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Background Prognostic understanding in advanced cancer patients and their caregivers may have an impact on the delivery of effective care. The aims of this study were to explore prognostic understanding at diagnosis in both patients with advanced lung cancer and their caregivers and to investigate correlates of their understanding. Subjects, Materials, and Methods A total of 193 patients with newly diagnosed advanced lung cancer and their 167 caregivers were enrolled at 16 hospitals in Japan. We assessed their perceptions of prognosis and goals of therapy and examined their associations with their sociodemographic characteristics, clinical status, quality of life, mood symptoms, and the status of disclosure of information by their treating physicians. Results One fifth of patients and caregivers (21.7% and 17.6%, respectively) mistakenly believed that the patients’ cancer was “completely curable.” Substantial proportions of them (16.9% and 10.3%, respectively) mistakenly believed that the primary goal of therapy was to remove all the cancer. Levels of anxiety and depression in both patients and caregivers were significantly higher among those who had accurate understanding of prognosis. In multivariate analyses, inaccurate perceptions of prognosis in patients were associated with sex, better emotional well-being, and lower lung cancer-specific symptom burden. Caregivers’ inaccurate perceptions of patients’ prognoses were associated with better performance status and better emotional well-being of patients. Conclusion Substantial proportions of advanced lung cancer patients and their caregivers misunderstood their prognosis. Interventions to improve their accurate prognostic understanding should be developed with careful attention paid to its associated factors. Implications for Practice This study demonstrated that substantial proportions of patients with newly diagnosed advanced lung cancer and their caregivers had misunderstandings about their prognosis. Accurate perceptions of prognosis, which are indispensable in the delivery of effective care, were associated with elevated levels of anxiety and depression in both patients and caregivers, warranting psychosocial care and support for them immediately after diagnosis. Inaccurate perceptions of prognosis in patients were associated with better emotional well-being and lower lung cancer-specific symptom burden. Illness understanding in caregivers was associated with patients’ physical and mental status. Those findings provide insight into how they obtain accurate illness understanding.

This Phase II study was conducted to evaluate the efficacy and safety of S-1 and irinotecan combination therapy as a second-line treatment in patients with advanced non-small cell lung cancer.Irinotecan was administered at 60 mg/m(2) on Days 1 and 8. Oral S-1 was administered on Days 1-14 every 3 weeks at 80 mg/day for patients with a body surface area of1.25 m(2), 100 mg/day for patients with a body surface area of 1.25-1.5 m(2) and 120 mg/day for patients with a body surface area of1.5 m(2). The primary endpoint was response rate, while the secondary endpoints were progression-free survival, overall survival and safety.Thirty-one patients were enrolled in this study. The response and disease control rates were 6.5 and 58.1%, respectively. Progression-free survival and median survival time were 2.8 and 12.6 months, respectively. Grade 3-4 adverse events were reported for 29.0% of the patients. Hematological toxicities of Grade 3 or 4 included leukopenia (9.7%), neutropenia (9.7%), febrile neutropenia (3.2%), thrombopenia (3.2%) and anemia (6.5%). Non-hematological toxicities of Grade 3 or 4 included pneumonitis (6.5%), diarrhea, colitis, dyspnea, rash, oral mucositis, anorexia and pulmonary thromboembolism/deep vein thrombosis (3.2% each).S-1 and irinotecan combination therapy at the present dose and schedule exhibited only modest efficacy with mild toxicities in previously treated patients with non-small cell lung cancer. No further clinical investigation with current dose and schedules is warranted for patients with non-small cell lung cancer who failed first-line platinum-based doublet chemotherapy.

The diversity of fossorial moles in East and Southeast Asia is contained in the 2 species-rich genera Mogera (8 species) and Euroscaptor (8 or more species), and the 3 monospecific genera Scapanulus, Scaptochirus, and Parascaptor. To better understand the evolution and biogeography of these fossorial moles, we conducted molecular phylogenetic analyses using mitochondrial cytochrome-b (Cytb; 1,140 base pairs [bp]) and 12S rRNA (approximately 830 bp) and nuclear recombination activating gene 1 (Rag1; 1,010 bp) gene sequences from 5 species of Euroscaptor ,6o fMogera, and the single species of Scaptochirus. Phylogenetic estimates revealed 5 distinct lineages of East and Southeast Asian fossorial moles: Mogera, Scaptochirus, Euroscaptor mizura, E. parvidens, and E. malayana–E. klossi–E. longirostris. Our results support the monophyly of Mogera but not Euroscaptor, indicating a need for taxonomic revision of the latter genus. We hypothesize that Mogera originated in the central portion of its range and then dispersed to peripheral islands, such as Taiwan and the Japanese Islands. The fragmented distribution of Southeast Asian Euroscaptor presumably arose from habitat competition (invasion) from Mogera species, long-range dispersal, vicariance events, or a combination of these, explaining the high species richness of fossorial moles in this region.

A new species of talpine mole from northern Vietnam is described and compared with other species of the genus Euroscaptor. This small mole was assigned to the genus Euroscaptor on the basis of its dental formula, but it also shows unique morphological and karyological characteristics. The new species is externally similar to E. parvidens from southern Vietnam, possessing warty protuberances on the muzzle not seen in other members of this genus. The tail of the new species is much shorter than in E. parvidens and E. malayana, both known to have short tails. The tail is not visible under the fur in the dorsal view, giving it an almost tailless appearance. The skull of the new species is similar to that of E. longirostris, but the palate is characteristically wider. The molars of the upper jaw are of a simple triangular shape, and there is no hypoconulid in the lower molars. The diploid number of the new species was determined to be 2n 5 38, which is a new karyotype for this genus. This mole inhabits the lower elevational areas of northern Vietnam and is partially peripatric with E. longirostris in the type locality. Because of the distribution of another taxon in northern Vietnam, Mogera latouchei, the ecological relationships among 4 species of Vietnamese moles also is discussed.