164

to 2400 and 700 to 1704, respectively. There

was no pulmonary toxicity or other unusu- al toxicities observed.

Complete response on CXR was seen in all patients by the end of 2 cycles. CT- scans after 2 cycles continued to show densities of uncertain importance in 2 of 6 cases, "normal" in 4/6 and one too soon to evaluate.

Preoperative Chemotherapy and Lung Resec- tion in Inoperable Non-Small Cell Lung Carcinomas. Takita, H., Regal, A.-M., Antkowiak, J.G. Roswell Park Memorial Institute, Buffalo, N.Y., U.S.A.

Since 1977, we have studies the feasi-

bility of surgical therapy following effec- tive preoperative chemotherapy in inoperab- le non-small cell lung carcinomas. A total of 53 patients were entered. Resectabili- ty was defined as follows: I) Grossly com- plete resection of all the lesions was ex- pected, and 2) patients considered a good surgical risk.

Twenty-eight patients presented with lo- cally far-advanced disease but limited to the hemithorax (M0): In 2 patients, the presence of mediastinal node metastasis was found by mediastinoscopy, but 25 other patients had more advanced diseases such as obvious mediastinal lymph-adenopathy by conventional PA chest x-ray (8), vocal cord paralysis (2), extension of tumor to the carina (2), superior pulmonary sulcus tumor (2), SVC syndrome (i), and poor ge- neral condition (2). Nine patients had pre- vious exploratory thoracotomy. The surgery was performed following 2 to 8 courses of effective chemotherapy. In 22 patients, pneu- monectomy was done. Additional procedures included partial resection of the SVC and descending aorta.

The operative mortaliry was 10.7% (3 patients). Of the 28 patients, 5 are surviving more than 5 years (20% - median survival of 19 months). Twenty-five patients presented with disseminated disease (M%). Only 2 patients of these survived more-than 5 years postoperatively (8.3% - median sur- vival of 10.5 months). Combination of ef- fective chemotherapy and surgery appears to produce acceptable therapeutic results in locally far-advanced inoperable non-small cell lung carcinomas.

Radiotherapy (RT) Enhanced by Cis-platinum (DDP) in Stage III Non Small Cell Lung Can- cer (NSCLC). Trovo, M.G., Roncadin, M., Bortolus, R., Boz, G., De Paoli, A., Franchin, G., Mina- tel, E., Arcicasa, M., Gobitti, C., Grigo- letto, E. Department of Radiotherapy, Centro di Riferimento Oncologico, 33081 Aviano, Italy.

From October 83 to January 85, patients (pts) with locally advanced NSCLC were entered in a prospective trial of RT combined with a daily low dose of DDP, Conditions of eligibili- ty included histological proof of NSCLC, UICC stage III disease, age less than 75 yrs, PS > 50, adequate renal function. Of the 42 eligible pts, 37 were males, 5 females; median age was 64 yrs (41-74), median PS 80 (50-100). 16 pts had a weight loss greater than 10% in the last 6 months. RT consisted in 45 Gy in 15 fractions in 3 weeks on the tumor and mediastinum. Spinal cord was shielded after 30 Gy. DDP was given ½ hour before irradiation at the dose of 6 mg/m i.v. daily. No i.v. fluids were administered, unless pts were unable to have an oral fluid intake of 1.5-2 its. 9 pts are not yet evaluab- le. In the 33 evaluable pts, 5 complete remis- sions (histologically proven), ii partial remis- sions and 17 unchanged were noted. 12 pts relap- sed (4 locally, 8 at distant sites) after 1.5- 8 months from completion of RT. 6 pts had hyper- creatininemia (grade I in 5; grade II in i). One patient, not adequately hydrated during treatment, died while on renal toxicity. Other toxicities were not relevant. At a median fol- low-up of 29 weeks, 14 pts were dead.

When adequate hydration is ensured, the DDP regimen chosen as radiosensitizer can be safely combined with RT. A controlled study is in pro- gress to assess its potentiating effect on RT.

Vinblastine (VLB) as Adjuvant Treatment to Radio- therapy (RT) in Limited Inoperable Squamous Cell Lung Cancer. A Randomized Study. schallier, D., Van Belle, S., De Neve, W., De Greve, J., De Wasch, G., Dotremont, G., Storme, G. Oncology Centre A.Z.-V.U.B., Laarbeeklaan i01, 1090 Brussels, Belgium.

To evaluate the possible antimetastatic action of the vincaalkaloids in human, we per- formed a randomized study in limited inoperab- le squamous cell lung cancer patients (pts). 49 pts (PS > 60; age < 70) were randomized to recei- ve RT on tumor a~d mediastinum (55 Gy in 6 weeks) plus VLB (g mg/m by weekly bolus injection) (group A: 25 pts) or RT alone (group B: 24 pts). Tumor response was assessed 3 months after ran- domization by chest x-ray. Follow-up was per- formed monthly in both groups. Every six months liver ultrasonography and isotopic bone scan were performed. On indication, additional inve- stigations to rule out metastatic disease were allowed at any time. Both groups were equiva- lant with respect to PS, age, TNM classifica- tion and number of surgically staged pts. Tumor response was observed in 12/18 pts in group A (5 CR, 7 PR) and in 8/20 pts in group B (I CR, 7 PR) (p = .i0). A trend towards an increased metastatic free survival (p = .14) (median: 56 w in A versus 44 w in B) and overall survival (median: 71 w in A versus 56 w in B) was also observed for group A, (p = .14). Acute toxicity in the combined modality groups was increased (dysphagia, frequent dose reductions of VLB due to myelosuppression). Nethertheless, during