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346 Abstracts/Lung Gmcer 13 (1995) 323-356
High-dose chemotherapy combined with peripheral blood stem cell transplantation for two cases with small-cell lung cancer Nakanishi Y. Ka\\asaki M. Matsuki H. Ochiai S, Yatsunami J, Hara N. Keseorch Inst. for Disease of Chest, Faculty of Afedicrne, Kyushu ~~‘nnr~r.~rh: h:&ushu. Jpn J Lung Cancer 1995.35:349-55.
Tuo pabents with small-cell lung cancer were treated with high dose intensification therapy combined with peripheral blood Stern cell transplantation. Case 1 was a 53 year-old male, who was diagnosed as linuted- stage small-cell lung cancer with superior vena cava syndrome. Cast 2 was a 55 year-old male. diagnosed as extensive-stage small cell lung cancer. Both patients achieved partial response (a greater than 90% reduction in tumor size) to conventional dose induction chemotherapy with cisplatin carboplatin and etoposide. Peripheral blood Slem cells were collected b! leukopheresis at a recovery phase of bone marrotv function rclth mobilization by granulocyte- colony stimulatmg factor following an Intensified chemotherapy with cisplatin and etoposide. Thereafter. they were treated with high dose etoposide (1200 mg/m’) and carboplatin (2. IOOmgIbody and 3.OOOmg/body) combined dth peripheral blood stein cell transplantation. Recovery ofbone marrow function after peripheral blood stem cell transplantation was seen on day 9 and 13, respectively. and other treatment related side effects were slight It is suggested that peripheral blood stem cell transplantation is useful for hematopoietic support after high dose intensification therapy.
Alternative daily subcutaneous injections of4ig/kg lenograstim in lung cancer case Kaburagi T, Kawada H, Yoshino K, Konno K. Jpn J Lung Cancer 1995:35:337-42.
To decrease the frequency of drug injections for the treatment of neutropenia on an outpatient basis after chemotherapy for lung cancer, we injected lenograstim (G-CSF) every other day at a dose twice the routine dose and compared the effect with that of daily injection at the routine dose (2ig/kg). The subjects were lung cancer case who developed neutropenia (leukocyte count <2OOO/mm’ or neutrophil count <lOOO/ mm’) after treatment with chemotherapy. The patients were allocated by the envelope method to either Group A, treated by subcutaneous lenograstim injection at a dose of lig/kg at 48-hours intervals; and Group B, treated by subcutaneous lenograstim injection at a dose of 2igIkg at 24-hour intervals. Changes in leukocyte and neutrophil counts and in blood G-CSF concentration were evaluated in each group. There were 19 patients in Group A and 15 in Group B. No significant difference between the two groups was observed in leukocyte or neutrophil counts after lenograstim injection. The mean period for recovery of the neutrophil count to 2OOO/mm’ or higher was 4.5A2.2 days in Group A and 4.W1.9 days in Group B. The mean peak blood G-CSF concentration in Group A was Zlng/dl, twice as high as in Group B. No infection was observed, side effects were mild and transient in both groups and consecutive lenograstim administration was possible. The effect of 4ig/ kg lenograstim injection every other day was similar to that of daily 2ig/kg injection and the safety of this treatment was coniirmed.
Radiotherapy and chemotherapy for inoperable non-small cell lung CanCer Bleasdale C, Jones B. Clanerbridge Centrefir Oncology, Bebinglon, Wirral L63 4JX Postgrad Med J 1995;71:3934.
Non-small cell lung cancer is a major cause of mortality and significant morbidity in the UK. The majority of patients are inoperable and the optimum management of these patients requires a multidisciplinary approach involving the cooperation of respiratory physicians, thoracic surgeons and clinical oncologists (radiotherapists). Treatment techniques are constantly being refined and new approaches developed.
New drugs for treating small cell lung caucer Ettinger DS. ;lohns Hopkins Oncology Center: Baltimore. MD. Lung Cancer (ldand) 1995:12:Suppl3:SS3-61.
Recently there has been a number of new active drugs which have been identified for treating patients with SCLC. These drugs include paclitaxel, docetaxel, CPT-I 1, topotecan and gemcitabine. The range of response rates are as follows for each of the drugs given: (1) to Previously mNreated patients: pa&axe1 (34-I I%), topotecan (39%) and gemcitabine (30%), and (2) to previously treated patients: dccetaxel (28%), CPT-I 1(47%) and topotecan (35%). Further studies with these. new drugs utilized in combination chemotherapeutic regimens are needed to define the role of these agents in the treatment of patients with SCLC.
Oral therapy for small cell lung cancer Postmus PE. Smit EF. Deparment of Pulmonary Diseases, Free Universqv Hospital, PO. Box 7057, 1 OOOMBAmsterdam. Lung Cancer (Ireland) 1995;12:Suppl 3:S63-70.
Aver a remarkable improvement of the very poor prognosis of small cell lung cancer with very simple therapy such as iv and oral cyclophosphamide the role of oral therapy has become minimal. However. since more than a decade results ofcombination chemotherapy are at a plateau and it is necessary to reconsider the role of simple therapy in patients without the prospect of cure. Oral therapy might be worthwhile because it is probably less effecting the quality of life of the patient and makes it unnecessary to visit the hospital frequently. All drugs available for oral use with known activity against small cell lung cancer are reviewed. The best example of the success of oral therapy is etoposide. other candidates that need to be tested in a modem way are oral cyclophosphamide and hexamethylmelamine. New concepts of prolonged chemotherapy and dose-intensity are easier evaluated by using oral drugs. The discovery of the activity of prolonged oral etoposide is an excellent example how to test a new concept in a very simple way.
Carboplatinletoposide combination chemotherapy in the treatment of poor prognosis patients with small cell lung cancer Camey DN. Mater Hospital, Eccles Sheet, Dublin 7. Lung Cancer (Ireland) 1995;12:Suppl 3:S77-83.
Advances in the treatment of SCLC have been slow but sure over the past decade. It is now recognized that a small subset ofpatients may be. cored of this disease, particularly with combined modality treatment with radiation therapy and systemic chemotherapy. However, perhaps only 25% of all patients will be candidates for this intensive/combined modality approach. Therefore, there is a need to identify effective combination chemotherapy regimens that can be easily administered to the remaining 75% of poor prognosis SCLC patients. Our studies and those of others would suggest that the combination of carboplatin and oral etoposide is a highly effective regimen for the treatment of these patients with results equal to and comparable with more intensive schedules. The. ease of administration ofthis combination with acceptable toxicity would suggest that for such a subset of patients it may be the treatment of choice against which other combination schedules should be compared.
Etoposide phosphate or etoposkk with cisplatin in the treatment of small cell lung cancer: Randomized Phase II trial Greco FA, Hainsworth JD. S. Cannon&Winnie Pearl Cancer Cente,: 250. 25th Avenue North, Suite 412, Nashville, TN 37203. Lung Cancer (Ireland) 1995;12:Suppl 3:S85-95.
Etoposide phosphate, a water soluble prodrug of etoposide, has several potential advantages including easier and more rapid admini-