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clusions can be made: (i) Resection for well-staged, modified stage I NSCLC results in a 5-year survival rate of 70%. Nearly half the deaths are unrelated to recurrence of the original cancer. (2) Recurrences are more frequent in T2N0 patients, but there is no survival dif- ference compared with TIN0 patients. Sys- temic recurrences are more frequent than local recurrences, and there is an ap- preciable incidence of second lung cancers. (3) Adjuvant chemotherapy or radiation therapy .does not seem justified, but systemic immunotherapy holds sufficient promise to warrant fur- ther investigation.

A 10-Year Experience With Combined Modality Therapy for Stage III Small Cell Lung Carcinoma. Jacobs, R.H., Greenburg, A., Bitran, J.D. et al. Department of Medicine, University of Chicago, Chicago, IL, U.S.A. Cancer 58: 2177-2184, 1986.

During the past 10 years, 240 patients with Stage III small cell lung carcinoma (SCLC) were treated with one of five chemotherapy programs plus thoracic irradiation. In addition, prophylactic irradiation to 194 patients receiving CAML-HC, VCAM or MOCA. Seventy-two patients had disease confined to the chest (Stage IIIM0), 30 patients had dis- ease in the chest plus ipsilateral supraclavicular nodal involvement (Stage IIIM0(SCN+)) and 138 patients had distant metastatic disease (Stage IIIMI); the median survivals were 15.2 months, 12.6 months, and 8.4 months, respectively. The overall complete response rate was 30% and the overall response rate (complete and partial) was 76%. The overall response rates by stage were 86% for Stage IIIM0, 90% for Stage IIIM0(SCN+), and 67% for Stage IIIMI. Eight patients (3%) were alive and free of disease at 24 months. Due to continued disease relapse in this group (4 of 8 patients), long- term survivors should not be identified for a minimum of 3.5 years from the time of initial therapy. Prophylactic cranial irradiation (PCI) effectively reduced the incidence of central nervous system (CNS) relapse in patients with a complete response to therapy (44% relapse without PCI versus 13% relapse with PCI, P < 0.01). More effective chemotherapy is required for the successful treatment and improved long-term survival of patients with SCLC.

Cisplatin and Etoposide Before Definitive Radiation Therapy for Inoperable Squamous Carcinoma, Adenocarcinoma, and Large Cell Carcinoma of the Lung: A Phase I-II Study of the Radiation Therapy Oncology Group. Cox, J.D., Samson, M.K., Herskovic, A.M. et al. Radiation Oncology Service, Columbia-Presbyterian Medical Center, New York, NY 10032, U.S.A. Cancer Treat. Rep. 70: 1219-1220, 1986.

A trial of 'neoadjuvant' cisplatin- etoposide and radiation therapy was con- ducted by the Radiation Therapy Oncology Group for non-small cell carcinoma of the lung limited to the thorax. Thirty evalu- able patients were studied: two achieved complete response and four achieved par- tial response after chemotherapy. All patients underwent radiation therapy as planned, with no unusual acute reactions. Sixteen patients had local failure, and 13 had distant metastasis. Twenty-seven patients are dead, two are alive with cancer, and one is clinically free of cancer at 145 weeks. Five of six patients who survived > or = 2 years after treat- ment had adenocarcinomas. There was no unexpected late toxicity. This combina- tion of chemotherapy and radiotherapy is unlikely to improve results in the treat- ment of inoperable non-small cell car- cinoma of the lung over those with radiotherapy alone.

i0. OTHER TREATMENT MODALITIES

Five-Year Disease-Free Survival of a Lung Cancer Patient Treated Only by Photodynamic Therapy. Kato, H., Konaka, C., Kawate, N. et al. Department of Surgery, Tokyo Medical College, Shinjuku-ku, Tokyo 160; Japan. Chest 90: 768-770, 1986.

A 59-year-old woman had suffered cough and sputum production for several months. Chest x-ray film findings were negative, but sputum cytology yielded a diagnosis of squamous cell carcinoma. This stage Ia lung cancer in the right upper lobe bronchus was deemed inoperable due to poor cardiopulmonary function. She was treated by photodynamic therapy in February 1981, involving intravenous in- jection of hematoporphyrin derivative and fiberoptic endoscopically delivered argon dye laser light. She responded well to the treatment and the lesion disappeared within a week. At present, she is ap- parently disease-free more than five years after treatment. This is the first known report of five-year disease-free survival following treatment of a malig- nant lesion by PDT only.

ii. REVIEWS

Pulmonary Carcinoid Tumours: A Clinico- Pathological Study of 35 Cases. Hasleton, P.S., Gomm, S., Blair, V., Thatcher, N. Department of Pathology, Wythenshawe Hospital, Manchester M23 9LT, U.K. Br. J. Cancer 54: 963-967, 1986.

A clinico-pathological study of 35 bronchial carcinoid tumours was undertaken. Age, T stage, N stage, lymph node involvement, number of lymph nodes involved and number of cigarettes smoked per day were the clinical variables af- fecting survival. The histological vari- ables related to survival were; mitotic count, necrosis, nuclear pleomorphism, vascular and lymphatic permeation and an