Physical Condition Of Patient Research Articles

JS-CME-2: REDUCTION IN CARDIOVASCULAR MORBIDITY AND MORTALITY BY CARDIAC REHABILITATION: WHAT'S THE EVIDENCE?

The Japanese Society of Cardiac Rehabilitation defines cardiac rehabilitation (CR) as follows. Cardiac rehabilitation refers to a long-term, multifaceted, comprehensive program designed to optimize a cardiac patients physical, psychological, social, and vocational status, in addition to stabilizing, slowing, or even reversing the progression of the underlying atherosclerotic or heart failure processes, thereby reducing recurrence, rehospitalization and mortality and enabling patients to live comfortably and actively. CR programs include medical assessment, prescribed exercise training, coronary risk factor modification, patient education, counseling and optimal medical therapy for individual patients, which are provided by a multi-disciplinary team in a coordinated manner. Comprehensive CR consists of continuous multidisciplinary team medical care centered on exercise therapy and disease management. Comprehensive CR improves exercise tolerance and physical function in most heart diseases. Improvements in subjective symptoms and QOL are also observed in many heart diseases. Concerning long-term prognostic improvement effect, it is observed in coronary artery disease and heart failure. Reduced readmissions are also observed in heart failure patients. Mechanisms for improving the long-term prognosis of patients with coronary artery disease and heart failure include: 1) improvement of coronary risk factors, 2) improvement of vascular endothelial function and systemic anti-arteriosclerosis/anti-inflammatory effects via suppression of oxidative stress, 3) improvement of autonomic nerve function, 4) increase in skeletal muscle mass and associated various myokine actions. Based on the above-mentioned evidence, all clinical guidelines of the Japanese Circulation Society, AHA, and ESC strongly recommend participation in CR as class I (evidence and/or general agreement that a given procedure or treatment is effective and useful) for patients after acute myocardial infarction. In post-CABG patients, American and European guidelines recommend CR as Class I. As for chronic heart failure, exercise therapy is strongly recommended as class I in all heart failure clinical guidelines in Japan, Europe, and the United States. However, a clinical problem is the low rate of CR participation in patients with heart disease. This tendency is particularly conspicuous in Japan. Furthermore, an increase in the number of elderly heart failure patients with frailty is also a major issue. There is a need to create a system that supports patients through a community network throughout the acute, recovery, and maintenance phases.

Основні напрямки медико-психологічної реабілітації учасників бойових дій

The war in Ukraine actualized the problem of post-traumatic stress disorder. Comprehensive rehabilitation of combatants after the end of hostilities, that is, after the termination of the stressor, is of particular importance for society. Reducing the impact of the consequences of traumatic stress on somatic health and preventing psychosomatic pathology in these patients is an important task of medicine. The purpose of the study was to analyze the main directions of medical and psychological rehabilitation of combatants and measures to improve them. Materials and methods. A review of the literature in specialized publications and the Internet was carried out. Results and discussion. Medical and psychological rehabilitation of combatants should include several areas: diagnosis of the syndrome of socio-psychological maladaptation; psychological counseling; psychological correction; training in self-regulation skills; socio-psychological trainings; assistance in professional self-determination, career guidance for retraining and subsequent employment. The medical and psychological rehabilitation of combatants should be based on the main provisions of the integrative coping concept, according to which overcoming stress is a process in which an individual attempts to change or eliminate the problem, to reduce its intensity by changing their point of view on it, to ease its impact by distracting themselves from something or using other various coping methods. Conclusion. The results obtained clearly proved that today the rehabilitation of only the physical condition of patients is no longer relevant, since without taking into account the psychological status of the individual, its social adaptation, it is impossible to talk about the full functioning of the individual. All combatants will have to go through a period of social and psychological rehabilitation. The implementation of the Concept of the State Target Program for the physical, medical, psychological, social rehabilitation and professional readaptation of combatants requires the implementation of organizational and legal measures related to the conduct of targeted and coordinated actions on the part of government bodies, executive authorities, local governments, non-state institutions and organizations, and on a nationwide scale should provide medical, social and economic efficiency. The system of providing medical and psychological assistance and rehabilitation of combatants actions in terms of material, technical and personnel support should be considered as a component of the national security of the state

