Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer
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Kappa statistics is used for the assessment of agreement between two or more raters when the measurement scale is categorical. In this short summary, we discuss and interpret the key features of the kappa statistics, the impact of prevalence on the kappa statistics, and its utility in clinical research. We also introduce the weighted kappa when the outcome is ordinal and the intraclass correlation to assess agreement in an event the data are measured on a continuous scale.
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Malignant airway obstruction accounts for significant morbidity and mortality in patients with lung and metastatic cancer. We prospectively assessed the effects of bronchoscopic interventions for the treatment of malignant airway obstruction, with specific attention to exercise capacity and quality of life (QoL). ⋯ Bronchoscopic intervention for malignant airway obstruction is associated with improvement in 6MWT, spirometry, and dyspnea at 30 days.
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Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive modality with a high diagnostic yield for mediastinal lymph node staging of patients with lung cancer. Although limited to the use of needle aspiration during EBUS-TBNA, aspirates has been shown to be useful for molecular analysis. However, the ideal methodology of the specimen handling during EBUS-TBNA has not been described. ⋯ Obtaining adequate samples through a non-surgical biopsy technique for pathologic diagnosis as well as molecular analysis will be of immediate importance for personalized management of lung cancer. EBUS-TBNA is an ideal approach that allows combined pathological and molecular analysis of metastatic lymph nodes.
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Based on favorable preliminary clinical data and the need to identify effective, well-tolerated neoadjuvant regimens for patients with locally advanced esophageal cancer, this clinical trial was undertaken. ⋯ The neoadjuvant regimen tested within this phase II trial demonstrated antineoplastic activity but fell short of yielding a complete pathologic response rate that merits further testing.
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Randomized Controlled Trial Multicenter Study
Pemetrexed with or without matuzumab as second-line treatment for patients with stage IIIB/IV non-small cell lung cancer.
This randomized phase II study investigated pemetrexed in combination with the epidermal growth factor receptor (EGFR)-targeting monoclonal antibody matuzumab compared with pemetrexed alone as second-line therapy for patients with advanced non-small cell lung cancer. ⋯ Although the analysis on the pooled matuzumab-treated arms did not demonstrate a statistically significant improvement in objective response for the addition of matuzumab to pemetrexed compared with pemetrexed alone, the trends for improvement in objective response and overall survival for pemetrexed plus weekly matuzumab compared with pemetrexed alone warrant confirmation in additional clinical trials.