%, 73. 9%, and 76. 7%, respectively , and were 95. 0%, 91. 3% and 93. 0% respectively according to the criterion of the slope of the drug peak. CONCLUSIONS The LIF spectroscopy following intravenous injection of the new photosensitiser HMME can differentiate lung cancer from normal bronchus and can increase the sensitivity, specificity and the accuracy comparing to the laser-induced auto fluorescence in the diagnosis of lung cancer.