Osteomyelitis therapy with hyperbaric oxygen

Osteomyelitis is a diffuse inflammation that affects the periosteum, cortical bone, and cancellous bone components. The inside of the bone that has been infected will become soft and experience swelling which causes the tissue to press against the outer wall of the bone and the blood vessels in the marrow whichcauses blood flow and oxygen supply to the bone decrease drastically. Usually surgical therapy is needed to treat osteomyelitis, but if the patient's physical condition does not allow it, hyperbaric oxy-gen therapy can be done to increase the supply of oxygen to the hypoxic bones. Hyperbaric oxygen therapy is an adjunctto conven-tional antibiotic or surgical treatment of resistant osteomyelitis, using large, multiposition or monoposition pressure tubes for one patient. The patients are given 100% oxygen with a pressure dose of 2-2.4 Atm for 90-120 minutes per day; five or six times per week for 8 weeks or more. Overall usage ranges from 80 to over 130 hours.

Application of a therapeutic exercise program to improve physical condition in patients with post-COVID-19 syndrome

The post-COVID syndrome is a set of signs and symptoms that can persist from 3 weeks to 3 months after the resolution of an acute process, predominantly including fatigue and dyspnea, this makes it very difficult to return to your activities. the daily life of those who suffer from it. The objective of the research is to propose a therapeutic exercise program that improves physical condition in patients with post-COVID 19 syndrome. To meet the objective, a search and analysis of articles that included information related to post-COVID syndrome was carried out. COVID-19, its evaluation and the treatments provided with therapeutic exercise and respiratory physiotherapy. The proposed program was applied to university staff and students who met the inclusion criteria. Two evaluations were carried out, one initial and one final; the results show significant data of improvement in physical condition. Conclusion: The proposed exercise program allows the patient to recover functionality, impacting the physical condition, which as a consequence improves the quality of life and facilitates their integration into society.

Depression: a new look at etiopathogenesis and treatment

Depression is considered a multifactorial disease, the trigger of which is unknown. Eye diseases and depressive disorders may have a common trigger - excessively constricted pupils (experimental data). The hypothesis of the occurrence of depression: in genetically predisposed individuals, long-term negative emotions cause - through cortico-nuclear pathways - excessive narrowing of the pupils. Narrowed pupils (reduction of light flux) through the optic-vegetative system trigger pathological biochemical processes in the body, which leads to deterioration of the mental and physical conditions of patients. It is proposed to investigate experimentally (taking into account the principle of "direct - feedback" in the optic-vegetative system), whether the terms of treatment of patients with postpartum depression will be shortened when dilating one pupil with atropine (simulation of Adi's syndrome) against the background of standard therapy. With a positive effect of treatment, the above method can be used for other types of depressive disorders

Respiratory frequency-tunable dynamic imaging for lung function: New exam method using chest X-ray cine imaging considering various respiratory diseases.

A convenient way to conduct pulmonary function tests while preventing infectious diseases was proposed, together with countermeasures for severe coronavirus disease 2019 (COVID-19). The correlation between diagnosis result and diagnosis result was examined for patients with mild chronic obstructive pulmonary disease (COPD) of the most abounding as a subject of spirometry, and the possibility of using this method as an alternative to spirometry was examined. This study was conducted in Kanagawa, Japan. Ten normal volunteers and 15 volunteers with mild COPD participated in this study. All images were taken by EXAVISTA (Hitachi, Japan) between October 2019 and February 2020. Continuous fluoroscopic images were taken in 12.5 frames per second for 10-20 s per subject. Images that do not adopt the automatic image processing of the equipment and only carry out the signal correction of each pixel were used for the analysis. The mean total dose for all volunteers was 0.2 mGy. There was no major discrepancy in the detection of lung field geometry, and no diagnostic problems were noted by the radiologist and physician. Existing X-ray cine imaging was used to extract frequency-tunable imaging. It is possible to identify abnormal regions on the images compared to spirometry, and it does not require maximum effort respiration; therefore, it is possible to perform a stable examination because the patient's physical condition and the ability of laboratory technicians on the day are less affected. This can also be used as a countermeasure in examining patients with infectious diseases. UMIN UMIN000043868.

