148 Abstracts/ Lung Cancer IO (1993) 123-150

in four random&d pmqective ttiaIs conducted by the Radiation Thmppy Gncology Group (RTGG). The data wem pooled for . retrqective analysis of survival end prognostic t&tcws by race. Rent&~: Unitiate aneIy.sis showed significant diffaencos bshmm BI~~Whi(sswith~gudtossx,wei~tloss,histology,~RTOG Tstage(Pc.05). bet theonlycliaiully dgnificantdift&wtce(l’Y.Ol) was weight loss. Despite tbeue tiedings, ovezeIl SurviveI for Blacks and Whitesdidnotdi~significantIy(P = .67). MediaasuwivaIforBlac~ and Whites with I KamorsLy ~&nmaw statw(KPS)of9Oormore was 12.1 and 11.3 months, rsspsctivsly (P = .45). Swivel for Blacks andwhiteswitheKpSoflsss~9owps7.8~6.8mollths, rwpectivcly. Case of de& did not differ betwea the two races. For b&races, KPS, ege, sex, weight loss, and RTGG TandNstagsswere significant prognostic factors for muviwl (P< .Ol), but race was not P significant prognostic factor. Concltuion: Further shtdies of the differential in cancer survival for Blacks and Whi& may be indicated, but greeter impact may be achieved by addreesiag socioeconomic factors, lifestyle and oxupatioapl risk factors, health education, and access to adequate health care.

Rcsults of radietberapy with awire Intent In non-smaIl cell lung -.Ana&sIsdl3Opatie& Rein&s hf. Skolyswaki I. Kmcmiowski S. Rqecki W. Center of OncokJgy. M. sklcdowsko-clui~ Memorial Insl., ul. Gunmmka II, PL 31-115 K?akow. Stdde.nthslonLol 1992;168:573-8.

Behvea 1970 and 1985,130 patients were irradiated with curative inteat at the Cater of Gncology in Krakow. The bistologicpl diagnosis was squntous-cell cercinoma in 60.8% of patieots, adeaocarcinotne in 25.4 % of patimts and other non-s&l cell cancer in 13.8% of p&eats. Get of 130 irradiated patients 21.5% retiwed surgery, 26.2% were inoperable for medical reasxms, and 52.3% bed unrese~table tumors. Accotdiag to the UICC TNM 1987 classification, 62 (47.7%) patieate had early (stagea I end II) disease. The remaining 68 (52.3%) petieots bed stage IIl A cancer. Additional criteria for patients selection to radiotherapy with curative intent were: Kamofsky performance status SO, nod no respiratory insufficiency. All patients were treated with megavoltage radiation. Patients with stage I were treated by three isocatric beans. Tumor dose was 6ooo cGy in 24 fractions over five weeks. In patients with stage II and III A disease the Rdiothenpywprstutedwithhuo~lelopposedbeoms~co~ing primary lesion and mediastinum. Tbe dose of 4ooo cGy was given in 20 fractionsover fourweeks, followed bye ‘boost’doseof2OOOcGy in the tiactions over two weeks, delivered with three isoceatic beams. 54% of patiats were disease-free et the twelfth month, 24.6% at the 36th month, and 18.5 I of patients survived five years without evidence of cancer. AsigDificslltlybe(tersurvivnlhPsbeeaobservcd inpatientswith stages I and II, with Kamofsky performeece statis 70, and with complete mdiologicsl regression eight weeks atIer radiation therapy. The main cause of tilure of the VePtment were distant mstastase.s.

cIblicaI stqe II non-small cell lung cancer treated with radiation therapy alone: The signifianee of clinically staged ipsilatwel bilnr adenopathy (Nl disease) Rose&PI SA, Curme WJ Jr, Herbert SH, Hughes EN, Sandier HM, Stafford PM et al. UCSFIUCD Dept. of Radiation Onmlogy, UCD cancer Center, 4501 X Strrer, Sacramento. CA 95817. Cancer

