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Thành phố Bạc Liêu, Vietnam

Shi Y.,Peking Union Medical College | Au J.S.-K.,Queen Elizabeth Hospital | Thongprasert S.,Chiang Mai University | Srinivasan S.,Apollo Speciality Hospital | And 6 more authors.
Journal of Thoracic Oncology | Year: 2014

INTRODUCTION:: PIONEER (NCT01185314) was a prospective, multinational, epidemiological study of epidermal growth factor receptor (EGFR) mutations in patients from Asia with newly diagnosed advanced lung adenocarcinoma. METHODS:: Eligible patients (aged ≥20 years) had untreated stage IIIB/IV adenocarcinoma. The EGFR mutation status (primary end point: positive, negative, or undetermined) of tumor samples (biopsy, surgical specimen, or cytology) was determined (Scorpion amplification refractory mutation system). EGFR mutation frequency was calculated and compared between demographic and clinical subgroups. RESULTS:: Of 1482 patients from seven Asian regions, 43.4% of patients were female, median age was 60 years (range, 17-94), and 52.6% of patients were never-smokers. EGFR mutation status was evaluable in tumors from 1450 patients (97.8%) (746 [51.4%] positive; 704 [48.6%] negative). Country, sex, ethnicity, smoking status, pack-years (all p < 0.001), disease stage (p = 0.009), and histology type (p = 0.016) correlated significantly with EGFR mutation frequency. Mutation frequency was 61.1% in females, 44.0% in males; lower in patients from India (22.2%) compared with other areas (47.2%-64.2%); highest among never-smokers (60.7%); and decreased as pack-year number increased (>0-10 pack-years, 57.9%; >50 pack-years, 31.4%) (similar trend by sex). Ethnic group (p < 0.001) and pack-years (p < 0.001) had statistically significant associations with mutation frequency (multivariate analysis); sex was not significant when adjusted for smoking status. CONCLUSION:: PIONEER is the first prospective study to confirm high EGFR mutation frequency (51.4% overall) in tumors from Asian patients with adenocarcinoma. The observed high mutation frequency in demographic/clinical subgroups compared with white populations suggests that mutation testing should be considered for all patients with stage IIIB/IV adenocarcinoma, even males and regular smokers, among Asian populations. © 2013 by the International Association for the Study of Lung Cancer. Source


Rades D.,University of Lubeck | Huttenlocher S.,University of Lubeck | Gebauer N.,University of Lubeck | Hornung D.,University of Hamburg | And 3 more authors.
Anticancer Research | Year: 2015

Aim: Renal cell carcinoma (RCC) is a relatively radioresistant tumor and may require for higher radiation doses than other tumor types. Patients and Methods: Nineteen patients treated with 20 Gy of stereotactic radiosurgery (SRS) alone for one to three cerebral metastases were compared to nine patients treated with 16-18 Gy. Results: SRS with 20 Gy led to significantly better local control than did 16-18 Gy (81% vs. 50% at 12 months; p<0.001). Results were also significant on multivariate analysis (risk ratio: 6.30; p=0.033). SRS dose did not associate with freedom from new cerebral metastases (75% vs. 62% at 12 months; p=0.42) or survival (16% vs. 56% at 12 months; p=0.46). On multivariate analyses, better survival was associated with higher Karnofsky performance score (p<0.001) and absence of extracranial metastatic disease (p=0.006). Conclusion: In patients treated with SRS alone, local control of cerebral metastases from RCC was better after 20 Gy than after 16-18 Gy. © 2015, International Institute of Anticancer Research. All rights reserved. Source


Rades D.,University of Lubeck | Huttenlocher S.,University of Lubeck | Rudat V.,Saad Specialist Hospital | Hornung D.,University of Hamburg | And 5 more authors.
Anticancer Research | Year: 2015

