214 Abstracts/Lung Cancer 13 (1995) 185-232

patients undergoing surgery for that disease over the same period. Half of the surgical procedures were pneumonectomies. The post-operative mortality observed in the first 2 months was 16,6%. No patient presenting with nztastatic involvement of the mediastinal lymph nodes survived to the 3 year follow-up point. w thirds of the patients died due to neoplastic disease progression. The advisability of surgical treatment of lung cancer in the patient aged 80 years has not only to be considered in the physiological context but also with respect to the degree of disease progression in patients staged N2, the probability of recovery may be considered lower- than the risk of post-operative mortality and this factor must be taken into account.

Tracheal obstruction atIer placement of a metal wire expandable stent (W&tent) Koater MEY, Baas P, Wagenaar JPM, Van Zandwijk N. Department

Pulmonoty Disease, Onze Lieve IJvuwe Gasthuis, le Oosterporkstraat 279, 1090HMAmstetri~7m. Lung Cancer (Ireland) 1995;12:77-80.

Metal win expandable stents are increasingly being used to alleviate tracheal obstruction due to malignancies. Patients usually tolerate these stents well and experience good to excellent palliation of their symptoms [ 11. We report a case in which severe tracheal obstruction occurred 5 days tier placement of a Wallstent(lXl), caused by formation of fibrinoid plaques at the proximal end of the stent.

Prediction of survival time for patients with lung cancer and assessment of therapeutic effect Usuda K, Saito Y, Sakuma T, Handa M, Okaniwa G, Nakada T et al. Department ofSurge?y, Sendai Kousei Hospital, Sendoi. Jpn J Lung Cancer 1995;35:17-22.

Predicted survival time was calculated based on tumor size and growth rate using the Geddes’ nomogram in 174 patients with primary lung cancer, and the obtained predicted survival time was compared with actual survival time in each case. Predicted survival curves based on predicted survival time were compared with actual survival curves. In 48 patients who did not undergo resection, multivariate analyses using Cox’s propotional hazard model were used to evaluate the risk of death related to predicted smvival time and other prognostic factors. There was no significant correlation between actual survival time and predicted survival time. In patients who did not undergo resection, the actual survival curve was similar to the predicted survival curve. On the other hand, in patients who underwent resection, the actual survival curve was significantly better than the predicted survival curve @ < 0. 0001). The predicted survival time was proved to be useful to evaluate therapeutic effect. Multivariate analyses using Cox’s proportional hazard model identified three significant variables: N factor (p = 0. 00 11); M factor (p = 0. 0146); predicted survival time (p = 0. 0265). Predicted survival time was a signilicaut prognostic factor in patients who did not undergo resection.

The value of limited resection for ‘clinical’ stage I peripheral non-small cell lung cancer in poor-risk patients: Comparison of limited resection and lobectomy by a computer-assisted matched study Date H. Audou A. Shimizu N. Department of Surgery II, Okayama University Medical School, 2-5-I Shikata cho, Okayama 700. T~m0ri

1994;80:422-6. Aim: A computer-assisted retrospective matched study was devised

to compare limited resection and lobectomy for non-small cell lung cancer. Methods: Of 353 patients undergoing operation for ‘clinical’

stage I peripheral non-small cell lung cancer, 16 patients undergoing limited resection (because of poor risk) could be matched satisfactorily with 16 patients undergoing lobectomy (as a standard procedure) on the basis of age, sex, histology, tumor location, and hunor size with computer assistance. Results: No hospital death was observed in the 32 patients. Three of the 16 limited resection patients (19%) developed local recurrence in the same lobe. The 5-year sun&al rate was 55.5% for limited resection and 73.7% for lobectomy (P = not significant). For tumors more than 2.0 cm in diameter, 3-year survival rate was significantly lower in the limited resection group than in the lobectomy group: 34.3% versus 85,70/o, P < 0.05. For adenocarcinoma, limited resection seemed to be more unfavorable than lobectomy: 5-year survival rate, 34.3% versus 75.00/, P = 0.07. Conclusions: Limited resection offered a good survival rate without hospital death for poor-risk patients; however, lobectomy should be performed for good-risk patients.

Chemotherapy

Combination chemotherapy for unresectable lung cancer - Prevention of delay of courses and chemotherapy-induced neutropenia with administration of rhG-CSF Sasaki H, Asakawa M, Abe S. Third Department of Internal Med., Sapporv Medical University, School of Medicine, Minami-l-jo Nishi- l&chome, Chuo-ku. Sapporo 060. Biotherapy (Japan) 1995;9:557-61.

We have treated unresectable lung cancer patients with CDDP + IFX + VDS for squamous cell carcinoma, and CDDP + IFX + ETP for small-cell lung cancer. Bone marrow toxicity was moderately severe. To lessen toxicity and maintain the schedule of treatment courses, we administered rhG-CSF from February, 1992 to September, 1993. rhG- CSF was given for 14 days from day 8 in the 1st course and from day 4 in the following courses in squamous cell carcinoma patients. In small- cell carcinoma patients, rhG-CSF was given for 14 days from day 4. The interval of each course was fixed at 28 days in squamous cell carcinoma patients, and at 21 days in small-cell carcinoma patients. Some 62 courses in 26 patients were eligible. Bone marrow toxicity and the course interval were compared with those of historical control (82 courses in 34 patients). Neutropenia and delay of treatment courses were significantly decreased (from 79.3% to 29.3% for neutropenia, and 50% to 6.3% for interval).

A phase II trial of oral tegafur and uracil plus cisplatin in pa- tients with inoperable nonsmall cell lung cancer Ichinose Y. Takanashi N, Yano T, Asoh H, Yokoyama H, Tayama K et al. Department of Chest Surgery. National Kyushu Cancer Center; 3-1- 1, Notame. Minami-ku, Fukuoka 815. Cancer 1995;75:2677-80.

Background. The combination of uracil and tegafur in a 4: 1 molar concentration (UFf) has a greater antitumor activity than 5-fluorouracil (5- FU) and tegafur. Because the combination of 5-FU and cisplatin has been proven to have a synergistic antitumor effect in many experimen- tal and clinical studies, a Phase II study was conducted using the com- bination of UFT and cisplatin in patients with inoperable nonsmall cell lung cancer. Metho& Thirty+ne patients with measurable disease were entered into the study; all were evaluable for toxicity and response. Their median age was 61 years (range, 36-75 years). There were 13 patients with Stage III and 17 with Stage IV disease. Twenty-two (7 1%) patients had received no prior treatment. UFI (400 ms/m’) was admin- istered orally on days I through 21 and cisplatin (80 mg/m*) was injec- ted intravenously on day 8. This treatment was repeated every 4 weeks. Results. The median number of treatment cycles was two (range, 1-4 cycles). There were II partial responses (35%; 95% confidence inter-