手术前后血清血管内皮生长因子水平与非小细胞肺癌的关系

目的探讨非小细胞肺癌患者手术前、后血清血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)的动态变化规律及其与非小细胞肺癌(non-smallcelllungcancer.,NSCLC)的关系。方法采用ELISA法检测120例非小细胞肺癌患者手术前、后血清VEGF水平和60例健康体检者血清VEGF水平。结果①NSCLC患者手术前、术后第1天及术后第7天血清VEGF水平显著高于正常对照组(P<0.01),分别为:(270.8±82.4)pg/ml、(302.7±85.6)pg/ml、(523.8±91.3)pg/ml和(91.4±40.7)pg/ml;②NSCLC患者术后第7天血清VEGF水平显著高于术前和术后第1天血清VEGF水平(P<0.01),分别为:(523.8±91.3)pg/ml、(270.8±82.4)pg/ml和(302.7±85.6)pg/ml;③NSCLC患者手术前、后血清VEGF水平与肺癌原发肿瘤大小、淋巴结转移和分期呈正相关(P<0.05),与肺癌细胞分化程度、组织学类型、患者性别和年龄无关(P>0.05)。结论NSCLC患者血清VEGF水平升高,且与NSCLC的发生、发展和淋巴结转移呈正相关,NSCLC患者血清VEGF水平可作为检测NSCLC患者病情进展、判断预后的参考指标。     

血管内皮生长因子在非小细胞肺癌患者血清中表达的研究

目的:研究血管内皮生长因子(VEGF)在非小细胞肺癌(NSCLC)患者血清中的表达及其与NSCLC疗效、组织病理类型、分期的关系。方法:收集符合入组条件的NSCLC患者60例,血清标本分别在化疗前和化疗2个周期后抽取,同时选取30例健康人血清做为对照组,应用酶联免疫吸附法测定VEGF含量。化疗采用NP方案。结果:NSCLC患者血清VEGF含量水平高于健康对照组,分别为(736.16±34.67)pg/ml和(197.22±36.40)pg/ml;NSCLC患者化疗前后血清VEGF水平分别为(736.16±34.67)pg/ml和(406.14±56.24)pg/ml,两者差异有统计学意义(P<0.01)。NSCLC患者治疗前血清中VEGF水平与临床分期相关,Ⅲ期和Ⅳ期NSCLC患者血清VEGF水平分别为(695.50±30.30)pg/ml和(815.95±36.85)pg/ml,两者差异有统计学意义(P<0.01),而与NSCLC肿瘤组织类型、年龄、性别、吸烟与否等无关。结论:NSCLC组血清VEGF表达水平明显高于健康人,化疗能够降低NSCLC患者血清VEGF表达,疗效不同的NSCLC患者化疗后VEGF变化趋势有所不同,治疗前血清VEGF含量与NSCLC临床分期相关。     

小细胞肺癌患者血清血管内皮生长因子含量水平的临床意义

目的探讨小细胞肺癌(SCLC)患者血清血管内皮生长因子(sVEGF)水平的临床意义。方法用酶联免疫吸附法(ELISA)测定45例SCLC患者、30例肺炎及50例健康人sVEGF的含量,并分析了sVEGF与患者临床分期、淋巴结及远处转移、化疗效果及化疗前后关系。结果SCLC组sVEGF水平(325.21±45.22μg/ml)明显高于对照组(175.18±60.56μg/ml,P<0.001)及肺炎组(182.29±45.22μg/ml,P<0.01),Ⅰ、Ⅱ期SCLC患者sVEGF水平(328.38±35.21μg/ml)低于Ⅲ、Ⅳ期(379.12±61.51μg/ml,P<0.005);与无转移者比较,淋巴结及远处转移者具较高的sVEGF水平(368.54±44.27μg/ml,P<0.001;376.21±21.52μg/ml,P<0.001)。29例患者治疗3个月后sVEGF水平下降(258.23±31.53μg/ml,P<0.001),但当肿瘤复发时sVEGF升高。结论SCLC者sVEGF变化与肿瘤转移、复发及预后等可能有关。     

