Advanced Stage Lung Cancer: Persisting Challenges in the Era of Molecular Targeted Therapy-Our Experience
Introduction: Lung cancer is the pioneer among all the cancers and also the leading cause of cancer related mortality worldwide. In India unlike in western countries most patients are diagnosed at advanced stage (Stage III/Stage IV) which in turn adversely affects the patient prognosis and survival....
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JCDR Research and Publications Private Limited
2018-05-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/11481/35799_CE[Ra1]_F(SHU)_PF1(MJ_AP)_PFA(MJ_AP)_PB(MJ_SS)_PN(AP).pdf |
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| author | Srinidhi Govindarajan Deepa SA Adiga Flora D Lobo Ranjitha Rao Krishna Prasad Chaithra Gowthuvalli Venkataramanna |
| author_facet | Srinidhi Govindarajan Deepa SA Adiga Flora D Lobo Ranjitha Rao Krishna Prasad Chaithra Gowthuvalli Venkataramanna |
| author_sort | Srinidhi Govindarajan |
| collection | DOAJ |
| description | Introduction: Lung cancer is the pioneer among all the cancers and also the leading cause of cancer related mortality worldwide. In India unlike in western countries most patients are diagnosed at advanced stage (Stage III/Stage IV) which in turn adversely affects the patient prognosis and survival. Studying the proportion of the total lung cancer cases which will present in advanced stage and their clinical, pathological and radiological profile will give us an insight into the problem. Aim: To know the percentage incidence of patients presenting with advanced stage lung cancer (Stage IIIB/Stage IV) and to study the clinical, pathological and radiological profile of these patients along with treatment details and follow-up. Materials and Methods: This was a descriptive retrospective study spanning four years from January 2013 to December 2016. All patients with a histopathological diagnosis of Stage IIIB and Stage IV lung cancer, treated during this period were included. Clinical features, radiological (X-ray and CT) findings, histopathological findings including immunohistochemistry if done, treatment modality and survival were analysed based on the information collected from the medical records. Results: Out of 82 cases diagnosed as advanced stage disease, complete clinical data was available for 67 cases which formed the material for the study. Of 67 patients, 47 were male and 20 were female forming a Male: Female ratio of 2.35:1. The mean age of the patients was 61.3 years. Patients presented with cough (59.7%), chest pain (34.3%) dyspnoea (29.8%), weight loss (17.9%), fever (16.4%), haemoptysis (11.9%). Histologically majority were Adenocarcinoma (ADC) (35.8%) followed by Squamous Cell Carcinoma (SCC) (29.8%) small cell carcinoma (14.92%) and just one case of large cell carcinoma. Forty five cases (64.17%) presented with metastases. The most common site for metastasis was bone followed by brain. Three patients who tested positive for Epidermal Growth Factor Receptor (EGFR) mutation were treated with Erlotinib/Gefitinib. The remaining 64 cases were treated with regimens including combinations of premetrexed, platinum based compounds and etoposide. On follow-up 17 patients died during the course of the treatment. Conclusion: High proportion of lung cancer patients present at advanced stage. This demand for public awareness programs about the smoking hazards, early symptoms and importance of early treatment. |
| first_indexed | 2024-12-11T00:00:46Z |
| format | Article |
| id | doaj.art-1b9b52b390af41dbbbe595c41ff58926 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-11T00:00:46Z |
| publishDate | 2018-05-01 |
| publisher | JCDR Research and Publications Private Limited |
