metastatic non-small cell lung cancer: a tunisian retrospective study about 100 cases.
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Abstract
Background: Background : Non-small cell lung cancer (NSCLC) is the most common histologic form, leading causes of cancer death among masculine population. Half of CNPC was metastatic at diagnosis.
Aim : To report the epidemiologic, anatomoclinic profile, therapeutic protocols and results of a retrospective study of non-small cell lung cancer (NSCLC) initially metastatic.
Methods : our retrospective study include patients with NSCLC histologically confirmed with inaugural metastasis collected from January 1999 to december 2012. We had analysed epidemiologic, anatomopathologic data (TNM 2009), therapeutic protocols and results in term of overall survival, median survival and event free survival. Results : 100 case of NSCLC have been collected, mea nage was 57 years (22 to 81) and sex –ratio was 4,6. The majority of cases (74%) had a good performance statut (PS ≤ 2). Pathologic analysis leads to 81 cases of adenocarcinoma (ADK), 16 epidermoid carcinoma. 34% was stager T4 and 31% N2. Metastasis was located to bone in 36 cases, pleural in 26 cases, controlateral lung 26 cases, adrenal gland 17 cases and brain in 13 cases. 82% of patients underwent polychemotherapy as first line of treatment based on regimens conteined platine with mean number of 4 cycles. We have observed 4% of complete response, 61 of partial response, 20% of stabilisation, and 15% of progression. A palliatif radiotherapy of bone or brain metastasis was performed in 38 % of cases. With a median follow-up of 71 months (12 to 130 months), mean survival was 11 months; overall survival (Kaplan-Meier) at 1, 3 and 5 years was respectively 44, 13 and 0 %.
Conclusion: Despite therapeutic progress in management of NSCLC, the prognosis of metastatic forms still reserved with a poor mean survival reported in litterature (12 years) valideted in our study. This push us to improve research mainly since advent of targeted therapy wich still a promising way in the management of these tumors
Aim : To report the epidemiologic, anatomoclinic profile, therapeutic protocols and results of a retrospective study of non-small cell lung cancer (NSCLC) initially metastatic.
Methods : our retrospective study include patients with NSCLC histologically confirmed with inaugural metastasis collected from January 1999 to december 2012. We had analysed epidemiologic, anatomopathologic data (TNM 2009), therapeutic protocols and results in term of overall survival, median survival and event free survival. Results : 100 case of NSCLC have been collected, mea nage was 57 years (22 to 81) and sex –ratio was 4,6. The majority of cases (74%) had a good performance statut (PS ≤ 2). Pathologic analysis leads to 81 cases of adenocarcinoma (ADK), 16 epidermoid carcinoma. 34% was stager T4 and 31% N2. Metastasis was located to bone in 36 cases, pleural in 26 cases, controlateral lung 26 cases, adrenal gland 17 cases and brain in 13 cases. 82% of patients underwent polychemotherapy as first line of treatment based on regimens conteined platine with mean number of 4 cycles. We have observed 4% of complete response, 61 of partial response, 20% of stabilisation, and 15% of progression. A palliatif radiotherapy of bone or brain metastasis was performed in 38 % of cases. With a median follow-up of 71 months (12 to 130 months), mean survival was 11 months; overall survival (Kaplan-Meier) at 1, 3 and 5 years was respectively 44, 13 and 0 %.
Conclusion: Despite therapeutic progress in management of NSCLC, the prognosis of metastatic forms still reserved with a poor mean survival reported in litterature (12 years) valideted in our study. This push us to improve research mainly since advent of targeted therapy wich still a promising way in the management of these tumors
Keywords:
Non-small cell bronchopulmonary carcinoma, metastatic, Management, chemotherapy, prognosis##plugins.themes.academic_pro.article.details##
References
- Ferlay J, Shin HR, Bray F et al. Estimates of worldwide burden of cancer in 2008: Globocan 2008. Int J Cancer 2010; 127: 2893-917.
- Quoix E, Lemarie E. Épidémiologie du cancer bronchique primitif : aspects classiques et nouveautés. Revue des Maladies Respiratoires 2011; 28: 1048-58.
- Fajraoui N, Charfi MR, Khouani H and al. Clinical epidemiology of primary lung cancer in Tunisia. 100 cases. Tunis Med 2007; 85: 766-72.
- Fenniche S, El Fekih L, Ben Abdelghaffar H and al. Palliative chemotherapy of non-small lung cancer in Tunisia. Prospective study of the cost and impact on the quality of life. La Tunisie Medicale 2011;89:539-43.
- Chandra S, Mohan A, Guleria R, Singh V, Yadav P. Delays during the diagnostic evaluation and treatment of lung cancer. Asian Pac J Cancer Prev 2009;10:453-6.
- Paliogiannis P, Attene F, Cossu A and al. Lung cancer epidemiology in North Sardinia, Italy. Multidiscip Respir Med 2013;8:45.
- Cheong K, Spicer J, Chowdhury S, Harper P. Combination therapy versus single agent chemotherapy in non-small cell lung cancer. Expert Opin Pharmacother 2005; 6: 1693-700
- Schuette W, Tesch H, Buttner H and al. Second-line treatment of stage III/IV nonsmall-cell lung cancer (NSCLC) with pemetrexed in routine clinical practice: evaluation of performance status and health-related quality of life. BMC Cancer 2012;12:14.
- Baggstrom MQ, Stinchcombe TE, Fried DB and al. Third-generation chemotherapy agents in the treatment of advanced non-small cell lung cancer: a metaanalysis. J Thorac Oncol 2007; 2: 845-53.
- Hayman JA, Abrahamse PH, Lakhani I and al. Use of palliative radiotherapy among patients with metastatic non-small-cell lung cancer. Int J Radiat Oncol Biol Phys 2007;69: 1001-7.
- Carrato A, Vergnenegre A, Thomas M and al. Clinical management patterns and treatment outcomes in patients with non-small cell lung cancer (NSCLC) across Europe: EPICLIN-Lung study. Curr Med Res Opin 2013.
- Reinmuth N, Payer N, Muley T and al. Treatment and outcome of patients with metastatic NSCLC: a retrospective institution analysis of 493 patients. Respir Res 2013;14:139.
- Reck M, von Pawel J, Zatloukal P and al. Overall survival with cisplatingemcitabine and bevacizumab or placebo as first-line therapy for nonsquamous non-small-cell lung cancer: results from a randomised phase III trial (AVAiL). Ann Oncol 2010; 21: 1804-1809.