Oncologists nowadays are faced with big amount of heterogeneous medical data of diagnostic studies. Possible errors in determining the nature and extent of spread the tumor process will inevitably reduce the effectiveness of treatment and increase the unnecessary costs to it. To reduce the burden on clinicians, various computer-aided solutions based on machine learning algorithms are being developed. We made an attempt to evaluate effectiveness of thirteen machine learning algorithms in the tasks of classification of pathologic tissue samples in cancerous thorax based on gene expression levels. For a preliminary study we used open data set of molecular genetics composition of lung adenocarcinoma and pleural mesothelioma. Effectiveness of machine learning algorithms was evaluated by Matthews correlation coefficient and Area Under ROC Curve. Best results were showed by two methods: Bayesian logistic regression and Discriminative Multinomial Naive Bayes classifier. Nevertheless, all of the methods were effective at automatic discrimination of two types of cancer. That proves machine learning algorithms are applicable in lung cancer classification. In the future studies it will be carried out a similar analysis of the diagnostic value of methods for other malignancies with more complex differential morphological diagnosis. Similar methods can be applied to other diagnostic studies including computerized tomography image analysis in the differential diagnosis of lung nodules.
Background. According to a report by the International Agency for Research on Cancer (IARC), lung cancer (LC) is among the leading causes of morbidity and mortality worldwide, with an estimated incidence of 14.1 million new cases of the disease and 8.2 million cancer deaths in 2012. Lung cancer is the most common cancer worldwide, accounting for 13 % of all new cancer cases and 19.4 % of deaths.The purpose of the study was to evaluate LC prevalence and to measure the quality of population-based cancer registries by the indices of the proportion of total incident cases.Material and methods. The study material was given from the monograph «Cancer on Five Continents», which included data from the database of the Cancer Registry of PA. Herzen Moscow Research Oncology Institute (St. Petersburg), surveys of morbidity and mortality in the North-West Federal District, estimations of proportion of the true incidence that was registered in population-based registries.Results. The analysis of lung cancer morbidity and mortality in Russia showed a significant improvement in analytical indices over the past 10 years, however, underestimation of primary cases, reduced the overall lung cancer incidence rate.Conclusions. The dynamics of age-specific lung cancer incidence was shown. The loss of primary lung cancer cases was estimated to be 15-20 % annually.
Cancer screening literature was discussed in this review publication. Broad spectrum of studies was used to make conclusion about effectiveness of screening methods in reaching its major objectives, perspective of screening methods for several cancer types were also discussed. Qualitative assessment of studies was done. Cervical cancer, breast cancer and colorectal cancer screening was proved to be effective. Effectiveness of prostate and lung cancer screening as well as population-based stomach cancer prevention is also discussed. Negative and inconclusive results of screening studies of the other cancer types were also mentioned and perspectives for future diagnostics option for cancer screening were given.
This article reviews the literature and summarizes single institution experience of applying different diagnostic algorithms for lung cancer. All diagnostic methods can be divided into three groups: non-invasive; minimally invasive and invasive. The non-invasive methods include clinical examination; imaging methods for anatomical, functional and multimodal visualization; sputum cytological, analysis of the exhaled breath, detection of various blood and sputum markers. Minimally invasive methods include endoscopy, percutaneous fine-needle and core-needle biopsy. Invasive methods include diagnostic thoracoscopy and laparoscopy, mediastinoscopy, parasternal mediastinotomy and diagnostic thoracotomy. While creating an individual diagnostic plan for each patient it is necessary to carefully analyze the effectiveness, safety, sensitivity, specificity and of different methods available among wide range of modern diagnostic techniques. Optimization of lung cancer diagnosis methods, which includes early cancer detection, is one of priority areas of modern oncology. Many aspects of this problem remain unresolved and require further research
One of the most important problems of modern medicine, which, in particular, precludes the effective implementation of new diagnostic methods such as population screening, is the steady increase of volumes of important medical data, as well as insufficient attention to the analysis of the dynamics of the patients’ condition. These problems can be solved by the information support of medical specialist in the process of research and in the formation of recommendations for further management of patients. In the study, we examined the possible ways of solving these problems through the development of software tools for creation of knowledge bases of recommendations for monitoring and treatment of various diseases, as well as intelligent decision support by the example of cancer. The results of tests of these solutions allow speaking about their effectiveness and applicability in clinical practice.
In this literature review we analyze the effectiveness of radiotherapy (as an independent method and in combination with surgery and chemotherapy) in the treatment of locally advanced non-small cell lung cancer. The postoperative adjuvant radiotherapy can increase overall survival and reduce the frequency of local recurrences in IIIA / N2 stage of NSCLC, however, its positive effect can be offset by the damage to surrounding structures. Modern high-tech equipment, improved planning systems, methods radiation doses delivery, and the fractionation regimen can improve the outcomes of radiation therapy. No bimodal treatment has shown advantages over other combinations. Some improvement in survival was noted in a number of studies using three-modal treatment, but it was also associated with an increase in the proportion of postoperative complications, especially after pneumonectomies. The heterogeneity of the IIIA / N2 NSCLC group and criteria for their operability present certain difficulties for a correct comparison of the treatment results, which requires further discussion. In most studies, insufficient attention has been paid to the influence of multimodal treatment on the quality of life of patients, which, taking into account comparable results of treatment, can be crucial in determining indications and contraindications.
An active introduction of screening programs potentially leads to a significant increase in the proportion of patients with early forms of non-small cell lung cancer. Surgical treatment, which is the standard of care for localized forms, due to functional limitations can be performed only in 65-70% of patients. The solution to this problem can be found in the improvement of the results of radiotherapy by using modern equipment, the planning systems, improved fractionation schemes and introduction of methods for summing radiation doses. Stereotactic radiotherapy allows high-precision delivery of high radiation dose to tumor with a minimal damage to surrounding healthy tissues. In this literature review based on the analysis of a large number of publications we show that it is not yet possible to make valid conclusions about the effectiveness and safety of stereotactic radiation therapy as an alternative to the surgical methods. It is necessary to plan and conduct randomized trials without further delay taking into account the expected high relevance of the method.
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