| Objective: In recent years, along with the developing of evidence-based medicine in China, more and more medical trails focused on the clinical data collection and statistical analysis.Excel is been used in most of the data collection, it is simple to learn, both can be analyzed and save the data, it can also seamless connect with SPSS statistical software. But with the development of clinical trials, the relationship between the clinical trial data become more and more complexed, the relationship between data from one to one to one-to-many or many to one. Traditional Excel in this area can no longer competent, and the entry interface is lack of input efficiency are also exposed.As the rapid development of information science, computer application technology, the establishment of malignant a diseases database (carcinoma cases database, CCD) to manage the clinical data of cancer patients well enough to overcome the above. This is a trend of clinical information, the inevitable modernization. We are based on the need of oberservation of oncology patients to write the specific oncology database : The main database, including non-small cell lung cancer database, breast cancer database, upper digestive tract cancer database and colorectal database.NCCN non-small cell lung cancer guidelines pointed out that the patients who are inappropriate use of bevacizumab treatment recommend the platinum-containing chemotherapy as the first-line therapy. However, no evidence exists that a platinum-containing chemotherapy regimens can be superior to the others. Evaluation of different chemotherapy regimens of the study are ongoing. Based on this, we use self-written non-small cell lung cancer database to collect the data of our department from 2007～2008 hospitalized patients with non-small cell lung cancer.We use the NSCLC database to get a main idea of the therapy situation of non-small cell lung patients in our department and the first-line short-term effect between platinum-containing chemotherapy.Method: non-small cell lung cancer database for oncology patients as part of the database platform. Database platform is divided into stand-alone and network version, standalone version of the software built using Microsoft Access2008 software, Web Edition with Microsoft SQL Server 2005 software to build the database. Using Microsoft C # 2008 to establish database management software platform.The non-small cell lung cancer database can entry, query and modify the NSCLC patients information. We Select a total of 400 inpatients, during 2007-1～2008-8 in the Department of Medical Oncology of Hebei Medical University Fourth Hospital and input their information in the database. A pathological diagnosis in patients with a total of 327 and the remaining 73 patients did not obtain pathological diagnosis. Remove only find the cancer cells in 34 patients, there is a clear pathological diagnosis in patients with a total of 293. Of 293 patients with gender, age, smoking status, pathological analysis of the situation and so on. 196 patients in the Department of Medical Oncology of the Fourth Hospital of Hebei Medical University for first-line chemotherapy for at least two cycles of chemotherapy in patients follow-up to 2009-3-1, lost to 14, for adjuvant chemotherapy in patients with 47, 50 other patients (including non-line chemotherapy is given only to those who best supportive care, chemotherapy to take the program back below the 2-cycle origin chemotherapy, those who switch to higher-level hospitals for further treatment, etc.). 196 patients with first-line treatment programs compared to evaluate the non-small cell lung cancer short-term efficacy of first-line chemotherapy regimens.Results:The use of the system, can easily and fast entry the data of non-small cell lung cancer patients from the disease began, pathology, treatment and adverse reactions. To post to provide complete and accurate statistical analysis of the raw data records. After the database's completition, human-machine interface is friendly, even if people do not understand software programming can easily manipulate the database. And the design of auto-detection feature, for possible misuse and terminate a timely reminder to prevent the error occurred.Database analysis results:1 Gender: male 201 patients (69%), female 92 patients (31%), Male: Female = 2.18:1.2 Age composition: male and female patients with median age of onset is 60 years old, the peak incidence in the 60-70 years age group, age composition is no statistical difference between men and women (P = 0.359).3 Smoking: The 293 patients ,smoking patients 134 (46%), non-smoking patients 159 (59%). Male: 132 patients were smokers, non-smoking patients 69; female: non-smoking patients 2, non-smoking patients 90. In the male groups, smokers in the squamous cell carcinoma (76.09%), adenosquamous carcinoma (76.47%) the proportion are higher, and in adenocarcinoma (51.19%), the ratio is relatively low. Squamous cell carcinoma of the relationship between men may be more closely associated with smoking, Smokers whose smoking index≥400 Zhi-year are more when compared with patients with less than 