- Email: [email protected]
Long term results in locally advanced inoperable Non Small Cell Lung Cancer (NSCLC): A randomised trial of induction chemotherapy (CT) plus radiotherapy (RT) vs radiation alone
161
Panamrt'strman-A-0 SalminenUlla-Stina.MaasiltaPaula. Taskinen Eero, HalttunenPaavo Departmentsof Thoracicand CardiovascularSurgery, Pubamary Medicine and Transplantation Laboratory, HelsinkiUniversityCentral Hospital,Helsinki, Finland This retrospectiveanalysiswas carriedout in order to study the optimal therapy and the effect of therapy on survivalin the rare Pancoast'stuaour.The case records and histologicalspecimensof all the 19 patientswho had been admittedto our departments with this tuaour during the years 1977 - 1986 were reviewed.The patientshad a mean age of 52 years, 16 were snokersand 13 were males. Six patientshad sn!allcellcarcinaaa,6 ade-cinaM,5sguaxous cell carcinunaand 1 large cell carcinana. Onepatient had osteosarcana.Shoulder/am pain was the presentingsyqtan in 18 patientsand Homer's syndrane was noted in 5. Rib destructionwas presented in 18 cases. The patientshad been syr@anatic in the maan 6.5 months (range1 - 24 months).Ten patients underwentsurgicaltreatment,8 of them "radical" surgery.Postoperativeradiotherapy(KT) was given to 7 patients,both pre- and postoperativeRT to one, only RT to 6, chen&herapy+F?T to 2 and one received no therapy.One patient is alive 6 years after preand postoperativeKT and radical surgery.The reneining patientshad a median survivalof 13 months (range 1 months - 6 years),but 12/18 survivedless than 5 xrmths. Both the delay in initialdiagnosis and inappropriateselectionof therapy seem to affect the unfavourableresults.
L. Cri&, F. De Marinis,M. Clerici,M. W?&zme,F.DiCcstznzo,E. Oiv.of
mi,
G. Coxxxi, P.
Corgna,M. Tat&o.
MedicalCnzolcgy, Pen&a
Hxpital;Forl&ni
Rara;BarrrmeoHospital,Milano; ardDiv.ofhkL
Hospital,
Q-cologyPsnm,
FerraraandTerniHcspitals,Italy @DXaxlVP16have
kemccnsi~~
the nrxtactivesingle
agentstixLC~theircrJlbiraticnsearstobesynergicbuulti vivosnd
invitro. Basedon
-11
clinicaltrial enployingCEZLX and VPl6k-1 escalatiq
tksecasi~tiors
wedesigxzd a
cksaswithweeklyvCR+/-Radiotfieraw (a! inlimiteddisease (ID) ax3extazsive (ED) SCLC. In&me ~ticentictrial.
77 previas
1939, we begr~a
ccqxrative
untrealxl patients (pts) were
~~totfies~and73wa‘eevaluablef~respnse,sLnviM3. Endtoxicity.Theregimslusedws 103 mg/mz/iv/m
CFXA3coog/m2/iv
1,2,3 and VCR 1.4 mg/nfdqysl&14.
dayl,VPl6 Treatnentwas
repeatedevery 28dsys; af'cer6cycles ccmp1et.erespxcks IDundenentRT45Gyon
(CX) in
initiallxnxrvoluwarxiprc&ylactic
Q,'to the brxin. Results: CRrate
30
24.6%, PR rate 53.&Z. kin
toxicitywasmyelusuppreasicn:grxk ~wHoleucqeniaoccvrredin 1Sofptsand
werecordedcoedeath
[email protected]
ptsit
wssnecesszq
relatedtotreatmst tostap
_tiY. kconsiderthtinS4Xthis~haticn, isefficacicus and skuldk
dueto
VCR becauseof the
eventilywithc&VCR,
ccrkderrd in p-of
dose
intensification with CSF sqz0r-tbased on the myelotoxicityas the rrainside effect.
602 LcNGTEFMRESlJLTSINUX4LLYAINANcED
IrT.xmmLEmm
RNKBUSDTFlTALOFI~a3 CEUL~CAKER(WCLC):A (m)VSFmLATImALmE. -(cr)PmRADIL. CrimY+, M. Meaxi*, E. Corg?a*, E. -*, checcaglini**, S. hwi?h*, P. Latini~, M. Tcnato*. Di".ofMfxlicalc7xol~,Radio~,~a.