A CASE REPORT ON RIGHT SIDE CORTICO- CAVERNOUS FISTULA

INTRODUCTION: The cortico-cavernous fistula is uncommon and uncommonly uncommon. A cortico-cavernous fistula is characterized by an abnormal vascular connection between the internal or external carotid arteries and the venous channels of the cavernous sinus. If left untreated, it might cause additional complications such as intracerebral hematoma, subarachnoid hemorrhage, epistaxis, and otorrhagia. Secondary cortico-cavernous fistula cause glaucoma.CASE PRESENTATION: The interventional radiology unit of the tertiary care hospital in Wardha received an admission of a 22-year-old man. He arrived complaining of a 15-day-old facial and nasal bone injury, which had left him with suitable eye redness, pain, and edema in addition to a headache. Additionally, he was traumatized by a vehicle accident. There is no history of hematemesis, nausea, or vomiting. There is no history of a cold, a cough, or a concussion. Such illnesses as diabetes mellitus, hypertension, T.B., and asthma were absent. There was a physical examination. Save for the eye, other physical characteristics are typical. Redness and swelling are seen in the right eye. Above the conjunctiva, is a thick, red blood vessel. The S1 and S2 noises were usual. On the abdomen, there are no scars or enlargements.THERAPEUTIC MANAGEMENT: The patient was admitted for interventional radiology therapy of a cortico-cavernous fistula. Vital readings for the patient, like blood pressure, were 120/80. The measurements were 37 °C temperature, 75 b/m pulse, and 15 b/m respiration rate. After the patient's accident-related medical history was obtained, an evaluation of the patient's physical condition, blood work, a C.T. Scan, an MRI, an X-ray, and an E.C.G was evaluated. The patient had received antibiotics, antiplatelet medications, antiemetics, antacids, and analgesics. The patient had received antibiotics, antiplatelet drugs, antiemetics, antacids, and painkillers. The patient has been advised to undergo cortico-cavernous fistula embolization surgery.

Treatment of Scabies in A Persian Mixed Cat at UPTD. Puskeswan, Bukittinggi City

Background: Sarcoptes scabiei is one of the ectoparasites that usually attack cats. This parasitic disease can be transmitted through direct contact with other animals affected by scabies or by the presence of a source of scabies in the area where the cat lives. Purposes: This study aimed to determine the handling of cases of scabies in a Persian mixed-breed cat (Pobo) at UPTD. Puskeswan, Bukittinggi City. Methods: Handling began with anamnesis and continued by examining the patient's physical condition and observing the body parts infected with scabies. A deep skin scraping was performed on the facial area, followed by microscopic and hematological examination. Results: Examination showed Sarcoptes scabiei infestation in the scraped skin layer and the cat was anemic. The cat patient with scabiosis received Ivomec® as an antiparasitic. Symptomatic treatment was also carried out by giving Vet-oxy SB® and Vetadryl® injections as antibiotics because a secondary infection was suspected. Conclusions: The therapy administered showed positive progressive results in the patient.

Activité Physique Adaptée et cancer métastatique : quels besoins et quelles attentes ?

Between October 2019 and March 2020, 60 medical oncologists and 305 patients with metastatic cancer were asked to fill in a self-completed questionnaire. The benefits of physical activity are recognised by most oncologists and patients. These benefits were perceived more by oncologists in prevention (78%) or in the early stage (72%) of the disease than in the metastatic stage (55%) (P=0.01). Patient's physical condition (45%) and age (37%) but also the lack of time during the consultation to explain supportive care (35%) are the main obstacles identified by the oncologist to the integration of physical activity into patient care. Furthermore, lack of knowledge of adapted programmes is the main reason given by the physicians who have never prescribed physical activity (51%). On the patient side, while 88% of them had heard of the benefits of physical activity, only 11% had received a prescription. Most oncologists and patients were very interested in receiving information on where and what types of activities to practice, as well as what to avoid. Efforts in terms of information for both oncologists and patients seem necessary to increase the level of physical activity prescription and practice for patients followed for metastatic cancer.