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| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-1b9b52b390af41dbbbe595c41ff589262022-12-22T01:28:28ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2018-05-01125EC14EC1710.7860/JCDR/2018/35799.11481Advanced Stage Lung Cancer: Persisting Challenges in the Era of Molecular Targeted Therapy-Our ExperienceSrinidhi Govindarajan0Deepa SA Adiga1Flora D Lobo2Ranjitha Rao3Krishna Prasad4Chaithra Gowthuvalli Venkataramanna5MBBS Student, Kasturba Medical College, Mangalore, MAHE, Manipal. Karnataka, India.Associate Professor, Department of Pathology, Kasturba Medical College, Mangalore, MAHE, Manipal. Karnataka, India.Professor, Department of Pathology, Kasturba Medical College, Mangalore, MAHE Manipal, Karnataka, India.Assistant Professor, Department of Pathology, Kasturba Medical College, Mangalore, MAHE Manipal, Karnataka, India.Associate Professor, Department of Oncology, Kasturba Medical College, Mangalore, MAHE Manipal, Karnataka, India.Assistant Professor, Department of Pathology, Kasturba Medical College, Mangalore, MAHE Manipal, Karnataka, India, India.Introduction: Lung cancer is the pioneer among all the cancers and also the leading cause of cancer related mortality worldwide. In India unlike in western countries most patients are diagnosed at advanced stage (Stage III/Stage IV) which in turn adversely affects the patient prognosis and survival. Studying the proportion of the total lung cancer cases which will present in advanced stage and their clinical, pathological and radiological profile will give us an insight into the problem. Aim: To know the percentage incidence of patients presenting with advanced stage lung cancer (Stage IIIB/Stage IV) and to study the clinical, pathological and radiological profile of these patients along with treatment details and follow-up. Materials and Methods: This was a descriptive retrospective study spanning four years from January 2013 to December 2016. All patients with a histopathological diagnosis of Stage IIIB and Stage IV lung cancer, treated during this period were included. Clinical features, radiological (X-ray and CT) findings, histopathological findings including immunohistochemistry if done, treatment modality and survival were analysed based on the information collected from the medical records. Results: Out of 82 cases diagnosed as advanced stage disease, complete clinical data was available for 67 cases which formed the material for the study. Of 67 patients, 47 were male and 20 were female forming a Male: Female ratio of 2.35:1. The mean age of the patients was 61.3 years. Patients presented with cough (59.7%), chest pain (34.3%) dyspnoea (29.8%), weight loss (17.9%), fever (16.4%), haemoptysis (11.9%). Histologically majority were Adenocarcinoma (ADC) (35.8%) followed by Squamous Cell Carcinoma (SCC) (29.8%) small cell carcinoma (14.92%) and just one case of large cell carcinoma. Forty five cases (64.17%) presented with metastases. The most common site for metastasis was bone followed by brain. Three patients who tested positive for Epidermal Growth Factor Receptor (EGFR) mutation were treated with Erlotinib/Gefitinib. The remaining 64 cases were treated with regimens including combinations of premetrexed, platinum based compounds and etoposide. On follow-up 17 patients died during the course of the treatment. Conclusion: High proportion of lung cancer patients present at advanced stage. This demand for public awareness programs about the smoking hazards, early symptoms and importance of early treatment.https://jcdr.net/articles/PDF/11481/35799_CE[Ra1]_F(SHU)_PF1(MJ_AP)_PFA(MJ_AP)_PB(MJ_SS)_PN(AP).pdfadenocarcinomasmokingsquamous cell carcinoma |
| spellingShingle | Srinidhi Govindarajan Deepa SA Adiga Flora D Lobo Ranjitha Rao Krishna Prasad Chaithra Gowthuvalli Venkataramanna Advanced Stage Lung Cancer: Persisting Challenges in the Era of Molecular Targeted Therapy-Our Experience Journal of Clinical and Diagnostic Research adenocarcinoma smoking squamous cell carcinoma |
| title | Advanced Stage Lung Cancer: Persisting Challenges in the Era of Molecular Targeted Therapy-Our Experience |
| title_full | Advanced Stage Lung Cancer: Persisting Challenges in the Era of Molecular Targeted Therapy-Our Experience |
| title_fullStr | Advanced Stage Lung Cancer: Persisting Challenges in the Era of Molecular Targeted Therapy-Our Experience |
| title_full_unstemmed | Advanced Stage Lung Cancer: Persisting Challenges in the Era of Molecular Targeted Therapy-Our Experience |
| title_short | Advanced Stage Lung Cancer: Persisting Challenges in the Era of Molecular Targeted Therapy-Our Experience |
| title_sort | advanced stage lung cancer persisting challenges in the era of molecular targeted therapy our experience |
| topic | adenocarcinoma smoking squamous cell carcinoma |
| url | https://jcdr.net/articles/PDF/11481/35799_CE[Ra1]_F(SHU)_PF1(MJ_AP)_PFA(MJ_AP)_PB(MJ_SS)_PN(AP).pdf |
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