OBJECTIVE To assess the risk of acute cardiactoxicity associated with anthracyclines use in patients with breast cancer and investigate the influencing factors on acute cardiactoxicity.METHODS Cross-sectional analysis was carried out for 213 inpatients with breast cancer who received chemotherapy.RESULTS ECG changes occurred in 37％ patients.It was estimated that the incidence of acute cardiactoxicity associated with anthracyclines was about 30％.The main risk factors of acute cardiactoxicity were previous chemotherapy or radiotherapy,relative higher age(≥55),and menopause.CONCLUSION ECG is an effective examination method for the patients who have acute cardiactoxicity reactions associated with anthracyclines.Clinical pharmacists should give more pharmaceutical care to post-menopause patients who have previously received chemotherapy or radiotherapy and are relatively old(≥55 years).

目的 探讨影响70岁以上老年非小细胞肺癌( NSCLC)患者预后生存的因素.方法 回顾性分析2005年1月至2006年12月收治的361例70岁以上老年NSCLC患者的临床资料,随访生存情况,分析年龄、性别、吸烟状况、Karnofsky评分(KPS)、TNM分期、病理类型、治疗方式、合并症情况(Charlson合并症指数CCI)等因素,对老年非小细胞肺癌患者生存期的影响.结果 全组患者平均年龄(73.4±3.1)岁(70 ～86岁),确诊肺癌后中位生存期34.0个月(0.3 ～83.0个月),5年生存率34.1％.对年龄、性别、病理类型、是否吸烟、KPS、TNM分期、治疗方式、是否伴有合并症等预后因素进行单因素分析,结果显示:TNM分期、治疗方式、KPS、是否伴有合并症与预后相关.Cox多因素分析显示TNM分期、有无合并症、治疗方式是影响患者生存及预后的独立因素.结论 TNM分期、治疗方式、合并症等多种因素影响70岁以上老年NSCLC患者的预后生存.老年肺癌患者多伴有合并症,重视并积极控制合并症,有助于改善预后,延长生存.

Objective This study aimed at validating the Charlson comorbidity index(CCI) and Simplified comorbidity score(SCS) in elderly patients with Non-small cell lung cancer(NSCLC),and assess the impact of comorbidity on prognosis and survival.Methods We retrospectively reviewed 693 patients with NSCLC who were hospitalized in The Cancer Hospital of Chinese Academy of Medical Sciences between January 2005 and December 2006.All the potential prognostic factors,including gender,age,smoking status,pathological type,clinical stage,Karnofsky performance score(KPS),CCI,SCS and therapeutic method were evaluated.Univariate analysis by Kaplan-Mierer combining with log-rank test and multivariate Cox regression model was used to determine the significance of prognostic variables in the survival.Results Of all the patients,the median survival was 34.0 months(0.2-84.0 months) and the five-year survival rate was 35.4%.Univariate analysis revealed that smoking status,clinical stage,KPS,SCS and therapeutic method were factors significantly related to prognosis and survival in elderly NSCLC.Multivariable analysis showed that clinical stages,SCS,therapeutic method were independent prognostic factors.Conclusions Clinical stages,SCS,therapeutic method may be independent prognostic factors of NSCLC in the elderly.The SCS appears more informative than the CCI in predicting NSCLC patient outcome.Comorbidities might be taken into account as an important variable on treatment of NSCLC.

Objective To investigate the prognostic factors for breast cancer patients with brain metastasis.Methods From Jan.1999 to Dec.2009,89 patients with brain metastasis(BM) from breast cancer,who had both complete medical charts and follow-up data were eligible for this retrospective analysis.A number of potential factors which might affect prognosis were evaluated,including age,Karnofsky Performance Score(KPS),primary disease stage,ER,PR,HER-2 status,menses status,first sign of brain metastasis(BM),extension and numbers of BM lesions,control of primary tumor,presence of extracranial metastasis and sites of metastasis,chemotherapy,etc.Univariate analysis by Kaplan-Mierer combining with log-rank test and multivariate Cox regression model was used to determine the significance of prognostic variables in the survival.Results The mean age of 89 patients was 49.0 years(range 23-74 years).The median survival time was 8.6 months(range 0.2-61.5 months).Among 89 patients,the 1-year survival rate and mediean survival were significantly lower in patients with HER-2-positive tumors than in patients with HER-2-negative tumors(1-year survival rate:12.5% vs 46.2%,P=0.003,mediean survival: 6.3 months vs 10.9 months,P=0.003).The 1-year survival rate and median survival time were significantly lower in patients whose Karnofsky performance score was less than 60 than in patients whose Karnofsky performance score was greater than 60(1-year survival rate:15.0% vs 43.5%,P=0.017,median survival time:5.3months vs 10.1months,P=0.019).The 1-year survival rate and median survival time were significantly better in the patients who used hormonal therapy than in the patients who had not used hormonal therapy(1-year survival rate:66.7% vs 32.5%,P=0.027,median survival time:29.3 months vs 8.5 months,P=0.003).The patients who had received comprehensive treatments had got better outcome than those who hadn′t received comprehensive treatment(1-year survival rate:48.1% vs 21.6%,P=0.014,mediean survival time:13.6 months vs 6.0 months,P=0.006).In the Cox multivariate analysis,KPS,HER-2 status and comprehensive treatments were significant prognostic factors.Conclusions KPS,HER-2 status and comprehensive treatments were independent prognostic factors.