Stand-Up Assistive Devices Allowing Patients to Perform Voluntary Movements Within the Safety Movement Tolerance

This paper proposes a novel standing assistance robot, which realizes voluntary movements of the patient within a safety motion range. In previous studies, conventional assistive robots did not require patients to use their own physical strength to stand, which leads to decreased strength in the elderly. Such general assistive robots helped patients by using a fixed motion reference pathway in spite of their original intention, and as a result, these robots failed to use the physical strength of the patients. Therefore, this study proposes a novel method for assisting the patient to stand up safely while using their physical abilities, by determining the range of movements that can be safely performed from the patient's physical condition, and allowing the patient to move freely within this range. The standing motion is a set of different movements: inclining the trunk forward, lifting the trunk and extending the trunk. In this study, the range of movements in which the patient can safely stand in each movement was determined in terms of body stability and the muscle output that the patient can generate. Furthermore, this study proposes a robot control method that allows movements based on the patient's free will if the patient's posture is within the safety tolerance, and corrects the movements when the patient's posture is estimated to fall outside of it. Proposed idea is implemented to our new prototype and its effectiveness is verified by experimental results with elderly subjects who lives in the nursing care house.

Effects of Dexmedetomidine on Postoperative Pain and Recovery Time in Obese Patients.

Objective The objective of this study is to investigate the effect of dexmedetomidine on postoperative pain and recovery time in obese patients. Methods A total of 100 obese patients with body mass index (BMI) ≥ 30 kg/m2 who underwent laparoscopic sleeve gastrectomy under general anesthesia in our hospital from January 2019 to December 2021 were included and assigned into DEX group (dexmedetomidine group) and NS group (normal saline group). The bariatric surgery patients who were given normal saline pump were the NS group (n = 50), and the bariatric surgery patients who were given the dexmedetomidine pump were the DEX group (n = 50). The patients in the DEX group were given continuous intravenous infusion of dexmedetomidine before, during, and after induction of anesthesia at a dose of 0.4 μg. kg-1. h-1, 0.4 μg·kg-1. h-1, 0.2 μg·kg-1. h-1, respectively. The NS group was infused with the same volume of normal saline for the same time. The two groups of patients were treated with the same anesthesia induction and maintenance program. By comparing the operation, anesthesia, postoperative extubation, and recovery time of the two groups of patients, the effect of dexmedetomidine on the postoperative recovery time of obese patients was analyzed. Visual analogue scale (VAS) and adverse reactions were compared to analyze the effect of dexmedetomidine on postoperative pain in obese patients. Results The operation, anesthesia, postoperative extubation, and recovery time of the DEX group were significantly lower than those of the NS group, whereas the VAS and adverse reactions were significantly lower than those in the NS group (P < 0.05). Conclusion An appropriate dose of dexmedetomidine in bariatric surgery for morbidly obese patients can effectively shorten the recovery time and extubation time of patients, reduce postoperative pain and the incidence of adverse reactions, and is worthy of clinical application. Dexmedetomidine 2 μg/kg has promising anesthesia benefits in bariatric surgery of obese patients, can provide favorable analgesia and quality of recovery, help reduce the degree of stress response of patients, and does not increase the risk of adverse events. However, this study has certain limitations, so physicians should tailor the dosage according to the patient's physical condition in clinical practice.

Effect of the preoperative physical status on postoperative nausea and vomiting risk: a matched cohort study

