Virtual Library
Start Your Search
Xi Fang Wang
Author of
-
+
MA10 - Assessing and Managing Supportive Care Needs (ID 215)
- Event: WCLC 2020
- Type: Mini Oral
- Track: Palliative and Supportive Care
- Presentations: 1
- Moderators:
- Coordinates: 1/31/2021, 11:45 - 12:45, Scientific Program Auditorium
-
+
MA10.09 - Efficacy of Thalidomide in the Treatment of Extensive Stage SCLC with CACS (ID 2767)
11:45 - 12:45 | Presenting Author(s): Xi Fang Wang
- Abstract
Introduction
Patients with advanced tumor have varying degrees of cancer anorexia-cachexia syndrome (CACS), refers to skeletal muscle, fat loss and anorexia as the main manifestations of metabolic disorders, resulting in weakness and systemic inflammation-based clinical syndrome. For CACS. On the one hand, it is the result of the role of inflammatory cytokines in the body. current studies have confirmed that inflammatory cytokines are an important pathogenesis of CACS. On the other hand, there are some adverse consequences caused by some cytokines released by tumor, which can promote catabolism; TNF- α and IL-6,INF- γ are closely related to the occurrence of CACS .
Thalidomide is a glutamic acid derivative, as an inhibitor of TNF- α, has become one of the methods for the treatment of CACS.
We found that thalidomide combined with balanced nutrition therapy could significantly reduce the incidence of CACS in patients with advanced tumor. so we included 188 patients with extensive-stage small cell lung cancer with CACS (control group 92 cases. Trail group 96 cases: thalidomide 100mg / night, maintenance therapy for 8 weeks). At the same time, both groups were given balanced nutritional support therapy. Static variables (serum albumin, total protein, total lymphocyte count, body mass index), dynamic variables (retinol binding protein, prealbumin, cholinesterase) average body weight, appetite, ECOG PS score, improvement of fatigue and side effects were observed. After 8 weeks of treatment, the above observation project were summarized and statistically analyzed. The results showed that the trail group could significantly improve the incidence of CACS in patients with extensive-stagesmall cell lung cancer compared with the control group, and the adverse reactions were tolerable. Therefore, we believe that thalidomide combined with balanced nutrition therapy can improve the prognosis of patients with extensive-stage small cell lung cancer with CACS.
Methods
188 patients with extensive-stage small cell lung cancer complicated with cachexia with more than 10% weight loss were randomly divided into experimental group and control group. The treatment group took thalidomide 100mg every night for 8 weeks, and both groups were given balanced nutritional support. Static variables (serum albumin, total protein, total lymphocyte count, body mass index), dynamic variables (retinol binding protein, prealbumin, cholinesterase) and nutrition screening tools (detailed history collection, physical examination, body weight, appetite and fatigue score, ECOG PS score, grip strength and quality of life score) were used to observe the changes of various indexes between the two groups.
Results
After 8 weeks of treatment, the static variables (serum albumin, total protein, total lymphocyte count, body mass index), dynamic variables (retinol binding protein, prealbumin, cholinesterase) and the average body weight, appetite, ECOG PS score, fatigue and other indexes of the patients in the treatment group were significantly promote than that in the control group, and had statistical significance. Side effects: there were significant differences in constipation and excessive sedation between the two groups (p ＜0.005), but there was no significant difference in other symptoms.
Conclusion
Thalidomide is effective and safe in the treatment of patients with extensive-stage small cell lung cancer complicated with CACS.