非小细胞肺癌患者血清中VEGF和Ang-2的表达和临床意义

目的:检测非小细胞肺癌（NSCLC）患者血清中血管内皮生长因子（VEGF）和血管生成素-2（Ang-2）的含量,探讨血清中VEGF和Ang-2与肿瘤血管生成的关系及其临床意义。方法:收集40例NSCLC患者血清和肿瘤组织,以40例健康志愿者血清为对照,采用ELISA方法检测血清中VEGF和Ang-2的含量,应用免疫组化法检测肿瘤组织中的微血管密度（MVD）,分析血清中VEGF和Ang-2与肿瘤血管生成、临床病理资料和预后的相关性。结果:NSCLC患者血清中VEGF［（625.6±312.5）pg/ml］和Ang-2［（2450.2±1021.1）pg/ml］的含量明显高于正常对照组血清中VEGF［（321.4±102.6）pg/ml］和Ang-2［（1020.6±421.6）pg/ml］的含量（P<0.05）。NSCLC患者血清中VEGF和Ang-2的含量均与肿瘤的MVD呈正相关(r=0．525,P<0.01;r=0．612,P<0.01)。NSCLC患者血清中VEGF和Ang-2的含量与肿瘤大小、淋巴结转移及临床分期有关（P<0.05）。血清中VEGF和Ang-2高表达的患者总生存时间明显低于低表达患者（P<0.05）。结论:VEGF和Ang-2 在NSCLC的血管生成和发展中发挥重要作用,两者可作为NSCLC诊断和预后判断的潜在的分子标志物。     

VEGF、ICAM-1和MMP-9在良恶性胸腔积液中的作用

目的研究血管内皮生长因子(VEGF)、细胞间粘附分子1(ICAM-1)和基质金属蛋白酶9(MMP-9)在良恶性胸腔积液形成过程中的作用.方法81例胸腔积液患者分成4组::27例胸液细胞学检查阳性的肺癌患者、16例胸液细胞学检查阴性的肺癌患者、26例结核性胸腔积液,12例其它病因(8例低蛋白血症、4例心衰).采用双抗体夹心法(ELISA)分别检测胸液中可溶性血管内皮生长因子(sVEGF)、可溶性细胞间粘附分子1(slCAM-1)和MMP-9的表达水平.结果胸液中sVEGF、sI-CAM-1和MMP-9的含量为,肺癌恶性胸液细胞学检查阳性组(1187±757pg/ml,1423±607 ng/ml,151±112 ng/ml)、肺癌恶性胸液细胞学检查阴性组(655±538pg/ml,968±397,120±88 ng/ml)、结核性胸液组(465±565 pg/ml,1037±371 ng/ml,178±130 ng/ml)和其它病因组(116±78pg/ml,86±45,36±15 ng/ml).各组之间的sVEGF相比均有显著性差异(P＜0.05),而恶性与结核性胸液中的sICAM-1和MMP-9均明显高于其它病因组(P＜0.01).胸液中的sVEGF和sICAM-1与乳酸脱氢酶(LDH)水平呈显著性正相关(γ=0.58,0.38;P＜0.05),MMP-9与腺苷脱苷酶(ADA)呈正相关(γ=0.38,P＜0.05).结论恶性胸腔积液的形成与VEGF密切相关,同时ICAM-1和MMP-9也在恶性胸液的形成机制中起着重要的作用,而MMP-9可能与结核性胸膜炎的纤维化形成的组织重建有关.     

NSCLC患者血清Ang2与VEGF动态变化的关系

目的 探讨非小细胞肺癌（NSCLC）患者病程中血管生成素2（Ang2）和血管内皮生长因子（VEGF）的变化情况,评价在肿瘤发生、进展、预后的临床意义。方法 对82例首诊未经治疗的NSCLC患者行ELISA法定量检测外周血Ang2与VEGF水平。结果 NSCLC患者外周血Ang2与VEGF水平较对照组明显升高［Ang2：（1326.8±942.9）pg/ml vs. （445.0±213.0） pg/ml, P<0.01;VEGF：（846.8±459.6）pg/ml vs. （691.3±369.6） pg/ml, P<0.05］。Ang2在早期NSCLC开始明显升高,但在各进展期之间比较差异无统计学意义,进入晚期后在越接近死亡的患者Ang2又再有上升趋势。VEGF在早期未见升高,进入进展期后逐渐升高,在未有远处转移的患者,原发灶直径越大,VEGF越高。COX回归分析显示临床分期与VEGF是NSCLC生存预后的独立危险因素(P<0.05）。结论 NSCLC患者血清Ang2与 VEGF均明显升高, 对早期NSCLC患者检测血清Ang2较VEGF有更好的辅助诊断价值,在NSCLC进展期检测血清VEGF较Ang2更有助于评价肿瘤进展情况,在NSCLC晚期检测血清Ang2升高较VEGF更能提示临终期。     