BackgroundThe American Society of Anesthesiologists Physical Status Classification System is commonly used for preoperative assessment. Patient physical status before surgery can play an important role in postoperative nausea and vomiting. However, the relationship between the physical status classification and postoperative nausea and vomiting has not been well defined.MethodsAdults aged ≥ 18 years who underwent procedures under anesthesia between 2015 and 2020 were included in the study. We analyzed the relationship of postoperative nausea and vomiting with physical status classification score using propensity score matching and Cox hazard regression. Differences in intraoperative use of vasopressor and inotropes and invasive monitoring were investigated according to the classification.ResultsA total of 163,500 patients were included in the study. After matching, classification 1 versus 2 included 43,400 patients; 1 versus ≤ 3, 13,287 patients; 2 versus ≤ 3, 23,530 patients (absolute standardized difference, 0–0.06). Patients with physical status classification ≤ 3 had a significantly lower postoperative nausea and vomiting risk than those with classification 1–2 (physical status classification 1 vs. ≤ 3, hazard ratio 0.76 [0.71–0.82], P < 0.001; 2 versus ≤ 3, hazard ratio 0.86 [0.82–0.91], P < 0.001). Intraoperative use of vasopressor or inotrope and invasive monitoring were noted more in the high physical status classification than the low physical status classification (absolute standardized difference [0.19–1.25]).ConclusionThere were differences in intraoperative invasive monitoring and use of vasopressor or inotrope among the classifications, and a score of 3 or higher reduced the risk of postoperative nausea and vomiting more than a score of 1–2.

1568P Physical condition in patients with a recent diagnosis of colorectal cancer

Assessment of physical condition (PC) is of utmost interest for physicians and specifically for medical oncologists, since it is highly informative for the process of therapeutic decision-making. PC is the ability to carry out daily tasks with vigour and alertness, without undue fatigue and with ample energy to engage in leisure time pursuits and to meet the above-average physical stresses encountered in emergency situations. The concept of PC includes different components: (a) body composition, (b) cardiorespiratory component, (c) muscular component (muscular strength and muscular endurance), and (d) motor component (balance, flexibility, speed).

Differentiation and prediction of pneumoconiosis stage by computed tomography texture analysis based on U-Net neural network

Background and ObjectiveThe progressive worsening of pneumoconiosis will ensue a hazardous physical condition in patients. This study details the differential diagnosis of the pneumoconiosis stage, by employing computed tomography (CT) texture analysis, based on U-Net neural network. MethodsThe pneumoconiosis location from 92 patients at various stages was extracted by U-Net neural network. Mazda software was employed to analyze the texture features. Three dimensionality reduction methods set the best texture parameters. We applied four methods of the B11 module to analyze the selected texture parameters and calculate the misclassified rate (MCR). Finally, the receiver operating characteristic curve (ROC) of the texture parameters was analyzed, and the texture parameters with diagnostic efficiency were evaluated by calculating the area under curve (AUC). ResultsThe original film was processed by Gaussian and Laplace filters for a better display of the segmented area of pneumoconiosis in all stages. The MCR value obtained by the NDA analysis method under the MI dimension reduction method was the lowest, at 10.87%. In the filtered texture feature parameters, the best AUC was 0.821. ConclusionsCT texture analysis based on the U-Net neural network can be used to identify the staging of pneumoconiosis.

Airway Foreign Bodies in Patients that Underwent Bronchoscopies with General Anesthesia in Dr. Soetomo General Academic Hospital Surabaya

Introduction: Airway foreign body (AFBs) is the most common emergency for ENT-HN (Ear, Nose, Throat-Head Neck) that requires immediate treatment. The gold standard management for AFBs is a bronchoscopy performed under general anesthesia (GA). Objective: This study aims to determine the profile of AFBs patients who underwent bronchoscopies with GA at Dr. Soetomo General Hospital Surabaya from January 2018 – December 2019. Methods and Materials: This is a descriptive, retrospective study that uses data from medical records. Microsoft Excel was used to analyze the data. 22 patients met the inclusion criteria. Results: The most common ages were 11 to 20-year-olds (73%), 55% were female, and 45% were male. The patients were from outside (73%) and inside (27%) Surabaya. As much as 67% of the sampled patients had coughs and 23% were symptomless. The foreign bodies found were pins (67%), clipboard nails (14%), and nuts (9%). These AFBs were located in the left main bronchus (45%), trachea (32%), and right main bronchus (18%), and in 5% of these cases, the AFBs could not be located. The duration between the event and the bronchoscopy was mostly less than 1 day (54%), 2 days (32%), and 3 days (14%). Most cases (90%) were without AFBs complications, but some had obstruction (5%), and hemoptysis (5%). Most patients also had an uncomplicated bronchoscopy (81%), however, some suffered lesions (14%) and bleeding (5%). A majority of the patients were also ASA I (68%), and the remainder were classified as ASA II (18%), and III (14%). The premedication drugs administered were fentanyl (41%), and a combination of fentanyl and midazolam (41%). Meanwhile, the most frequently maintained anesthetic agent was Isoflurane+O2 (27%). Most patients also did not have any comorbid factors (85%), but some had anemia (5%), obstruction (5%), as well as obesity followed by sputum retention and hypernatremia (5%). Conclusion: Most AFB patients who underwent bronchoscopy under GA were 11-20 years old, female, and had a cough as a clinical symptom. Most AFBs were pins at the left main bronchus. The duration between the incident and the bronchoscopy was less than 1 day. There were also mostly no complications of AFBs and bronchoscopies. The most common physical status in patients was ASA I, with fentanyl only or fentanyl and midazolam as a premedication drug. The most common agent used to maintain the anesthesia was a combination of isoflurane and O2. Most patients also had no comorbid factors for GA.

