Clinical and histopathological research on predictive evaluation of the effect of radiotherapy combined with or without chemotherapy for lung cancer

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In the present study, quantitative levels of telomerase activity and hTERT gene mRNA (hTERT) expression playing a key role in telomerase activation were analyzed in cancerous and non-cancerous lung tissues of 62 lung cancer patients by telomeric repeat amplification protocol and reverse transcription-PCR, respectively. The telomerase expression levels of each group of tissue samples were compared with clinicopathologic variables. Telomerase activity and hTERT were detected in cancerous tissues (75.8 and 75.8%, respectively), while these parameters were not observed in any non-cancerous tissues. In quantitative assessment of telomerase expression, both telomerase activity and hTERT were significantly correlated with lymph node metastasis (NO vs. N+, P<0.05). Telomerase activity also correlated with tumor cell differentiation and stage classification (P<0.05), but did not correlate with other clinicopathologic variables. The disease-free survival in patients with lung cancer demonstrated … More that patients with hTERT-positive tumor survived for a significantly shorter period than those with hTERT negative tumor (P=0.0334). Since hTERT levels are correlated with N factor which represents the true aggressiveness of patients' disease concerning the evaluation of clinical outcome, hTERT was found to be one of the important markers revealing biological malignant potentials for lung cancer. To reduce the normal tissue damag, we adopted three-dimensional (3D) conformal single high-dose boost radiosurgery (SRS) by using our spiro-analyzer respiratory gating system for peripheral T1 non-small cell lung cancer (NSCLC). Twenty-four palients were treated with a standard fractionation of 30 GY/10 fractions or 40 Gy/20 fractions and a single high-dose boost of 20 Gy using 3D non-coplanar SRS. Twenty tumors (83%) showed a local responce. No radiation pneumonitis greater than National Cancer Institute-Common Toxicity Criteria Grade 1 was noted except one patient had grade 2 pneumonitis. 3D conformal single high-dose boost SRS using our respiratory gating system was useful for the treatment of peripheral TI NSCLC. Less