Positron emission tomography-computed tomography(PET/CT)has been widely used in diagnosis,staging and treatments for Non-small Cell Lung Cancer(NSCLC).The experience of its utilization is accumulated in our country with the technique progression and application.At the same time,the clinical research and application of PET/CT in precise radiotherapy for NSCLC are being updated.In this review,we discuss the research progress of PET/CT guided precise radiotherapy for NSCLC based on our clinical experience and international progress.

Objective Incidence and mortality data of lung cancer collected from population-based cancer registries were analyzed in Chinese registration areas from 2003 to 2007.Methods The analysis was based on the data obtained from 32 cancer registries in China.Incidence and mortality were calculated by cancer site,age,gender and area.Age-specific incidence and mortality trends of lung cancer in different areas were analyzed,and the data between China and other countries in the world obtained in the same period was compared.Results The incidence rate of lung cancer was 48.90 per 100,000 in 2003—2007 in China.Lung cancer,which accounted for 18.39% of the total cancer cases,was the most common cancer in China.The mortality rate of lung cancer was 43.48 per 100,000,translating to 25.30% of all cancer death,which was the leading cause of cancer death in China.The incidence and mortality rates in the 5 years kept increasing steadily while a plat level was present after adjusted by the standard population.Compared with 184 countries or areas worldwide,the incidence and mortality rates of lung cancer in China were higher than the average level of the world,ranked the 30th among males and the 13th among females,respectively.In terms of the mortality rate,it was ranked the 55th for men and the 30th for women among 184 countries.Conclusion Lung cancer is the most important cancer threatening people's health in China.Population aging is the main factor,which contributes to the rising of the incidence rate.Urgent prevention and treatment of lung cancer is needed.

Lung cancer remains one of the most frequent causes of cancer death in worldwide.Most of patients with bronchogenic carcinoma will be diagnosed with Non-small Cell Lung Cancer(NSCLC).With the popularization of computed tomography(CT)screening,NSCLC are increasingly detected at an early stage(IA or IB).Surgical resection remains the standard treatment for patients with stage I NSCLC.But only 60% of them is operable.The conventional radiotherapy administering a total dose of 60~66Gy in 1.8 to 2.0Gy/fraction for early-stage NSCLC is considered reasonable nonsurgical therapy for patients who can not tolerate surgery,with poor local control rates and survival rates.The poor results with conventional radiotherapy have been attributed to doses that are too low to control the tumor.Many long-term follow-up research demonstrate that SBRT has become the standard treatment for patients with early-stage NSCLC who cannot be resected,even for those who can tolerate surgery.

Objective To explore the influence of Bcl-2 gene expression by RNAi on cell cycle and activity of cell and the radiosensitivity of Non-Small cell lung cancer cell line NCI-H460.Methods Making use of pCYU6/GFP/Neo on vectors containing shRNA targeting Bcl-2 gene were transfected into NCI-H460.Western blot were used to compare the efficiency of gene silencing.The transfected cell were exposed to 6Gy X-rays generated by a linear accelerator.MTT and Flow cytometry were used to explore the activity of generation and the cell cycle of NCI-H460.Results Bcl-2/shRNA was successfully transfected NCI-H460 cell lines.Western blot analysis that expression of Bcl-2 was suppressed by Bcl-2/shRNA;The activity of generation of cells transfected with Bcl-2/shRNA was lower than others at 6Gy irradiation,and higher percentage of G₂/M phase was observed on cells transfected with Bcl-2/shRNA than others by cytometry.Conclusion RNAi could inhibit Bcl-2 gene expression and enhance the activity of generation and the cell cycle of NCI-H460 cells.

Objective To study safety and clinical results of single utility port video-assisted thoracoscopic surgery(VATS)for lung cancer.Methods From September 2009 to Octomber 2011,183 lung cancer patients underwent lobectomy and dissection of systematic mediastinal lymph nodes with single utility port video-assisted thoracoscopic surgery.Results Of the 183 patients,38 left upper lobectomy,31 left lower lobectomy,53 underwent right upper lobectomy,16 right middle lobectomy,43 right lower lobectomy,2 bilobectomy.The procedure was successful in all patients with no patient transferred for open thoracotomy.The mean operative time was(136.7±29.2)min,the average number of dissected lymph nodes from each patient was 11.9.The lung cancer was classified as TNM stageⅠA,ⅠB,ⅡA,ⅡB,and ⅢA in 117,22,18,5 and 21 cases,respectively.No post-operative death occurred.The postoperative complications occurred in 12 cases,atelectasis 6 cases,arrhythmia 5 cases,and bleeding 1case.Conclusion Single utility portal VATS is technically safety to perform complete lobectomy and dissection of systematic mediastinal lymph nodes for lung cancer,and with the advantages of lower morbidity and rapid postoperative recovery.

As a kind of precise radiotherapy means,image-guided radiation therapy(IGRT)has been gradually applied in clinical treatment,which obtains exciting clinical curative effect.This review will discuss the research progress of IGRT technology in radiotherapy of lung cancer and provide clinical evidence for promoting IGRT.

The radiation-induced lung injury is in the process of chest radiation therapy for common complications,happening mechanism with many factors related,aimed at the molecular mechanism research into hot.Studies show that many kinds of cell factors such as interleukin(IL),tumor necrosis factor(TNF),transforming growth factor(TGF)associate with radiation-induced lung injury.IL-6 and IL-8 as inflammatory cells factor and anti-inflammatory factor IL-10 in radiation-induced lung injury occurs and play an important role in the development process.

Nowadays,targeted therapies for lung cancer have entered into the clinical phase.Anti-epidermal growth factor receptor (EGFR)drugs have been successfully applied in the clinical treatment of lung cancer.Molecular mechanisms of lung cancer are very complex,more and more attention has been focused on some new molecular targets in lung cancer in recent years.In the present paper we review the roles of these new biomarkers in lung cancer therapy and the progress in clinical research.

More than 47% of cases of all NSCLC are diagnosed in patients over the age of 70 years.Elderly patients have more comorbidities and tend to be less tolerant to toxic medical treatments than younger.Thus,clinical data obtained in a younger population cannot be automatically extrapolated to the great majority of nonselected elderly patients with Non-small Cell Lung Cancer(NSCLC).The bulk of prospective clinical data regarding chemotherapy and molecularly targeted therapy for elderly NSCLC patients come from studies in advanced disease.In elderly advanced NSCLC patients,single-agent chemotherapy with third-generation agents(vinorelbine,gemcitabine,taxanes)is to be considered the routine standard of care for unselected patients,based on phase Ⅱ and Ⅲ trials specifically designed for this special population.Cisplatin-based chemotherapy with cisplatin at has been demonstrated to be an active and feasible option in phase Ⅱ trials.Among targeted therapies,the epidermal growth factor receptor tyrosine kinase inhibitors,erlotinib and gefitinib,antivascular endothelial growth factor monoclonal antibody,bevacizumab,have relevant phase Ⅱ prospective data showing activity and good tolerability as first-line treatment in this population.In this article,we review progress on chemotherapy for elderly advanced NSCLC.

Objective The aim of this study is to explore the prognostic factors of advanced NSCLC patients treated with erlotinib.Methods Clinical characteristics of fifty-five advanced NSCLC patients treated with erlotinib were collected.The association of their clinical characteristics with median progression-free survival time(PFS)and overall survival(OS)was analysed.Results High serum LDH level and grade 0-1 rash were independent risk factors for bad prognostic in patients.Conclusion Serum LDH level and grade of rash are important prognostic factors in advanced Non-small Cell Lung Cancer treated with erlotinib.