Chemotherapy drug potency assessment method of ovarian cancer cells by digital holography microscopy

Drug potency assessment plays a crucial role in cancer chemotherapy. The selection of appropriate chemotherapy drugs can reduce the impact on the patient's physical condition and achieve a better therapeutic effect. Various methods have been used to achieve in vitro drug susceptibility assays, but there are few studies on calculating morphology and texture parameters quantitatively based on phase imaging for drug potency assessment. In this study, digital holography microscopy was used to get phase imaging of ovarian cancer cells after adding three different drugs, namely, Cisplatin, Adriamycin, and 5-fluorouracil. Based on the reconstructed phase imaging, four parameters of ovarian cancer cells changed with time, such as the average height, projected area, cluster shade, and entropy, were calculated. And the half-inhibitory concentration of cells under the effect of different drugs was calculated according to these four parameters. The half-inhibitory concentration, which can directly reflect the drug potency, is associated with the morphological and texture features extracted from phase images by numerical fitting. So, a new method for calculating the half-inhibitory concentration was proposed. The result shows that the morphological and texture feature parameters can be used to evaluate the sensitivity of ovarian cancer cells to different drugs by fitting the half-inhibitory concentration numerically. And the result provides a new idea for drug potency assessment methods before chemotherapy for ovarian cancer.

Using mHealth Technologies to Promote Public Health and Well-Being in Urban Areas with Blue-Green Solutions.

European and International cities face crucial global geopolitical, economic, environmental, and other changes. All these intensify threats to and inequalities in citizens' health. The implementation of Blue-Green Solutions in urban and rural areas have been broadly used to tackle the above challenges. The Mobile health (mHealth) technologies contribution in people's well-being has found to be significant. In addition, several mHealth applications have been used to support patients with mental health or cardiovascular diseases with very promising results. The patients' remote monitoring can be a valuable asset in chronic diseases management for patients suffering from diabetes, hypertension or arrhythmia, depression, asthma, allergies and others. The scope of this paper is to present the specifications, the design and the development of a mobile application which collects health-related and location data of users visiting areas with Blue-Green Solutions. The mobile application has been developed to record the citizens' and patients' physical activity and vital signs using wearable devices. The proposed application can also monitor patients physical, physiological, and emotional status as well as motivate them to engage in social and self-caring activities. Additional features include the analysis of the patients' behavior to improve self-management. The "HEART by BioAsssist" application could be used as a health and other data collection tool as well as an "intelligent assistant" to monitor and promote patient's physical activity.

Physical rehabilitation for fractures of the lower extremities in mature men

Features of physical rehabilitation at fractures of the lower extremities in men, which are one of the most dangerous and serious traumatic conditions, are considered. The program of physical rehabilitation, which allows the most economical and rational approach to solving the problem of rehabilitation of patients with diaphysis and fragmentary fractures of the tubular bones of the lower extremities. he effectiveness of this program, which included exercise therapy; physiotherapy; massage and hydromassage, gave positive results and the recovery process took less time. The program will help restore walking skills and improve the physical condition of patients through methods, principles, objectives of physical therapy.

