Is chemosensitivity a predictive factor for radiosensitivity in non-small cell lung cancer? Lesson from European Lung Cancer working party phase III randomised trial

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Abstracts

sites when compared to cases without this manifestation c* Mann-Whitney test). Conclusions: Small bowel metastatic involvement in NSCLC is a rare metastatic site, significantly associated with severe widespread metastatic disease. This metastatic site deserves attendance when extensive local treatment in NSCLC is considered. Duplicite

malignant

tumours

in lung cancer

patients of Tuberculosis Plzen, Czech Republic; Uni. Hosp. Bratislava,

PeSek M, Lisa M, TamLSovL M. Department and Pneumology, Faculy of Medicine, Department of Pulm. Dis. Comenius Slovak Republic.

During the period 1992-1997, 76 patients suffering from lung cancer and some duplicite malignant tumours were treated in both Czech and Slovak institutes. There were 51 duplicite tumour Czech patients selected from 1238 lung cancer patients and 21 Slovak from 275, it means 4.36% of Czech and 8% of Slovak lung cancer populations (P < 0.05). Three Czech patients even suffered from triplicite malignancies. The highest incidence of multiple tumours is in 60-69.year old patients in both groups. Most frequent locations of second malignancy in men were head and neck cancer, second lung cancer and gastrointestinal tumours, whereas in women the first two were uterus and breast cancers. The highest risk of second malignancy appearance is still 7 years after the first one. Our results justify active therapeutic strategy even in such patients. It has been demonstrated, that therapeutic outcome is comparable with other lung cancer patients. Exploratiye

thoracotomy

in lung cancer

*Department of Radiotherapy tal Kosice, Slovak Republic.

and Oncology,

Univ.

Teach. Hospi-

Chemo- and radioresistance are major obstacles to successful cancer therapy. There are many well known reasons for drug and radiation resistances. Some in vitro studies have demonstrated cross-resistance between chemotherapy (CT) and radiotherapy (RT) and others have suggested that some chemotherapy resistant NSCLC might be radioresistant. The ELCWP conducted a phase III randomised trial in non-metastatic NSCLC in order to compare, in responders to induction CT, consolidation treatment by further CT or by chest RT. A total of 462 untreated patients were eligible for three courses of induction CT (MIP) consisting of cisplatin (50 mg/m”), ifosfamide (3 g/m2) and mitomycin C (6 mg/m21. Objective responders (OR) were proposed to be randomised between three further courses of MIP or chest RT (60 Gy/6 weeks). Patients with no change (NC) or local progression underwent chest RT. For the present analysis purpose, three groups of patients having received chest RT were constructed: the chemosensitive group who presented an OR to CT, the intermediate group with NC at CT effect assessment, and the chemoresistant group who presented local progression. The results were the following:

Chemosensitive Intermediate Chemoresistant group group group

patients

Fiala P, Cermak J, Zatloukal P, Tob&ny M. Dept. of Pneumology and Thoracic Surgery, 3’” Faculty of Medicine, Universi& Faculty Hospital Bulovka, Prague.

Charles

The purpose of the present retrospective study is to identify factors indicating inoperability of lung cancer. From 1985 to 1990, 496 consecutive patients with lung cancer underwent thoracotomy at our institute. Pulmonaty resection was done in 465 patients and 31 (6.25%) patients experienced explorative thoracotomy and these are subject to further analysis. Disagreement between cTNM and pTNM was found mainly in T descriptor (28 pts, 90%) while the difference between cN and pN was only in 13 pts (42%). The most frequent cause of inoperability was direct tumor spreading into the mediastinum (25 pts). There was no surgery-related death within 30 postoperative days. Three patients of 31 survived 5 years (9.6%) and this is comparable with the survival with patients in the given stage. With the introduction of more accurate preoperative diagnostic methods the number of patients with explorative thoracotomy will probably decline, but at present it cannot be eliminated completely. Is chemosensitivity a predictive factor for radiosensitivity non-small cell lung cancer? Lesson from European Cancer working party phase III randomised trial

in Lung

Baumohl* J, Sculier JP, Paesmans M, Bureau G, Recloux P, Van Cutsem 0, Berchier MC, Thiriaux J, Iafitte JJ, Mommen P, Van Houtte P, Ninane V, Klastersky J and the European Lung Cancer Working Party (ELCWP). Brussels, Belgium.

N 79 OR MST (weeks) 56 2 years survival 23%

119 28% 35

11%

40 7.5% 23 7%

These differences were highly statistically significant (P < 0.0001). So this study confirms the hypothesis that NSCLC patients with resistance to MIP CT arc also radioresistant. Possible ways to overcome drug and RT resistances are under investigation, as concomitant chemoradiotherapy using taxol, carboplatin and hyperfractionated RT.

Posters Distribution of inflammatory syndrome indicators among lignant, tuberculous and pneumonic lung infiltrates

ma-

Mitic T, Kunosic J, Nedeljkovic B, Radivojevic S, Skodric V, Djurisic M, Odalovic R. Institute of Pulmonary Disease and TB, CCS of Serbia, Belgrade,

Yugoslavia.

Distribution of certain indicators of the inflammatory syndrome with respect to the final diagnosis: pulmonary malignoma (MA), specific process (TB) or unspecific pneumonia (PN) was observed in 90 patients admitted with the referral diagnosis of lung infiltrates. Each subgroup included 30 sub-