Patients and Methods: Patients receiving 20 Gy (n=20) were compared to those receiving 16-18.5 Gy (n=10) for local control, distant brain control and overall survival. Seven other variables were also evaluated.Aim: To determine the optimal dose of radiosurgery-alone for patients with 1-3 cerebral metastases from breast cancer.Results: Radiosurgery dose achieved significance on univariate (p=0.002; log-rank and Wilcoxon test) and multivariate analysis (p=0.004) of local control. Twelve-month local control rates were 94% after 20 Gy and 48% after 16-18.5 Gy. On univariate analysis of distant brain control, radiosurgery dose was not a significant factor, with 12-month rates of 73% and 60%, respectively. Regarding overall survival, radiosurgery dose was of borderline significance (p=0.059; Wilcoxon test). Twelve-month overall survival rates were 75% and 40%, respectively. On Cox regression analysis, radiosurgery dose exhibited a trend for improving survival (p=0.10).Conclusion: Radiosurgery with 20 Gy resulted in significantly better local control and led to a trend towards improved overall survival compared to treatment with 16-18.5 Gy. Source


Rades D.,University of Lubeck | Gerdan L.,University of Lubeck | Segedin B.,Institute of Oncology | Nagy V.,Oncology and Radiotherapy Institute | And 2 more authors.
Strahlentherapie und Onkologie | Year: 2013

Background and purpose: This study was performed to evaluate the prognostic role for survival of the number and the type of involved extracranial organs in patients with brain metastasis. Material and methods: The data of 1146 patients who received whole-brain radiotherapy (WBRT) alone for brain metastasis have been retrospectively analyzed. In addition to the number of involved extra cranial organs, seven potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), primary tumor type, number of brain metastases, and the interval from cancer diagnosis to WBRT. Additionally, subgroup analyses were performed for patients with involvement of one (lung vs. bone vs. liver vs. other metastasis) and two (lung + lymph nodes vs. lung + bone vs. lung + liver vs. liver + bone vs. other combinations) extracranial organs. Results: The 6-month survival rates for the involvement of 0, 1, 2, 3, and ≥ 4 extracranial organs were 51, 30, 16, 13, and 10 %, respectively (p < 0.001). On multivariate analysis, the number of involved extracranial organs maintained significance (risk ratio 1.26; 95 % confidence interval 1.18-1.34; p < 0.001). According to the multivariate analysis, age (p < 0.001), gender (p = 0.002), and KPS (p < 0.001) were also independent prognostic factors for survival. In the subgroup analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the extracranial organ involved. Conclusion: The number of involved extracranial organs proved to be an independent prognostic factor in patients with brain metastasis, regardless of the organs involved. The number of involved extracranial organs should be considered in future trials designed for patients with brain metastasis. © 2013 Springer Heidelberg Berlin. Source


Gerdan L.,University of Lubeck | Segedin B.,Institute of Oncology | Nagy V.,Oncology and Radiotherapy Institute | Khoa M.T.,Hanoi Medical University | And 3 more authors.
Strahlentherapie und Onkologie | Year: 2014

Background and purpose: This study investigated the potential prognostic value of the number of involved extracranial organs in patients with brain metastasis from non-small cell lung cancer (NSCLC). Material and methods: A total of 472 patients who received whole-brain radiotherapy (WBRT) alone with 5 × 4 Gy or 10 × 3 Gy for brain metastasis from NSCLC were included in this retrospective study. In addition to the number of involved extracranial organs, 6 further potential prognostic factors were investigated including WBRT regimen, age, gender, Karnofsky Performance Score (KPS), number of brain metastases, and the interval from cancer diagnosis to WBRT. Subgroup analyses were performed for patients with metastatic involvement of one (lung vs. bone vs. other metastasis) and two (lung + bone vs. lung + lymph nodes vs. other combinations) extracranial organs. Results: The survival rates at 6 months of the patients with involvement of 0, 1, 2, 3, and ≥ 4 extracranial organs were 52, 27, 17, 4, and 14 %, respectively (p < 0.001). On multivariate analysis, the number of involved extracranial organs remained significant (risk ratio 1.32; 95 % confidence interval 1.19-1.46; p < 0.001). Age < 65 years (p = 0.004), KPS ≥ 70 (p < 0.001), and only 1-3 brain metastases (p = 0.022) were also significantly associated with survival in the multivariate analysis. In the separate analyses of patients with involvement of one and two extracranial organs, survival was not significantly different based on the pattern of extracranial organ involvement. Conclusion: The number of involved extracranial organs is an independent prognostic factor of survival in patients with brain metastasis from NSCLC, irrespective of the pattern of extracranial organ involvement. © 2013 Springer Heidelberg Berlin. Source

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