ESBL-KP exhibited less susceptibility to various non-β-lactamase antibiotics, and infections due to these organisms were related to LOS and preexisting use of antibiotics. Thus, judicious use of all antibiotics should be underscored to reduce the infections caused by ESBL-KP.
LCNEC is an aggressive subtype of non-smallcell lung cancer (NSCLC), with a biology and prognosis comparable to small cell lung cancer (SCLC). The optimal treatment strategy is unknown. Prophylactic cranial irradiation (PCI) is known to reduce the incidence of brain metastases and improve survival in patients with SCLC. The purpose of this study is to determine the incidence of brain metastases and survival outcomes after treatment of LCNEC with curative intent. Materials/Methods: Retrospective chart review was conducted on patients in Nova Scotia diagnosed with primary LCNEC of the lung between September 1998 and February 2014. Information was collected from patient charts including tumor staging, treatment intent and type, brain metastases, and dates of relapse and death (if applicable). The primary endpoint was the incidence of brain metastases in patients treated with curative intent. The secondary endpoints included overall survival (OS), disease free survival (DFS), and the incidence of brain metastases as the first site of relapse. Results: 87 patients were eligible. 53 patients were treated with curative intent, and 34 with palliative intent. Median follow-up time was 16.9 months (IQ range 11.4-30.2 months) for patients treated with curative intent and 8.1 months (IQ range 2.5-13.9 months) for those treated with palliative intent. The most common therapy for patients treated with curative intent was surgery alone (34 patients, 64.1%). Ten patients received surgery with adjuvant therapy (5 receiving chemotherapy and 5 receiving concurrent chemoradiation therapy), 6 received definitive concurrent chemoradiation, and one received radiation therapy alone. For patients treated with curative intent, the incidence of brain metastases was 20.6% at 1 year and 42.5% at 2 years. Of 19 patients experiencing brain relapse, 15 developed brain metastases either as an isolated first site of relapse or as part of the first relapse (with other sites). The median OS and DFS in patients treated with curative intent were 19.1 months and 13.3 months. Considering all patients, the incidence of brain metastases was 23.4% at 1 year and 44.8% at 2 years. Conclusion: For patients treated for LCNEC of the lung with curative intent, the incidence of brain metastases approaches that noted in SCLC. PCI should be investigated further as a means of preventing brain metastases.
The median GTV at about 30 days after the beginning of X-irradiation compared with that before treatment was 70.2% (48.8-92.7, CDDP and S-1) and 72.3% (28.8-92.6, CDDP and vinorelbine), respectively. At 30 days, the shrinkage rates of GTV after CCPT were significantly higher than those after CCRT using either regimen of chemotherapy. Conclusion: CCPT using CDDP and S-1 is considered to be very effective in obtaining a favorable primary response. The treatment appeared to have a strong tumor-shrinking effect during an early period. Frequent verification and adaptive plan making according to a verification plan are considered necessary. Further investigation with more patients and more detailed evaluation seems to be warranted.
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