F.
S. Lbmish*, V. Mimtti*, L. Cri&*, M. Lu@telli*, R. Rcssetti*, E. -, F. checcaglull, P. Fiaxhini, A. Sidmi, E. tiisrelli, 0. Pensa,U. &n&i,
M.Tcnato*. M&ical&xzolc@,
Rxlio~,Surgery,Pathology,Div.ofPewgiaHs6pital,Italy. 42patients(pta) stageIIL4rwLCwith extzznt, (37 n&es,5 wdisnPS=9%)
clinicallyapparentN2
farales;median age58
yrs(rarlge 45-70),
received nefadjuvant ck&hrapy
(CT) with 2-3
cyclesof cisplati (P) 120 m&n* d 1 axI etqxside (E) 1cO m&n', d1,2,3every3
wks.For8pts
CTwascarlsined withtho-
(RT) (?XlGy splithoarse). 41 pts are evalu&le for reqxnae (1 early death):4cnlplete respcrse(CN, 3Opartial respase(PR (overallrqxns+91%; 34/42),5stabledisease (SD), 2pmive disease (P). 26 pts ur&rwntsmgay:23hadacarpleterezxticn (~0fal1p~/~0fptshav~surgery).5pts(1~, n,turrinresected toxicity.There-1 l2ptshavedied: lewlydeath hr.
4PR)had
specinm.Mild~el~rx?sionwas sqsys,3episodesof
themain
fetrilezeutrqxnka.
5progressive dis.ea=+e, 4surgical ~licaticrx,
(after cyclel), 1
myccardialinfarction, lseccnd
23 pts are being follarredoff tx-eah?nt wit-ha median
follouwq,of12mnths 3lccally
(rzmgeX?9). 4ptshave
(1 incarplete resecticn).We
relapsed:lbrain,
amdude:
1) PEis
an
effectivenexdjuvant regiwn for NSCLC. 2) slngery is feasible follavirg cr+Frr. 3) Hi&l culplete
resection rates folkwing
respasetonec&juvanttreatmmtcanbeobtained.4)Al~ f&her
follw-qz is required, the&ts
rxxkmizedtrials.
indicatethe needfor
Panamrt'strman-A-0 SalminenUlla-Stina.MaasiltaPaula. Taskinen Eero, HalttunenPaavo Departmentsof Thoracicand CardiovascularSurgery, Pubamary Medicine and Transplantation Laboratory, HelsinkiUniversityCentral Hospital,Helsinki, Finland This retrospectiveanalysiswas carriedout in order to study the optimal therapy and the effect of therapy on survivalin the rare Pancoast'stuaour.The case records and histologicalspecimensof all the 19 patientswho had been admittedto our departments with this tuaour during the years 1977 - 1986 were reviewed.The patientshad a mean age of 52 years, 16 were snokersand 13 were males. Six patientshad sn!allcellcarcinaaa,6 ade-cinaM,5sguaxous cell carcinunaand 1 large cell carcinana. Onepatient had osteosarcana.Shoulder/am pain was the presentingsyqtan in 18 patientsand Homer's syndrane was noted in 5. Rib destructionwas presented in 18 cases. The patientshad been syr@anatic in the maan 6.5 months (range1 - 24 months).Ten patients underwentsurgicaltreatment,8 of them "radical" surgery.Postoperativeradiotherapy(KT) was given to 7 patients,both pre- and postoperativeRT to one, only RT to 6, chen&herapy+F?T to 2 and one received no therapy.One patient is alive 6 years after preand postoperativeKT and radical surgery.The reneining patientshad a median survivalof 13 months (range 1 months - 6 years),but 12/18 survivedless than 5 xrmths. Both the delay in initialdiagnosis and inappropriateselectionof therapy seem to affect the unfavourableresults.
L. Cri&, F. De Marinis,M. Clerici,M. W?&zme,F.DiCcstznzo,E. Oiv.of
mi,
G. Coxxxi, P.
Corgna,M. Tat&o.