Effects of Exercise in People with Severe Mental Illness and Recommendations for its Implementation as Add-on Therapy

There are many reasons for people with (and without) severe mental illness to exercise regularly. In people with schizophrenia, major depression and bipolar disorder, it has already been shown that regular physical activity as an add-on therapy can improve quality of life and symptom severity. This is particularly important in domains that standard therapy is currently not able to treat sufficiently, such as cognitive deficits. Postulated underlying neurobiological effects include increased volume in hippocampal areas as demonstrated by data of a current clinical trial in people with schizophrenia.Furthermore, regular exercise is essential to counteract the increased cardiovascular morbidity and mortality of people with severe mental illness. However, most people with severe mental illness do not achieve the recommended amount of physical activity and the potential of exercise as an add-on therapy is currently not even close to being fully realized. On the one hand, it is important that mental health staff also considers the physical condition of patients with mental illnesses and counsels them on their health behavior. On the other hand, there is a need for individually adapted training programs delivered by qualified exercise professionals that incorporate motivational and adherence strategies. Examples of barriers and facilitators for the implementation of exercise as an add-on therapy are discussed on the basis of current local projects.DisclosureNo significant relationships.

A phase I study of anlotinib with concurrent chemoradiotherapy for limited-stage small cell lung cancer.

8579 Background: Concurrent chemoradiotherapy (CCRT) is the standard treatment for limited-stage small-cell lung cancer (LS-SCLC). However, LS-SCLC remains an area of high unmet medical need. Anlotinib is an antiangiogenic multi-target tyrosine kinase inhibitor. In the phase II ALTER-1202 trial, anlotinib significantly improved clinical outcomes in advanced small-cell lung cancer. We report here a phase 1 trial of anlotinib with CCRT for LS-SCLC. Methods: This is a prospective, single-arm, phase I clinical trial using a 3+3 design. Patients aged between 18 and 75 with previously untreated LS-SCLC, PS 0-1 and adequate organ function are eligible. Patients received anlotinib (12mg, qd, d1-14, q3w) and chemotherapy (etoposide, 100 mg/m2, d1-3, q3w and cisplatin, 25 mg/m2, d1-3, q3w) for cycle 1, then anlotinib [dose escalation at 3 levels (DL1-3) 8mg, 10mg and 12mg, qd, d1-14, q3w], chemotherapy (etoposide, 50 mg/m2, d1-5, q4w and cisplatin, 25 mg/m2, d1-3, q4w) and thoracic radiotherapy (60-66 Gy in 30-33 daily 2-Gy fractions starting on day 1 of cycle 2) for cycles 2–3, then anlotinib (12mg, qd, d1-14, q3w) and chemotherapy (etoposide, 100 mg/m2, d1-3, q3w and cisplatin, 25 mg/m2, d1-3, q3w) for cycles 4-6. Cycles 5-6 were given as appropriate according to the patient's physical condition. Prophylactic cranial radiation was given according to the judgment of the investigator after CCRT. The purpose of this study is to determine the maximum tolerated dose (MTD) of anlotinib when combination with CCRT. Results: Twelve patients were enrolled from May 2020 to September 2021. No DLTs were observed in DL1 (3 patients) or DL2 (3 patients). At DL3 (6 patients), 1 patient had a DLT of grade 3 pulmonary embolism. Grade 3 adverse events were white blood cell count decreased, neutrophil count decreased, lymphocyte count decreased, hypertension, albumin decreased and pulmonary embolism. One patient had grade 3 pulmonary embolism and grade 4 neutrophil count decreased in DL3 at cycle 1. One patient had grade 2 radiation pneumonitis after cycle 5 and grade 1 radiation esophagitis at cycle 3 in DL3. One patient had grade 2 radiation esophagitis at cycle 3 in DL2. The MTD was not reached. Conclusions: Combined treatment with anlotinib and CCRT for limited-stage small cell lung cancer is well tolerated and further clinical investigation is warranted. Clinical trial information: NCT04882033.