Granulocyte colony-stimulating factor in lung cancer

AbstracidLung

m patients

wth

constructed

by analyzing

requwed

small-cell

to stage

Procedural

costs

small-cell

lung

were. detennmed, patient

Bethesda,

Md.

from the permutation Srttmg:

untreated,

into therapeutic 1973 through

cancer protocol Measure: when

lung

cancer.

was applied

Cancer

1973 to 1989. The final algorithm

hundred

institute,

fifiydne

the National

was

patients

wth

Cancer

pmwously

protocols

applied

and patients’

maJor factor

population.

saved

$1418

in reducing

An algorithm

procedures

Results: procedures

m&static

consisting

can accurately

compared

to all patients.

of stoppmg

disease il patients

treatment

modalities

followed

by

were

treated

value,

de Pneumologie,

Sainr-Anroine,

B. Chastang

C, Leclerc

log-rank

test).

lung cancer

Johnson

lung

standard

cell

The aim of tlus study

lung

syndrome

cancer:

procedures,

mcidence,

efficacy

survival

III patients

patwits

wth

Sauvaget

I.

1993;153:384-

period.

we reviewed

The incidence emergency

proved

of

resulted

therapy

intenswe

in complete

Methods:

small-cell

significantly

responses

4 weeks

m 7

surwval

with SVCS (median, Asignificant

increaseminitial in patients

therapy

m small-cell

must be performed underlymg

cause.

chemotherapy.

lung

cancer.

in patients Initial

Histologw

with SVCS

enwrgawy

tomography

of the brain should

SVCS,

prophylactic

pahents. smallsell

chemotherapy

Apparently SVCS lung cancer.

routtnely could

is not a pwr

spinal

cord

secondary

or

factor

wth

in such in treated

Purpose:

M&static

spinal cord compression

to cancer,

Ananalysiswasperfonned cancer

in East Denmark

total series

included

adenocarcmoma and large-cell

(MSCC)

is a disabling

for which

is not settled.

forall patie&withMSCCsecondary

tolung

the optimal fmm

treatment

1979 to 1988. Patients

ICI2 cae.s with small-cell

(ACL;

26 %), squamous

carcinoma(LCC;

aodthempettticmsultsnredesctibed.

and Methods:

carcinoma

cell carcinoma

9%). Symptoms, Results:

growth

on lung cancer

(SCLC; (SQLC;

The 40%), IS %)

clinical presentations,

Theoutcomeoftreatment

growth.

study

also

hematopaetlc

been

Lung

and GM-CSF, associated

G-CSF

reduced

the incidence in two placebo

are lacking

for GM-CSF.

significant

studies

more

of dyspnea,

neutropaia

data

further

with

consistmg

has clearly

Similar

havebeenwell

associated

reaction

by fever during

is needed

protective

to ascertain

effect

Lamb&-Eaton

direct effect

are necessary

to clarify

what

has on response

impact,

if any,

the

and survival.

syndrome

and small

cell lung cancer

ZenoneT, Souquet PI, Mlchaud E, El Khoury MT, Demolombe-Rague S, Bady Bet al. Servicede Pneumologie, Cenrre HospiralierLyon-Sud, Pierre-&wire.

Rev Med lnteme

1993;14:54-7.

TheauthorsreporttwocasesofLambert-Eatonmyasthenicsyndrom~ associated

with small cell lung carcinoma. diagnosis

of this syndrome

pathogen&s

and

syndromeandsmallcellcancer. that

block

tetinals.

the

Following

the observations,

is considered.

the

relation

We discuss

between

the

paraneaplasttc

Thissyndromeiscausedhyaut~tibodiff

voltage-dependent

calcium

channels

at motor

newe

Smallcellcarcinomacellsappeartoexpresscalciumchannsls, that autoantibody

production

may be triggered

by tumor

calciumchanneldetenninants.Theautoimmuneparaneoplasticsyndrome theory

refers

to cross-antigenicity,

Women with lung cancer: Sama L. School of Nursing, Los Angeles,

QuaI.

of this shtdy

in women death

Life Res 1993;Z: 13-22.

was to describe

suffering

fmm

in the United

disruptions

lung cancer,

States.

in quality

of

the leading

cause of

QGL was measured

with the

CARES-SF.SymptomdistresswsmeawedwiththemodifiedSymptom Distress

Scale., and fitnctional

PerfomumceStatwScale. in a one-time age,

data collection.

married,

forover

sample.

had

compared

greater

about cancer

chores,

serious

worry

progrcwion.

sigmficantly

p = less

in global

heterogeneous

disruptions

about ability = 0.69,


strongly

was under

65 years of

cell lung cancer

andwsnotcurrentlyrecewing and

were fatigue,

its

cancer

difficulty

score. was moderately

p = <0.OOl),andtosymptom

Symptom

distress

of QGL (r = 0.80,

with

QOL female

to care for self, and worry

The global CARES-SF

corre.latedtotimctionalstahas(r

but

with the Knmofsky

non-small

disruptions

to a normative

The most prevalent

with household

subject

or recurrent

hadlitniteddisease,

Subjects

dimensions

The typul

has had primary

12months,

treatment.

stahrs was measwed

Sixty-nioewo_withlungcancerpPlticipPted

nonambulatory

In non-SCLC,

Impact on quality of life University of California, 10833 Le Conre,

CA 90024-6918.

with the physical

ability.