晚期非小细胞肺癌外周血血管内皮生长因子检测及其临床意义

目的 探讨晚期非小细胞肺癌(NSCLC)患者血清中血管内皮生长因子(sVEGF)水平及评价其临床意义.方法 应用酶联免疫吸附法(ELISA)测定sVEGF在96例晚期NSCLC患者血清中的表达,分别给含顺铂的联合化疗方案2～4个周期后再测定其sVEGF水平;同时检测50例健康体检者的sVEGF水平.结果 肺癌患者sVEGF含量明显高于健康对照组(P＜0.01);腺癌sVEGF水平与鳞癌相比差异无统计学意义(P＞0.05);Ⅲ、Ⅳ期患者sVEGF水平相比差异无统计学意义(P＞0.05);所有缓解病例化疗后sVEGF水平均显著下降(P＜0.05).结论 晚期NSCLC患者sVEGF水平与其诊断及治疗效果密切相关.     

血清VEGF表达水平与不能手术非小细胞肺癌同期放化疗相关性研究

目的 检测不能手术的非小细胞肺癌(NSCLC)患者在同期放化疗前后血清VEGF(sVEGF)水平,探讨其变化规律与病理生理特征、疗效及预后相关性.方法 采用ELISA双抗体夹心法定量检测50例不能手术NSCLC患者同期放化疗前后sVEGF表达水平,同时检测75例健康人群sVEGF水平.治疗前患者与健康对照比较采用成组t检验,治疗前后比较采用配对t检验.结果 患者治疗前sVEGF水平均显著高于对照组,分别为(241.09±52.45)ng/L和(103.72±39.22)ng/L(t=2.50,P＜0.05).治疗前sVEGF表达水平与原发灶大小、远处转移、细胞分化及临床分期有关(t=9.61～14.94,P值均＜0.05),与原发部位、淋巴结转移、组织学类型、年龄及吸烟史均无关(t=0.58～1.84,P值均＞0.05).治疗前VEGF水平显著高于治疗后水平,分别为(241.09±52.45)ng/L和(133.64±33.62)ng/L(t=12.20,P＜0.01).治疗后sVEGF平均水平与治疗前比较,完全缓解组均显著降低(92.35 ±37.48)ng/L(t=3.79,P＜0.01),进展组降低不明显(276.32±47.98)ng/L(t=1.32,P＞0.05),而部分缓解组和无变化组介于两者之间(113.10±39.20)ng/L(t=13.58,P＜0.01)和(198.10±42.68)ng/L(t=4.78,P＜0.05).结论 同期放化疗前后sVEGF表达水平与不能手术NSCLC的发生发展、远处转移、细胞分化和临床分期等密切相关,其表达水平的变化是预测不能手术NSCLC生物学行为的有效指标,可为疗效和预后判断提供实验依据.     

血清中肝细胞生长因子含量对非小细胞肺癌的影响

目的:探讨血清中肝细胞生长因子(HGF)含量对非小细胞肺癌(NSCLC)的影响.方法:用ELASA方法测定12例肺良性疾患和54例非小细胞肺癌(NSCLC)患者血清中肝细胞生长因子(HGF)含量在术前及术后第1、3、7、14天的变化,测定12例健康者血清中HGF含量.结果:12例健康者和12例肺良性疾病患者血清中都有微量的肝细胞生长因子(HGF),而肺癌患者血清中HGF含量(470.7±378.4pg/ml)明显高于正常健康者和肺良性疾病患者(P＜0.05),其含量与病理类型、病理组织分级和临床分期、淋巴结转移情况无关.2年随访46例中死亡16例,其血清HGF含量明显高于30例生存者(P＜0.05),21例血清HGF≥400pg/ml,其生存率明显低于＜400pg/ml者(P＜0.05).66倒手术患者术后血清HGF含量明显升高,术后第3天达高峰,而且肺癌患者术后第3天血HGF含量明显高于肺良性疾病(P＜0.05).术后第7、14天逐渐下降,而16例死亡病例术后第14天血清HGF仍明显高于术前(P＜0.05).结论:增高的血清HGF在肺癌中预示了一种更具有侵袭性的生物学行为.血清HGF含量水平可作为早期肺癌患者的高危因素指标.术后2周血HGF含量对指导预后更有意义.血清HGF含量400pg/ml可望成为不良预后指标的参照值.     

