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Treatment-related death in patients with small-cell lung cancer in phase III trials over the last two decades.

ABSTRACT: INTRODUCTION: Treatment-related death (TRD) remains a serious problem in small-cell lung cancer (SCLC), despite recent improvements in supportive care. However, few studies have formally assessed time trends in the proportion of TRD over the past two decades. The aim of this study was to determine the frequency and pattern of TRD over time. METHODS: We examined phase 3 trials conducted between 1990 and 2010 to address the role of systemic treatment for SCLC. The time trend was assessed using linear regression analysis. RESULTS: In total, 97 trials including nearly 25,000 enrolled patients were analyzed. The overall TRD proportion was 2.95%. Regarding the time trend, while it was not statistically significant, it tended to decrease, with a 0.138% decrease per year and 2.76% decrease per two decades. The most common cause of death was febrile neutropenia without any significant time trend in its incidence over the years examined (p = 0.139). However, deaths due to febrile neutropenia as well as all causes in patients treated with non-platinum chemotherapy increased significantly (p = 0.033). CONCLUSIONS: The overall TRD rate has been low, but not negligible, in phase III trials for SCLC over the past two decades.

SUBMITTER: Ochi N

PROVIDER: S-EPMC3412813 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Treatment-related death in patients with small-cell lung cancer in phase III trials over the last two decades.

Ochi Nobuaki N Hotta Katsuyuki K Takigawa Nagio N Oze Isao I Fujiwara Yoshiro Y Ichihara Eiki E Hisamoto Akiko A Tabata Masahiro M Tanimoto Mitsune M Kiura Katsuyuki K

PloS one 20120806 8

<h4>Introduction</h4>Treatment-related death (TRD) remains a serious problem in small-cell lung cancer (SCLC), despite recent improvements in supportive care. However, few studies have formally assessed time trends in the proportion of TRD over the past two decades. The aim of this study was to determine the frequency and pattern of TRD over time.<h4>Methods</h4>We examined phase 3 trials conducted between 1990 and 2010 to address the role of systemic treatment for SCLC. The time trend was asses ...[more]

PMID: 22880112

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Project description:ObjectiveAs the number of female medical students and surgical residents increases, the increasing number of female academic surgeons has been disproportionate. The purpose of this brief report is to evaluate the AAMC data from 1969 to 2018 to compare the level of female academic faculty representation for surgical specialties over the past four decades.DesignThe number of women as a percentage of the total surgeons per year were recorded for each year from 1969-2018, the most recent year available. Descriptive statistics were performed. Poisson regression examined the percentage of women in each field as the outcome of interest with the year and specialty (using general surgery as a reference) as two predictor variables.SettingData from the American Association of Medical Colleges (AAMC).ParticipantsAll full-time academic faculty physicians in the specialties of obstetrics and gynecology (OB/GYN), general surgery, ophthalmology, otolaryngology (ENT), plastic surgery, plastic surgery, urology, neurosurgery, orthopaedic surgery and cardiothoracic surgery as per AAMC records.ResultsThe percentage of women in surgery for all specialties evaluated increased from 1969 to 2018 (OR 1.04, p<0.001). Compared with general surgery, the rate of yearly percentage change increased more slowly in neurosurgery (OR 0.84; P = .004), orthopaedic surgery (OR 0.82; P = .002), urology (OR 0.59; P < .001), and cardiothoracic surgery (OR 0.38; P < .001). There was no significant difference in the rate of yearly percentage change for plastic surgery (OR 1.01; P = .840). The rate of yearly percentage change increased more rapidly in OB/GYN (OR 2.86; P < .001), ophthalmology (OR 1.79; P < .001) and ENT (OR 1.70; P < .001).ConclusionsRepresentation of women in academic surgery is increasing overall but is increasing more slowly in orthopaedic surgery, neurosurgery, cardiothoracic surgery and urology compared with that in general surgery. These data may be used to inform and further the discussion of how mentorship and sponsorship of female students and trainees interested in surgical careers may improve gender equity in the future.

Project description:Studies focused on emissions and acid deposition of sulfur (S) and nitrogen (N) and the consequent precipitation acidity have a long history. However, atmospheric depositions of cations play a critical role in buffering precipitation acidity, and providing cationic nutrients for vegetation growth lacks sufficient studies equally. The spatiotemporal patterns of cation depositions and their neutralization potential across broad scales remain unclear. Through synthesizing the long-term data in forest sites (n = 128) derived from three monitoring networks (NADP in Northern America, EMEP in Europe, and EANET in East Asia) on wet deposition of cations (Na+, NH4-N, K+, Mg2+, and Ca2+), this study assesses the temporal changes and spatial patterns of cation depositions and their neutralization potential over the last two decades. The results showed that the depositions of cationic nutrients were considerably higher in EANET compared to NADP and EMEP. The depositions of sea salt-associated sodium exhibited a significant transition from marine (> 15 kg ha-1 year-1) to inland (< 3.0 kg ha-1 year-1) forest sites attributable to the precipitation quantity and influences of sea spray. The higher emissions of NH3 and particulate matter in East Asia explained the higher cation depositions in EANET than NADP and EMEP. The annual trends of cations revealed that only 20-30% of the forest sites showed significant changing trends and the sites widely spread across the three networks. Possibly, base cation (BC) deposition has reached a low and stable condition in NADP and EMEP, while it has high spatial heterogeneity in the temporal change in EANET. The difference in BC deposition among the three networks reflects their distinct development of economy. Our synthesis indicates that the annual trends of neutralization factor (NF) in NADP can be explained by the declining of acid potential (AP), not by neutralization potential (NP) as BC deposition has been stably low over the past two decades. Whereas, the concurrent decreases of AP and NP in EMEP or plateau period of both AP and NP in EANET have come to a standstill of acid neutralizing capacity.

Dataset Information

Treatment-related death in patients with small-cell lung cancer in phase III trials over the last two decades.

Publications

Treatment-related death in patients with small-cell lung cancer in phase III trials over the last two decades.

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