How is lung cancer diagnosed?


How is lung cancer diagnosed?

How is lung cancer diagnosed?

When Develops first lung cancer, there may be no Symptoms at all. Grows But as the cancer, it can cause, Furniture People Should watch for changes. Common Signs and Symptoms of lung cancer include:

Furniture a cough does not go away and gets worse over time

constant chest pain

coughing up blood

shortness of breath, wheezing, or hoarseness

repeated problems with pneumonia or bronchitis

swelling of the neck and face

Loss of Appetite or weight loss



Within 7 days of entry onto the study, all patients underwent a complete medical history and physical examination, including a full neurologic examination and documentation of ECOG performance status. Patients also underwent complete hematologic and biochemical testing and had an ECG and baseline chest x-ray performed. Within 3 weeks before the initiation of therapy, clinically indicated scans, including computed tomographic scans of the brain, thorax, and upper abdomen (or abdominal ultrasound) and radionuclide bone scans were performed.
All patients were required to complete quality-of-life (QOL) questionnaires before undergoing therapy. The Lung Cancer Symptom Scale was used in North America, and the European Organization for the Research and Treatment of Cancer quality-of-life questionnaire for lung cancer was used in Europe. Sixteen patients in North America and 25 patients in Europe completed both questionnaires.
Patients randomized to the docetaxel arm were premedicated with oral dexamethasone 8 mg bid for 5 days (10 doses) starting 24 hours before each infusion of docetaxel. In the second half of the study, this regimen was reduced to a total of five doses. Docetaxel 100 mg/m2 as a 1-hour intravenous infusion was administered every 21 days for the first half of the study. When interim safety-data monitoring identified a significantly higher toxic death rate in the chemotherapy arm of the study, the protocol was amended and the docetaxel dose was reduced to 75 mg/m2 given intravenously over 1 hour every 3 weeks for the second half of the trial.
For patients who developed grade 4 neutropenia that lasted more than 7 days or that was associated with a temperature of more than 38°C, a 25% permanent dose reduction was required. Patients with grade 4 thrombocytopenia were re-treated with a 25% dose reduction after recovery. 
Patients randomized to the BSC arm were treated with whichever therapy was judged to be appropriate by the treating physician. This treatment could have included treatment with antibiotics, analgesic drugs, transfusions, and palliative radiotherapy.
Patients in both arms of the study were evaluated every 3 weeks. At each follow-up visit, they underwent a complete medical history and physical examination, with documentation of weight and ECOG performance status. Vital signs were recorded and toxicities were evaluated. QOL questionnaires were also completed every 3 weeks. A chest x-ray was performed every 3 weeks, and scans were repeated every 6 weeks to document response or disease progression.
How is lung cancer diagnosed?
How is lung cancer diagnosed?

In the chemotherapy arm, treatment was continued until disease progression or unacceptable toxicity developed. In the BSC arm, patients continued to be evaluated as described above every 3 weeks for the first 18 weeks and then every 6 weeks.
Objective tumor response and duration of response were assessed only in the docetaxel arm. Standard World Health Organization response criteria were applied, and all responses had to be confirmed in 28 days or more after the initial documentation of response. Survival was calculated from the date of randomization until the date of death. Survival time was censored for loss of contact or initiation of antitumor therapy, including subsequent chemotherapy, immunotherapy, or surgery. Time to disease progression was assessed from the date of randomization until the date of disease progression. Time to disease progression was also censored at the last tumor assessment if there was no documentation of progression. Response duration was calculated from the date of randomization until the date of documentation of disease progression.

Statistical Considerations

The primary end point of the study was survival. The sample size was chosen on the basis of a log-rank test used to compare the two randomized groups. Comparisons of survival for the two halves of the study were made between the patients treated at docetaxel doses of either 100 mg/m2 or 75 mg/m2 and the corresponding BSC patients in that part of the trial. Secondary end points included objective tumor response and duration of response, as well as changes in QOL determined on the basis of the QOL instruments, changes in performance status and weight, and changes in analgesic use.
A sample size of 100 patients per group was estimated on the basis of a projected median survival of 7 months in the docetaxel group and 4 months in the BSC group and on the basis of the log-rank test with an alpha level of 5% (two-sided) and a power of 90% to compare the groups. The sample size was not estimated for an analysis intended to compare results within the four strata, as defined by performance status and response to prior therapy.

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