400 Zhi-year. Lower smoking rates in women of this group, no matter what kind of pathological types shown smoking and cancer were not significantly associated. This study show women in non-small cell lung cancer may affected by other factors.4 Pathological conditions: There is a clear pathological diagnosis of 293 patients, 145 of adenocarcinoma (49%), squamous cell carcinoma 106 (36%), adenosquamous carcinoma in 22 (8%), other 7 patients (7 %). Subgroup analysis showed that men 92 patients of squamous cell carcinoma (31%) accounted for male non-small cell lung cancer, men 84 of adenocarcinoma (28%), men adenosquamous carcinoma in 17 patients (6%), the other eight of male (3%); women, adenocarcinoma accounted for female non-small cell lung cancer the first one (21%), female squamous cell carcinoma 14 cases (5%), female adenosquamous carcinoma 5 patients (2%), female other 12 patients ( 4%).5 Tumor markers: tumor marker data selection in newly diagnosed treatment (without surgery and other treatments ago) patients, and there is a clear pathological diagnosis and CEA, CY21-1 values. A total of 59 patients were selected for research. 25 in which squamous cell carcinoma, adenocarcinoma 31 cases, the remaining 3 patients. 43patients CEA> 5 or CY21-1> 3.3, and the detection rate is 72.88%. CEA independently tested positive for 26 (44.07%), CY21-1 are independently tested positive for 37 (62.71%). The detection rate of three kinds of different (P = 0.005). The highest rate of combined detection, CY21-1 followed by detection rate, CEA detection rate of the lowest. CY21-1 for the detection rate of squamous cell carcinoma higher than CEA (P = 0.000), 80%, 24%,seperately. CEA and CY21-1 for adenocarcinoma detection rate are no significant difference (P = 0.202), 64.52% and 45.16%,seperately.6 First-line chemotherapy regimen short-term efficacy: 196 patients use the vinorelbine in patients with 66 patients (34%), 50 patients with paclitaxel (26%), containing in patients with gemcitabine in 10 patients (5%), with program in patients with etoposide in 28 patients (14%), the remaining 42 patients with other chemotherapy (21%). Further stratification showed 30 patients of application of NP, NC 32 patients, TP 8 patients. TC 6 patients, GP 9 patients, GC 1 patients, EP 23 patients, EC 3 patients.6.1 Efficiency and control rate comparison: NP CR 0 , PR 6 , SD 14 , PD 10 , RR 20%, DCR 66.67%. NC CR 1, PR 8 , SD 16 , PD 7 , RR 28.13%, DCR 78.13%. TP CR 0 PR 5 , SD 11 , PD 8 , RR 20.83%, DCR 66% .67. TC CR 0, PR 4 , SD 11 , PD 6 , RR 19.05%, DCR 71.43%; GP CR 0 , PR 3 , SD 3 , PD 3 , RR 33.33%, DCR 66.67%. As the GC only 1 patients (Evaluation of PD), after the removal , short-term effect of NP, NC, TP, TC, GP was no significant difference, P = 0.956.6.2 Disease progression-free time comparison: Vinorelbine + platinum , the median PFS time of 139 days (4.63 months, 95% CI102.528～175.472 days). Paclitaxel + cisplatin, the median PFS time for 119 days (3.97 months, 95% CI 86.886～151.114 days) Gemcitabine + platinum , the median PFS time of 126 days (4.2 months, 95% CI 14.868～237.132 days). 3, No statistically significant difference P = 0.770. (See Figure 17, Figure 19) Subgroup analysis showed that: Comparing paclitaxel, vinorelbine and platinum (cisplatin, carboplatin) combined four kinds of s: TC median PFS 103 days (3.4 months, 95% CI 89.84～116.16 days). TP median PFS 126 days (4.2 months, 95% CI 55.968～196.032 days). NC median PFS 167 days (5.57 months, 95% CI 124.056～209.944 days). NP median PFS 116 days (3.87 months, 95% CI 80.987～151.013 days). Four kinds of Chemotherapy Regimens, PFS was no significant difference, P = 0.112.Conclusion:1 We have established the "oncology patients with non-small cell lung cancer database", for non-small cell lung cancer patients have powerful data processing capability, capable of non-small cell lung cancer for rapid data input, modification, permanent storage, standards classification, fast retrieval and query, in order to carry out clinical trials and other projects bring great convenience, it is worth in the field of cancer research and promote the use of the work.2 Applications of "oncology patients with non-small cell lung cancer database" section of my general observation in patients with similar conclusions of epidemiological data to show the feasibility of accuracy and reasonableness of the data structure.3 For non-small cell lung cancer, CEA, CY211 highest detection rate of joint detection, CY21-1 followed by detection rate, CEA detection rate of the lowest. CY21-1 in combination with CEA, diagnosis, non-small cell lung cancer can be achieved in line with the rate of 72.88%. CY21-1 for the detection rate of squamous cell carcinoma higher than CEA. CEA for adenocarcinoma detection rate and CY211 no statistical difference.4 For first-line chemotherapy in non-small cell lung cancer to platinum-based combination chemotherapy of the 3rd generation drugs in the NP, NC, TP, TC, GP was no statistical difference between short-term effect. RR 20%～35%, DCR 66%～80%. NP, NC, TP, TC s median PFS 3.5～6 months. |
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