MedicalCnzolcgy, Pen&a
Hxpital;Forl&ni
Rara;BarrrmeoHospital,Milano; ardDiv.ofhkL
Hospital,
Q-cologyPsnm,
FerraraandTerniHcspitals,Italy @DXaxlVP16have
kemccnsi~~
the nrxtactivesingle
agentstixLC~theircrJlbiraticnsearstobesynergicbuulti vivosnd
invitro. Basedon
-11
clinicaltrial enployingCEZLX and VPl6k-1 escalatiq
tksecasi~tiors
wedesigxzd a
cksaswithweeklyvCR+/-Radiotfieraw (a! inlimiteddisease (ID) ax3extazsive (ED) SCLC. In&me ~ticentictrial.
77 previas
1939, we begr~a
ccqxrative
untrealxl patients (pts) were
~~totfies~and73wa‘eevaluablef~respnse,sLnviM3. Endtoxicity.Theregimslusedws 103 mg/mz/iv/m
CFXA3coog/m2/iv
1,2,3 and VCR 1.4 mg/nfdqysl&14.
dayl,VPl6 Treatnentwas
repeatedevery 28dsys; af'cer6cycles ccmp1et.erespxcks IDundenentRT45Gyon
(CX) in
initiallxnxrvoluwarxiprc&ylactic
Q,'to the brxin. Results: CRrate
30
24.6%, PR rate 53.&Z. kin
toxicitywasmyelusuppreasicn:grxk ~wHoleucqeniaoccvrredin 1Sofptsand
werecordedcoedeath
[email protected]
ptsit
wssnecesszq
relatedtotreatmst tostap
_tiY. kconsiderthtinS4Xthis~haticn, isefficacicus and skuldk
dueto
VCR becauseof the
eventilywithc&VCR,
ccrkderrd in p-of
dose
intensification with CSF sqz0r-tbased on the myelotoxicityas the rrainside effect.
602 LcNGTEFMRESlJLTSINUX4LLYAINANcED
IrT.xmmLEmm
RNKBUSDTFlTALOFI~a3 CEUL~CAKER(WCLC):A (m)VSFmLATImALmE. -(cr)PmRADIL. CrimY+, M. Meaxi*, E. Corg?a*, E. -*, checcaglini**, S. hwi?h*, P. Latini~, M. Tcnato*. Di".ofMfxlicalc7xol~,Radio~,~a.
F.
S. Lbmish*, V. Mimtti*, L. Cri&*, M. Lu@telli*, R. Rcssetti*, E. -, F. checcaglull, P. Fiaxhini, A. Sidmi, E. tiisrelli, 0. Pensa,U. &n&i,
M.Tcnato*. M&ical&xzolc@,
Rxlio~,Surgery,Pathology,Div.ofPewgiaHs6pital,Italy. 42patients(pta) stageIIL4rwLCwith extzznt, (37 n&es,5 wdisnPS=9%)
clinicallyapparentN2
farales;median age58
yrs(rarlge 45-70),
received nefadjuvant ck&hrapy
(CT) with 2-3
cyclesof cisplati (P) 120 m&n* d 1 axI etqxside (E) 1cO m&n', d1,2,3every3
wks.For8pts
CTwascarlsined withtho-
(RT) (?XlGy splithoarse). 41 pts are evalu&le for reqxnae (1 early death):4cnlplete respcrse(CN, 3Opartial respase(PR (overallrqxns+91%; 34/42),5stabledisease (SD), 2pmive disease (P). 26 pts ur&rwntsmgay:23hadacarpleterezxticn (~0fal1p~/~0fptshav~surgery).5pts(1~, n,turrinresected toxicity.There-1 l2ptshavedied: lewlydeath hr.
4PR)had
specinm.Mild~el~rx?sionwas sqsys,3episodesof
themain
fetrilezeutrqxnka.
5progressive dis.ea=+e, 4surgical ~licaticrx,
(after cyclel), 1
myccardialinfarction, lseccnd
23 pts are being follarredoff tx-eah?nt wit-ha median
follouwq,of12mnths 3lccally
(rzmgeX?9). 4ptshave
(1 incarplete resecticn).We
relapsed:lbrain,
amdude:
1) PEis
an
effectivenexdjuvant regiwn for NSCLC. 2) slngery is feasible follavirg cr+Frr. 3) Hi&l culplete
resection rates folkwing
respasetonec&juvanttreatmmtcanbeobtained.4)Al~ f&her
follw-qz is required, the&ts
rxxkmizedtrials.
indicatethe needfor