Combined therapy of small cell bronchial carcinoma

160 595 THORACOTOMY AFTER CHEMORADIOTHERAPY - A STUDY ON 20 LUNG CANCER PATIENTS. M.Yamamoto, Y.Masaki, H.Nishimura, S.Yoneda, M.Sakura. Saitama Cancer Center, Saitama, Japan. Twenty lung cancer(5squamous cell(SQ) r 7 adeno (AD), 2 small cell(SM),l large cell (LA) I 1 adenosquamous cell(AS); 9 in Stage ,and 2 in Stage IV) IIIa, 8 in Stage IIIb, patients were thoracotomized after chemoratlr btherapy(CRT) for pulmonary resection between October 1985 and March 1991. Preoperative CRT resulted in CR in 2, PR in 14, NC in 3, and PD in 1. No tumor cells were detected histologically in 6(3 SQ, 1 SM, t LA and 1 AS) after CRT. The tumors were destroyed extensively in 7 others(5 SQ, 2 AD) although not completely. Pulmonary resection was performed in 18 patients. In two(AD) of 20 cases, thoracotomy ended exploratory. Fourteen of the 20 patients are alive 7 to 94 months after the initial therapy. The median survival of 85 Stage III and IV cases operated on before chemo- or radiotherapy was 19 months. The neo-adjuvant therapy seems to be a safe and effective treatment for squamous cell lung cancer.

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597

598 SURVIVAL

AND

PROGNOSTIC

FACTORS

TREATED WITH

AND WITH SURGERY FOR OPERABLE

PTS

Paccagnella

Pappagallo

A,

Favaretto

A,

Chiarion-Sileni

V, Tomia L. Sotti

Fiorentino

Centro

1980

eligible

NV.

to 1988

age

CT

Brandes A,

349 observed

CT uith

SCLC pts,

CAV/DDP-VP.

N/F

273 (78%) Yere ratio:

retrospectively

aed

249/X;

according according

Out of 160 LO pts, 100 (62%) had operable disease:

78 were resected.

while 22 refused or had medical

by stage;tgperabilit

Survival

WITH

F, Rea F. Roberti G and

The pts were staged perspectively

57 (34-75).

AJC'87 (TNM).

Ghiotto C.

6, Sartori

to VALG (LD/ED) and to AJC'79 (TNR). to

GL,

(PTS)

ALTERNATING

Oncologico Regionale 35100-Padova, ITALY

out of

for alternating

median

PATIENTS

OF 273

SNALL CELL LUNG CARCINOIIA (SCLC)

From

ao‘ea.

est.me

.and surger us I la” S”PYI”I 1

contraindication.

as follow: S”PYl”OPS

after

3 yrs

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At Log-Rank LDH*OO:

intermediate): (COX’S

model)

importance):

P=N.S.; the

represent

only

disease

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Test:

P<

PQ70%:

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P=N.S.;

relevant operability

PS

an important

sex:

P&0001; P=N.S.;

weight losst5t: histology

At the multivariate

prognostic (P<.OOO).

(P=.O416).

The ,disease

independent

prognostic

factors

uere(in

analysis order

LO/ED stage according operability factor

in

P

(oat vs

seems SCLC.

of to to

COMBINED THERAPY OF SMALL CELL BRONCHIAL CARCINOMA H. Toomes, M. Semik SchillerhoeheHospital,Clinic for Thoracic Medicine,D 7016 Gerlingen- FRG In 1985 we introduceda new mode of treatmentfor small cell bronchialcarcinomas(stagesI - IIIa). Followingthree coursesof chemotherapy,the primary tumor site is resected. Chemotherapyis then continued in one or three courses,dependingon the histoloEica1evidenceof a viable/non-viable tumor (Group A). In cases where the diagnosisis establishedintraoperativelyor postoperatively three coursesof chemotherapyare undergonepostoperatively(GroupB). Both groups receiveprophylacticcerebralirradiation. Thirty-fivepatientswere operatedbetween 1985 and 1990 (GroupA 19, Group B 16). In Group A, following preoperativechemotherapy,68.4% showed complete, 26.4% partial,and 5.2% no, remission. In spite of the high rate of completeremission,viable tumors were proven in 73.G%, which underlinesthe need for surgeryand makes the adjustmentof chemotherapy necessary.Chemotherapycould be shortenedin the 27.0% without viable tumors.The survivalrates for the two groups,A and B, were after five years 44 and 37% respectively.