Lung Cancer, lung cancer diagnosis,lung cancer treatment

Since farewell former plan one, two, three times, the 21st century, the later period lung cancer patient has welcomed diverse, the individuation complex therapy. After surgery, radiotherapy, chemotherapy, the target to the medicine is in a tumor therapeutic schedule big luminescent spot, becomes gradually improves the patient quality of life, to realize a belt lump survival handle sharp weapon, is also the present global tumor clinical research attacking a fortified position topic. It and the chemotherapy are different, the chemotherapy medicine enters in vivo, during killing tumour cell's, because the selectivity is not high, also has certain injury to the normal cell; But the target takes the specificity target spot to the treatment by the lung cancer, therefore not or very little injures the normal cell, the untoward effect will be relatively small. The patient ability the target to the treatment, looks like generally lucky non-Tini every day so long as takes orally a grain of medicine, the patient does not use in hospital, could also resume former days' life hopefully, even some patients could also return to the operating post. As a result of the target to the treatment participation, the treatment later period lung cancer becomes a systems engineering. Doctor according to patient's physical ability, the condition characteristic, the medicine response and the side effect as well as the complications and so on various decided that is to uses the chemotherapy with the target, the push medicine utilization reasonable opportunity, the display chemotherapy medicine and the target to the medicine superiority, argues vigorously achieves each kind of medicine the optimal fit, this just like is a medicine �art�. On clinical, analyzes the treatment method through the tumor reduction situation effectiveness, the approximately 30% later period lung cancer patient can obtain benefits from the chemotherapy, the target is effective to the treatment to 27%-30% patients. The suitable target does not smoke to the treatment patient characteristic, the adenocarcinoma particularly pulmonary alveolus cell cancer, this part of patients in the target are born before the treatment often lack the effective medicine. , A two chemotherapy defeat's lung cancer patient majority of with difficulty continues to endure the chemotherapy, formerly these patients basic did not have the effective feasible remedial measure, now the target to the treatment is a very good choice. The target is being on the rise to the medicine research and development, some entered two issues clinical, three issue of clinical stages, therefore, the later period lung cancer patient faces no longer is a dead end, but will welcome the winding peaks and paths, ascends the survival confidence again.

??The lung cancer disease incidence rate rises year by year, at present has arranged at the tumor mortality rate first place, above 80% for non-cellule lung cancer, although uses the union chemotherapy and the radiotherapy, its cure rate was still very low, 5 year survival rate is only about 10-15%. Since the 90s the new chemotherapy medicine has entered unceasingly clinical, the present chemotherapy progress introduction is presently as follows. before 1 technique, the new auxiliary chemotherapy most memoirs thought that before the technique, the new auxiliary chemotherapy is safe effective, right?,?,?The time NSCLC patient survives has the remarkable profit, may increase?The time patient surgery excises opportunity. ??2 surgeries excise the thorough NSCLS most reports to think after the technique, is auxiliary the chemotherapy to this part of patient's survival situation not remarkable profit, but the Japanese Osaka General hospital reported that the surgery add-on for adds the fluorine with the uracil (UFT) the chemotherapy, the 400mg/d x 1 year, a UFT chemotherapy group 8 year survival rate reaches 74%, but pure surgery group only 57%. ??3 later period NSCLC later period NSCLC refers to cannot the surgery excise?B time,?After time patient and technique, radiotherapy, recurs, the shift patient, this kind of patient occupies the entire lung cancer patient above 2/3, is the main sickness which the tumor internal medicine department treats plants, the prognosis misses extremely, position life (MS) 16-17 weeks, 1 year survival rate only 10-15%. On actual the 80s appeared one after another along the platinum (DDP), foot Ye Yidai (VP16) and Tini anchors the glucoside (VM26) and so on medicines, its single medicine effectiveness is lower than 15%, if uses including the platinum class union chemotherapy plan may further raise the patient survival rate, the alleviation symptom and the improvement survival quality, but the curative effect was still low. Will present in the 90s later purple three pure (TAXOL), many west purple three pure (TAXOTERE), the different vinca rosea alkali (NVB), the lucky west his guest (GEMCITABINE, GEM), the analysis situs to be willing one after another (TOPOTECAN) to stand especially with Iraq for Kang (irinotecan; CPT-11) and so on new medicine, its single medicine effectiveness respectively is 26%, 20%, 21%, 13% and 27%, MS may enhance for 40 weeks, GEM 1000-1250mg/M2 1 time, is used together 3 week-long therapeutic schedule effectiveness every week above 20%, especially suits the old age patient; Low dose purple three pure 75mg/M2 1 time, is used together 3 week-long Shan Yao plan effectiveness to reach 25%,1 year survival rate every week is 71%, is approximate with the 100mg/M2 three week plan's curative effect. ??a 3.1 later period NSCLC treatment ???A present treatment uses new medicine +DDP/Carbo much the union platinum class plan, each kind of plan's curative effect is similar, total effectiveness 30-40%, MS8-10 month, 1 year survival rate about 35%. In the poisonous side effect aspect, is obvious including the DDP plan digestive tract response, but is mainly the blood platelet suppresses obviously including the Carbo plan, various plans' curative effect see Table 1. Side case number effectiveness % MS (week) 1 year survival rate % NVB+DDP 182 30 40 35 Taxol+DDP 191 32 40 39 GEM+DDP 155 38 37 33 VM26+DDP 179 15 39 37 Taxol+Carbo 190 23 33 32 Taxotere+DDP - 35 39 -- ???In does not increase under the toxic premise to be possible to join one new medicine again in the above 2 medicine plan foundation, because GEM its toxicity low, the single medicine curative effect becomes the first choice high, when three medicine union application should examine its hematology toxicity and the nerve toxicity strictly. ???The non-platinum class new medicine's two medicine joint program and the new medicine +DDP/Carbo two medicine union platinum class plan compares, its effectiveness, the position lifetime and 1 year survival rate does not have the obvious difference, the META analysis definitely to contain the platinum class + new medicine joint program is a later period NSCLC standard therapeutic schedule. ??3.2 later period NSCLC two treatments ??a 3.2.1 later period NSCLC therapeutic schedule treatment defeat's progress time patient, peaceful element Emperor 36-75mg/m2 1 time, 3 weeks, rests every week 1 week-long plan is continuously the present recognition standard plan, the effectiveness 5.5-5.7%, position life 5.7-7.5 months, 1 year survival rate 37%. ??3.2.2 Yi Ruisha 250mg/d Shan Yao the effectiveness 12-18.4%, the position lifetime 6.5-7.5 months, the symptom improvement rate 69.2%, feminine curative effect surpasses the male, adenocarcinoma's effectiveness 13%, the pulmonary alveolus cancer 25-35%, see �the non-cellule lung cancer molecular target auspicious to the treatment�. ??3.2.3 TarcevaTM is another kind of small molecular ammonia sour activating enzyme inhibitor, has the high selective inhibitory action to HER1/EGFR, but the ammonia sour activating enzyme's inhibitory action is very small to other related acceptors or the cytoplasma, its side effect and Yi Ruisha is similar, is mainly the skin rash and the diarrhea. ??3.2.4 Pemetrexet (business commodity name alimta) is one kind of new multi-target folic acid antagonist compound, through suppresses the chest glucoside sour synzyme (TS), the dihydrofolic acid reductases (DHFR) and the glucoside ammonia amide nucleotide transfers the methylation enzyme (GARFT) to block tumour cell's nucleic acid to gather the coring cell division to need the enzyme the production, overseas is carrying on?The time clinical research, the preliminary result prompts the total effectiveness is 44.8%. ??4 are not suitable unites the chemotherapy case here is mainly refers to the chemotherapy side effect to be obvious, the chemotherapy insensitive or creates factors and so on obvious influence to patient's survival quality, including:?A, the bronchial tube pulmonary alveolus cancer, the entire lung excision, the kidney merit energy balance, PS grade > after 2 and technique, restores the slow patient.