G-CSF

myelosuppression

has

However,

strongly

walking

ofMedicine.

7’N37232-5536.

specifically

dose

trials.

(I = 0.72,

regamed

Depanment

Nashvilk.

factor seems to have a clinically

distress

patients

m 97 W of

cord compression.

in lung cancer

in abrogating

a first

depended fundamentally on the patieat’s neurologic condition at the time of the diagnosis. All patients with SCLC who were able to walk at the tnne of MSCC remained ambulatory, whereas 15% of the SCLC

factor

GM-CSF

prospective

Neither

cancer-related

cancer

Bach F, Agerlin N, Sorensen JB, Rasmussen TB, Dombemowsky P, Sorensen PS et al. Depanmenrof Oncology, University Hospital He&w, DK-2730 Copenhagen. J Clin Gncol 1992;10:1781-7. complication

spinal

Computed

in patients

to lung

IS. log- rank

BothG-CSFandGM-CSF

and

The purpose

compression

in survival

(P =

diagnosisandimmediate

Oncology.

factors,

and tachycardia.

life (QGL) M&static

growth

to be effective

suggesting

to the

diagnosis

be helpful

prognostic

observed

1993;9:3543.

as manifested

and

procedures

in these patients.

irradiation

who were

the gait function

malignant

ofMedical

of infection

the chnical

is the first line of

before

was

It may preserve

who develop

although

autoimmune

bran

the treatment

radiotherapy,

be performed

brain

difference

Univ. School ofMedicine,

(Ireland)

not

with SVCS

diagnostic

to adapt

does not seem to he useful

and

because

hypotension

69310

died of

42 weeks)

was observed

Intensive

survival

than patients

Despiteashortsurvival,early

thrombocytopenia

in

was

metastases

(22% vs I I %). Conclusions:

Rapid therapy,

wlthoutSVCS(med1an,40weeks). a.t the time of diagnosis

Initial

Diagnostic

heparin

Median

who

by RT had a better

Results:

Two of these 87 patients

%

latninectomy

a 6.year

in 81% and no response

of chemotherapy.

in the patients

wth

either

Thegroupofpatieots

types of lung cancer

colony-stimulating

Vanderbilr

Further

sene.s of 724

with mortality.

often

of the

laminectomy

thisissuegirenthewnflictmginvitrodatacnnceminggrowthstimtdation.

m&an

seen during

who also had SVCS.

were not associated

or patiml

different

and

In a prospective

lung cancer

chemotherapy,

;

wthm

dlagnosttc

was not used in these patients.

I2 ?? data were not w&able apalsla

&sease.

was 87 of 724 at the time of diagnosis.

tn these patwnts

initiation

of

of the

tn small-

of chemotherapy,

data from patients

of SVCS

radiation

procedures

effects

with SVCS.

the features

as initial characteristics

d~ssemmation

and toxic

biopsy-

was to analyze

(SVCS)

significant

patients

tolerated

MI,

Med

82%

with

with

0 to 132 months)

hwtologic

DH. Division

Cancer

184 rue du Faubourg

75571 Paris Ceder 12. Arch Intern

vena cwa

No

is crucial

controlled

Background:

range,

the various

Granulocyte

staging

cancer

P, Botto

however,

compared followed

withcytotoxicchemotherapy.

Hopiral Saint-Antoine,

obsaved;

of

and the

the staging

I.

superior

3.5;

of lung cancer

from treatment

the

outcome

The

with small-cell

lung

types

= .03, clu’test).

laminectomy

Hematopoietic

Superior vena cave syndrome in small-cell T, L&au

(RT)

with

have proved

Urban

radiotherapy

22 46 regamed

treated wtth either laminstomy (median value, 1.5; range, 0 to 32 months)or RT(median value. I; range, Oto59 months) alone(P = .03,

procedures.

Service

were

benefited

whereas

in the immediate

histologic

non-SCLC

(47%)orRT(39W)alone(P

treatment

had been idenhtied.

of a set of sequential

stage disease

the various

test). Conclusion:

with

to be able to walk,

No maJo’ differences

between with

between

procedures

and save more than one tlurd of the costs of an incluwe

\et ot staging

lung

The least expenswe when

different patients

(median

from

Main Outcome

of stagmg

costs was the concept

after a ate ofdistant

Conclusions:

records.

per patient

set of stagmg

Institute

fromsmall-cell

medical

of each sequence

to the patvmt of a standard

procedures

Cancer

July 1989. Datawereohtained

databases

of procedures

application

at the National

continued

to walk.

treatment

to the

at the National

95 46 of patients abdity

with the lowest cost per accurately staged

The cost per patent

sequence

cancer

treated

was

of procedures

small-cell

and the model

government

Four

An algorithm

con~ut~vehistolog~c~llydocumentedsmall-celllungcancer

entered Apnl

A single

with

population

from

derived

Patvats:

Design:

of a sequence

m patients

patent. Institute.

cancer.

all pemwtat~ons

disease

lung cancer

Institute.

275

Cancer 10 (1993) 266-286

all other

was associated p = 0.001)

dimensions

and

of QGL.