小细胞肺癌化疗前后血清VEGF的变化及临床意义

目的:探讨化疗前后小细胞肺癌(SCLC)患者血清血管内皮生长因子(sVEGF)水平及临床意义.方法:用酶联免疫吸附法(ELISA)测定48例SCLC患者化疗前后sVEGF的变化,并与健康志愿者做对照.结果:化疗前SCLC组sVEGF水平为(351.57±30.93)μg/ml,健康志愿者(128.83±13.90)μg/ml,差别有统计学意义(P＜0.01).化疗后sVEGF为(274.99.4±38.20)μg/ml,明显低于化疗前(P＜0.01),但仍然高于健康志愿者(P＜0.01).结论:SCLC组sVEGF水平明显高于健康志愿者,化疗可以降低SCLC患者sVEGF水平,但仍高于健康志愿人,加用抗血管生成的分子靶向治疗是必要的.     

洛铂联合多西他赛行肿瘤细胞减灭术加腹腔热灌注化疗治疗腹膜癌的临床观察

目的 分析洛铂联合多西他赛行肿瘤细胞减灭术（cytoreductive surgery, CRS）加腹腔热灌注化疗（hyperthermic intraperitoneal chemotherapy, HIPEC）治疗腹膜癌（peritoneal carcinoma, PC）的围手术期安全性及疗效。 方法 PC患者行CRS+HIPEC治疗,药物为洛铂50 mg/m2、多西他赛60 mg/m²,加入12 000 ml 0.9%氯化钠溶液加热至（43±0.5）℃持续灌注60 min。记录术后6天体温和心率变化、围手术期不良事件、血常规及血生化指标、术后患者恢复情况及生存结果。结果 90例PC患者行95次CRS+HIPEC,手术时间180~450 min (中位数485 min）;术后6天最高体温、心率分别为36.4℃~38.6℃（中位数37.5℃）、76~124 bpm（中位数100 bpm）,严重不良事件16例,包括围手术期死亡2例。中位生存期20.8月（95%CI: 13.1~25.8月）,1、3、5年生存率分别为75.6%、45.6%、43.3%。 结论 洛铂联合多西他赛进行CRS+HIPEC治疗PC安全性可接受,有助于延长患者生存期。     

Endoscopic Endonasal Dacryocystorhinostomy: Best Surgical Management for DCR

EEDCR is a highly rewarding Endoscopic procedure for management of dacryocystitis when epiphora does not respond to medications or repeated syringing of nasolacrimal duct. It is a simple, less time consuming, safe but skilful, highly satisfying surgery both for the patients as well as the surgeons. There is very big advantage of EEDCR, it is close 100% successful procedure, even if there is recurrence of epiphora it is again correctable fully with no residual affects. EEDCR is far more superior to External DCR/Laser DCR and there are definite reasons for it. A total number of 578 cases have been operated by me from April 1, 2005 to March 31, 2011, only very few reoccurrences were there and they were corrected easily so much so that it can be said that it is a close 100% successful procedure and best surgical management of DACRYOCYSTITIS up to date. The successful outcome was defined as symptomatic relief from epiphora and dacryocystitis and a patent nasolacrimal duct upon syringing at the end of procedure and on follow up of patient.     