Patient: 2009 April, cough, bosom frowsty, sputum, with blood. Right hilar director a tumor. Chemotherapy can surgical treatment is first? Answer: hello, lung cancer chemotherapy after surgery can from following aspects: 1, tumor types: the first to clear, common types of lung cancer with squamous cell carcinoma and adenocarcinomas, if is small cell lung cancer generally do not advocate surgery. 2, the tumor: you need to understand the chest CT etc review after the lung cancer chemotherapy, such as the size of the tumor, local invasion, mediastinum, lymph node metastasis and other lobe are metastases, etc. 3 and the basic situation: your body to perfect the relevant examination if blood, urine and kidney function, electrocardiogram, abdominal type-b ultrasonic overall physical basis, more comprehensive understanding of the kidney function in cardiopulmonary state whether the evaluation, also tolerated surgical lung understand other organs have transfer, etc Comprehensive evaluation of the above information to decide whether to surgery, so do you suggest to hospital relevant examination.

Xu so-and-so, male patient, 64, anhui province. In April 2006, the left lung tumor door trachea proved to squamous cell carcinoma, due to severe coronary heart disease can't treat me, to the operation. Using standard chemotherapy for: Article 1 240mg paclitaxel Cisplatin 50mg 1-3 days 2 a cycle, mass decreased by 50% 6 periodic neoplasm disappear completely, also used as medicine relieve nausea and vomiting, reduce gastrointestinal side effects of cisplatin, reduce the toxicity of kidney toxicity of heart, paclitaxel successfully completed eight cycle chemo, 4 years patients died of a heart attack. Experience: 1. Select correct chemotherapy is very important. 2 patients complication, medicine for smooth finish chemotherapy auxiliary. See below for treatment and CT slices:

(1) smoking: lung cancer has close relationship with smoking, about three-quarters of lung cancer patients are important in the history of smoking tobacco tar, containing, benzopyrene, especially in cigarettes of carcinogenic substance, of which the most important benzopyrene. (2) : industrial waste and atmospheric pollution carcinogenic substance (mainly benzopyrene), coal, oil and gas combustion engine expressway asphalt, etc. Can be atmospheric pollution. According to statistics, industrialized countries to lung cancer than industrial underdeveloped countries for high, Lung cancer is higher than the city, big and small cities in suburban district for high, than for high, than for high, suburban exurb and industrial waste and the carcinogenic substance (mainly benzopyrene). (3) professional, physical and chemical nature carcinogenic factor: now recognized as a comparison of tobacco products, asbestos, chromium heating, chromate salt, beryllium, coal tar, asphalt, smoke, mustard, methylene chloride ether, chlorine armour ether, radioactive substances, uranium and radium, radon. Long-term exposure to the material, the incidence of lung cancer significantly increased. Chronic lung diseases (4) : smoking chronic bronchitis lung cancer than those smoking and chronic bronchitis the high incidence of lung cancer. In addition, the virus infection, fungi (aflatoxin) infection is easy to chronic infection with lung cancer. (5) diet and nutrition, and inhibit lung cancer among relevant vitamins including vitamin a, vitamin b and vitamin c, vitamin e. Vitamin a, vitamin e, an antioxidant that is direct inhibition benzopyrene and nitrosamines, methyl denier anthracene carcinogenic effect. Vitamin b: with lung cancer has occurred, lung cancer patients of b vitamins are often less than normal. Vitamin c, can block the carcinogenicity and nitro-compound, through the form of vitamin c detoxicification damage increased intake, carcinogens, can prevent cancer.