196 763 L-l
Prognostic factors in advanced non-small-cell lung cancer treated with cisplatin-containing combination chemotherapy
T. Fujikane, T. Itoh, K. Nakanishi, T. Takahashi, A. Takeda, T. Tsuji, H. Matsumoto, T. Shimizu. National Dohoku Hospital, Asahikawa, Japan Prognostic factors for survival were retrospectively evaluated in 105 patients with advanced non-small-cell lung cancer [clinical stage III or IV, performance status (PS): O-3 and age; 5751. All patients were treated with cisplatin-containing combination chemotherapy. Univariate analysis revealed that PS; O-l, prognostic nutritional index’ (PNI); 451, normal serum NSE levels, no body weight loss, clinical stage Ill and normal serum LDH levels were favorable prognostic factors. Multivariate analysis using Cox’s proportional hazard model revealed that PNI (P < O.OOOl), PS (P = 0.0002) and clinical stage (P = 0.0139) contributed independently to survival. Three prognostic subgroups were defined through recursive partioning and amalgamation. Good subgroup (PNI; 45<, PS; C-l and stage Ill), intermediate subgroup (PNI; 45<, PS; 2-3 and stage III or PNI; 454, PS; O-l and stage IV) and poor subgroup (PNI; 545 or PNI; 45<, PS; 2-3 and stage IV) showed 15.9, 9.3 and 5.5 months, respectively, for median survival times. PNI may be useful for the detection of inappropriate subgroups for chemotherapy in advanced non-small-cell lung cancer, PNI’: IO x serum albumin (g/dl) + 0.005 x total lymphocyte count (/mm3) by T. Onodera.
Prevalence of smoking among college students in Rio de Janeiro, Brazil
V.M.C. Silva, A.V. Pantoja, H.C.P. Adriano, Hospital, Fed Univ. Rio de Janeiro, Brazil
Luiz, A.L. Kritski.
TE 207 19.2%
MS 193 17.9%
LA 185 17.2%
For 890 college students between 15 and 22 years old, the following prevalence data related to smoking were obtained: 50% had tried cigarette smoking (E) (p = NS); 12.6% had smoked cigarettes regularly(R). Among these 12.6%: 70.5% had smoked currently (C) and 40.9% were Frequent Smokers (F). Among all regular smokers, cigarette use did not vary by sex (male = 13%; female = 12.3%, p = NS), age (p = NS) or income (p = NS). No differences were noted also by area of study, including MS. Other related conditions will be presented and antismoking programs for developing nations discussed.
Risk factors influencing patterns of failure and overall survival in patients with completely resected bronchoalveolar carcinoma of the lung
P. Gould, J. Bonner, T. Sawyer, P. Pairolero. Mayo Foundation,
C. Deschamps, V. Trastek, Rochester, MN, USA
Specialist oncology activity devoted to lung cancer patients compared with breast and colorectal cancer patients
N.P. O’Rourke, Glasgow, UK
To study tobacco smoking prevalence other related conditions among college students of Fed. Univ. of Rio de Janeiro, a cross-sectional survey was undertaken in a random sampling of 1077 out of 20,666 college students proportionally distributed among six main majors: Law (LW), Technology (TE), Medical Sciences (MS), Literature and Arts (LA), Behavior Sciences (BS), and Mathematics (MA). A standardized questionnaire from CDC (L. Kann et al. Results from the National School-Based 1991 Youth Risk Behavior Survey Public-Health-Rep-1993, 108 suppl 1: 47-67) was applied by trained interviewers. An Ever Smoker (E) was defined as person who had tried cigarette smoking even 1 or 2 puffs, a Regular Smoker (R) had at any time smoked at least one cigarette every day for 30 days, a Current Smoker(C) had smoked currently on one or more of the 30 days preceding the interview and Frequent Smokers (F) had smoked on 20 or more of the days preceding the interview.
institution with a histologic diagnosis of bronchoalveolar carcinoma of the lung who underwent thoracotomy between the years 1980 and 1993 was performed. 194 patients who underwent complete surgical resection were the subjects of this review. Of these patients, 21/194 (11%) underwent a resection of less than a lobe, 154/194 (79%) a lobectomy, 9/l 94 (5%) a bilobectomy, and IO/194 (5%) a pneumonectomy. Patients had Nl and N2 nodal stations sampled or dissected. Generally patients were obsewed following surgery although 8 receive thoracic radiation therapy and 3 received chemotherapy. All patients histories were reviewed for pathologic assessments, extent of disease, and failure patterns following surgery. A Cox proportional hazards model was utilized to consider multiple factors by step-wise regression and two factors were independently significant for local control and suwival. Local recurrence (LR) at 4 years (yr) was significantly greater for patients with primary tumors >3 cm compared to patients with tumors 53 cm (actuarial 4 yr LR 26% vs 8% p = 0.0001) as well as patients with N2 or Nl involvement compared to those with no nodal involvement (actuarial LR 48% vs 40% vs 12% respectively p = 0.0038). Overall suwival was also significantly diminished in patients with these prognostic factors. The 4 yr actuarial survival was 86% vs 50% (p < 0.0001) in patients with tumors 53 cm vs >3 cm. The 4 yr actuarial suwival was 75% vs 56% vs 28% in patients with NO, Nl and N2 involvement respectively. These prognostic findings have implications in the development of future trials addressing potential adjuvant therapies.
The tumor and patient prognostic factors influencing locoregional recurrence and overall suwival in bronchoalveolar lung cancer are not well defined. Therefore, a retrospective review of all patients treated at our
The Beatson Oncology Centre is the Cancer Centre sewing the population of the West of Scotland (about 2.6 million), with about 6,000 new patient referrals a year. The incidence of lung cancer in this area is among the highest in the world (~90/100,000 males) and it is now the most common cancer in women as well as men. This study investigates the level of uptake of specialist oncology services (clinical oncology, medical oncology and palliative medicine) by lung cancer patients, compared with breast and colorectal cancer patients. Oncology input is measured by out-patient clinic attendances and therapeutic intewentions in November 1996. Within the study period the number of new cases referred with each tumour type will be documented, with reference to the estimated respective prevalence of these cancers within the catchment population. The number of radiotherapy courses prescribed during the study period will be documented for the three tumour types, as will the number of cycles of chemotherapy prescribed. The study will also focus on patients who have already received their primary treatment: looking at the numbers who attend for review appointments, the time since most recent anti-cancer treatment, time since previous appointment and the number of patients who require a change in their treatment as a result of attendance. Analysis is in progress and will be complete March 1997. The differences in referral patterns, uptake of treatment, and duration and frequency of follow-up for the three cancers will be apparent from the results. The reasons for these differences will be discussed and the need for a change in patterns of practice will be reviewed.
A review of the pharmacoeconomic research on gemcitabine in the treatment of advanced non-small cell lung cancer
M.E. Minshall, A.M. Liepa. Eli Lilly & Co., Lily Research Indianapolis, IN., USA
Gemcitabine (GEMZAR@) is a novel nucleoside analogue with unique activity against a range of solid tumours including non-small cell lung cancer (NSCLC) and pancreatic cancer. As of December 4, 1996, gemcitabine has been approved for chemotherapeutic treatment in 32 countries: 12 for NSCLC only, 4 for pancreatic cancer only, and 16 for both NSCLC and pancreatic cancer. Over the past three years, a series of retrospective economic evaluations (cost identification or cost-minimization and costeffectiveness) have taken place in order to better estimate the economic impact of gemcitabine (single agent and in combination) in NSCLC treatment compared with other chemotherapeutic regimens.