参麦注射液对阿霉素所致大鼠心肌损伤保护作用的实验研究

目的　观察参麦注射液 (SMI)对阿霉素 (ADM )诱导大鼠心肌损伤的保护作用和抗氧化作用。方法　选用ADM诱导大鼠心肌损伤模型。SD大鼠 60只 ,随机分为 3个组 ,每组 2 0只 ,分别为正常组、治疗组、对照组。正常组 :实验第 1～ 9天注射生理盐水 ,每天 3ml/kg ,1次 /天。治疗组 :实验第 1～ 9天注射参麦注射液 ,每天 3ml/kg ,1次 /天 ,第 4天注射阿霉素 ,隔天 1次 ,连用 3次 ,用生理盐水配置成 1mg/ml,每次 3mg/kg。对照组实验 1～ 9天注射生理盐水 ,每天 3ml/kg ,1次 /天。第 4天注射阿霉素 ,以后隔天 1次 ,连用 3次 ,用生理盐水配置成 1mg/ml,每次 3mg/kg。到期测定血丙二醛 (MDA )含量和超氧化物歧化酶(SOD )活性 ,并进行心肌病理检查。结果　对照组MDA水平明显高于治疗组 ,对照组SOD水平则显著低于治疗组 ,即加用SMI可提高SOD活性 ,降低MDA含量。SMI能明显减轻大鼠心肌损伤 ,对照组与治疗组比较 ,治疗组心肌损伤明显减轻 ,治疗组与正常组比较无显著性差异。参麦注射液有抗氧化作用 ,与对照组比较 ,血SOD水平升高 ,MDA水平降低 ,心肌病理计分下降。结论参麦注射液有抗氧化作用和对阿霉素所引起的心脏毒性具有保护作用 ,为临床寻找有效的阿霉素所致心肌损伤保护药物提供良好的客观依据 ,值得临床推广应用     

Denosumab in patients with cancer and skeletal metastases: A systematic review and meta-analysis

Background

We conducted a systematic review of the literature to determine the efficacy and safety of denosumab in reducing skeletal-related events (SRE) in patients with bone metastases.

Methods

A literature search using MEDLINE, EMBASE, Web of Science and The Cochrane Collaboration Library identified relevant controlled clinical trials up-to-March 14, 2012. Two independent reviewers assessed studies for inclusion, according to predetermined criteria, and extracted relevant data. The primary outcomes of interest were SRE, time to first on-study SRE, and overall survival. Secondary outcomes included pain, quality of life, bone turnover markers (BTM), and adverse events.

Results

Six controlled trials including 6142 patients were analyzed. Compared to zoledronic acid, denosumab had lower incidence of SRE with a risk ratio (RR) of 0.84 (95% confidence intervals (CI) 0.80–0.88), delayed the onset of first on-study SRE (RR 0.83; 95% CI 0.75–0.90) and time to worsening of pain (RR 0.84; 95% CI 0.77–0.91). No difference was observed in overall survival with pooled hazard ratio of 0.98 (95% CI 0.90–1.0). For total adverse events, denosumab was similar to zoledronic acid (RR 0.97; 95% CI 0.89–1.0). No significant differences were observed in the frequency of osteonecrosis of the jaw (RR 1.4; 95% CI 0.92–2.1). Patients on denosumab had a greater risk of developing hypocalcemia (RR 1.9; 95% CI 1.6–2.3).

Conclusions

Denosumab was more effective than zoledronic acid in reducing the incidence of SRE, and delayed the time to SRE. No differences were found between denosumab and zoledronic acid in reducing overall mortality, or in the frequency of overall adverse events.     

体内诱导艾氏腹水瘤细胞的耐药性研究

肿瘤细胞耐药性的存在是临床化疗失败的主要原因之一。本实验在小鼠体内用阿霉素（ADR）诱导艾氏腹水瘤细胞（EHR）的耐药性，探讨细胞产生耐药性的机理。HPLC法测定细胞内药物浓度．结果表明耐药细胞─—EHR/ADR细胞内ADR积聚低于EHR细胞，而对ADR外排快于EHR细胞；异博定（VER）增加EHR／ADR细胞对ADR的摄取并阻滞其外排．而对EHR影响不大，揭示EHR／ADR细胞具有MDR特性。     

邻近腋窝的上皮样血管内皮瘤1例报道

We described a case of a 71-year-old woman with an epithelioid hemangioendothelioma (EHE) in her left axilla,a rare location which hasn't been reported yet. The patient suffered from numbness, pain and decreased muscle strength of her left upper extremity. Sonography revealed a hypoechoic mass surrounded the axillary artery and brachial artery. No obvious capsule was demonstrated. CT showed a soft-tissue mass with some calcifications and peripheral ring-like en-hancement. The MRI indicated a mass with mainly intermediate signal intensity on Tl-weighted imagine and intermediate signal intensity on T2-weighted imagine. The diagnosis was confirmed by histopathologic examination after surgery. There are some correlations of these imaging features with its histopathologic characters.     

Oxygen for relief of dyspnoea in mildly- or non-hypoxaemic patients with cancer: a systematic review and meta-analysis

The aim of this study was to determine the efficacy of palliative oxygen for relief of dyspnoea in cancer patients. MEDLINE and EMBASE were searched for randomised controlled trials, comparing oxygen and medical air in cancer patients not qualifying for home oxygen therapy. Abstracts were reviewed and studies were selected using Cochrane methodology. The included studies provided oxygen at rest or during a 6-min walk. The primary outcome was dyspnoea. Standardised mean differences (SMDs) were used to combine scores. Five studies were identified; one was excluded from meta-analysis due to data presentation. Individual patient data were obtained from the authors of the three of the four remaining studies (one each from England, Australia, and the United States). A total of 134 patients were included in the meta-analysis. Oxygen failed to improve dyspnoea in mildly- or non-hypoxaemic cancer patients (SMD=-0.09, 95% confidence interval -0.22 to 0.04; P=0.16). Results were stable to a sensitivity analysis, excluding studies requiring the use of imputed quantities. In this small meta-analysis, oxygen did not provide symptomatic benefit for cancer patients with refractory dyspnoea, who would not normally qualify for home oxygen therapy. Further study of the use of oxygen in this population is warranted given its widespread use.     

鼻咽癌患者放射性骨坏死引起的正电子显像假阳性结果1例及文献复习

目的:探讨鼻咽癌(NPC)患者放射性骨坏死(osteoradionecrosis,ORN)引起正电子假阳性结果的原因及避免因此引发诊断错误的方法。方法:回顾性分析1例放疗后的鼻咽癌患者,行鼻咽部MRI及正电子显像后,再行组织病理学检查,对三种结果进行分析、比较。结果:MRI及正电子显像均诊断患者颅底区域肿瘤复发,组织病理学结果则显示鼻咽部病灶为放射性骨坏死。因此正电子扫描结果为假阳性结果。结论:鼻咽癌患者放疗后所致的放射性骨坏死容易引起正电子显像假阳性结果并可能引发不必要的治疗,因此NPC患者的正电子图像,对于可能的局限性肿瘤复发诊断,应该非常慎重。     

Bortezomib-related neuropathy may mask CNS relapse in multiple myeloma: A call for diligence

Background: Neuropathy is a common adverse effect of bortezomib. Isolated central nervous system (CNS) relapse in MM remains exceedingly rare and carries a dismal prognosis. We present an unusual case of bortezomib related neuropathy masking a CNS relapse of MM. Case presentation: A 57-year-old female was diagnosed with standard-risk MM with clinical and cytogenetic features not typically associated with CNS involvement. She was treated with 4 cycles of bortezomib/cyclophosphamide/dexamethasone (VCD) and achieved a VGPR, after which she underwent an autologous stem cell transplant (ASCT) followed by bortezomib maintenance. Six months after ASCT she developed symptoms suggestive of peripheral neuropathy which was attributed to bortezomib. However the symptoms persisted despite discontinuation of bortezomib. Imaging and cerebrospinal fluid analysis subsequently confirmed a CNS relapse. Discussion: CNS involvement in MM (CNS-MM) is uncommon and is considered an aggressive disease. Recently published literature has reported biomarkers with prognostic potential. However, isolated CNS relapse is even less common; an event which carries a very poor prognosis. Given the heterogeneous neurologic manifestations associated with MM, clinical suspicion may be masked by confounding factors such as bortezomib-based therapy. The disease may further remain incognito if the patient does not exhibit any of the high risk features and biomarkers associated with CNS involvement. Conclusion: In the era of proteasome inhibitor (PtdIns)/immunomodulator (IMID)-based therapy for MM which carries neurologic adverse effects, it is prudent to consider CNS relapse early. This case further highlights the need for more robust biomarkers to predict CNS relapse and use of newer novel agents which demonstrate potential for CNS penetration.     

GF方案与TP方案一线治疗晚期非小细胞肺癌的临床对照研究

Objective  

The aim of the study was to evaluate the efficacies of initial gemcitabine plus cisplatin (GP) and paclitaxel plus cisplatin (TP) 1st-line chemotherapies for advanced non-small cell lung cancer (NSCLC) and observe their side effects.