1992;70:2410-7. &&ground. The prognosis of patiats with cliically staged

hilsr nodal involvement (Stage Nl) or clinical Stage II non-smnll cell lung cancer (NSCLC, Stage Tl-2NlMO) treated with radiation therapy (RT) done is not well established. Methods. Records of 758 ptieets with clinical Stage I-lI1 NSCLC treated with RT were reviewed. Sinty- two patients were identified with clinical Stage II NSCLC, and 126 patientsbadStageN1 disease.. Rwults.Tbemediaesurvival time(MST) of the 62 patieots with clinical Stage II disease was 17.9 months, with l-year, 2-y-, 3-y-r. and S-year overall actuarial survival ratea of 70%,33%, 20%. and 12%. respectively. Thesurvival of patientswith clinical StngendiseasewassignificaatlybetterthanthPt of389 patients

withclinicaIStageIIIAdisesse(MST, 11.3meetbs;P < O.O08)and267 patiettts with cliniul Stage IIIB disease (MST. 9.8 months; P = O.oaOS), but it was similar to that of 40 patie& with cliicrl Stage I lesions (MST, 15.0 months). Patients with performance statusa of O- 1 lived longer than those with a status of 2 or more (MST, 22.8 vemus 6.1 months; P < O.ooOl). Tbe mediae survival for pattieats with NO, NI, N2, and N3 disease was 13.7, 12.6, 10.9. and 9.1 months, respectively. PetimtswithStageNO-1 disease(MST, 13.2mcmths)had significantly improved MST compared with those with Stage N2-3 disease(MST, 10.3months). Conclusions. Thesurvivalofptieatswiti clinical Stage II NSCLC trerted with RT okme wea significantly better than that of those with clinical Stage IIIA or IIIB disease. It was comparable to that of patients with cliicpl Stage I lesions. The clinical staging of nodal involvement limited to the ipsileteral hilum does not neceswily portend P worse prognosis than that of patients with clinical Stage NO disease. The absence of clinically evideat Stage N2-3 disease is of significant predictive value. for patients with NSCLC treated with RT.

Endobmnchial irradiation with ‘Yr in the tmatment of malignant endobmnchIal obsbwtIon Par&lo JC, Waxman MI, ThmneBJ, B&x TA, Kqxcky WJ. Kanras City Pulmonary Clinic, 6420 Prospect, Kamu City, MO 64132. Chest 1992; 102: 1072-4.

From Jan 1, 1983 to April 30, 1989.32 patients umienveat 38 eedobmncbial treatments with ‘“Ir. bmocboscopicaIly inserted for treatment of endobmnchiaI obstructions seamday to bmnchogenic carcinoma. Thirty-four of the 38 treatments were far enough apart to allow separate twpotxse analysis. Thirty of tbe 34 patients were symptomatically improved or stable; 22 of 24 petients who could be evaluated roentgenographicelly showed improved or stable chest meetgenogmms, and tee of 12 ptieats evahuted bmncboscopically demonstrated improved patency of bmnchial lumen.

High dose rate bradtytbetnpy in patients with lecal maummxs after radiothesnpy of non-anaII cell lung cancer Sutecja G, Buis 0. Scheak~Kcming C, Van Zaedwijk N. Netherlands Camxrltwittue.Antotti wn~uwetthoekhttis. PLmkmlaan121.1066

CXAmt+?r&tn. Int J Radiat Cmcol Biol Phys 1992;24:551-3. Thirty-ooe patie& with recwreaceu of locaIly advanced

StngsI~lun~-werstrertcdwithhighdossntcbrpchythcnpy. All patimtn had previously received a full course extemaI beam irradietiw. AlI treatments were performed under topical aeaeahesia and took 6-14 mindependinpoethc~gtboftheIridium-192source. Thchigbdose ate bmchytherapy was c&ulated as 10 Gy at one cm from the source axis for each eessioe end this was reputed every 2 weeks to a maximum of three seasions. AI1 trentmmta were well tolerated and no immediate treatmeat &ted complicatioes were observed. Response ewIution 6

s&ival was i aad 3 months, *&wtively. AI1 ec&espomiers had ieitinlly presented with P T4N3 tumor. Tea patients died because of fatal pulmonary hemorrhages 2-24 weeks aRer bmchytherapy and three others died bxause of a breechid tishda. Bndobmnchial bmchytherapy appeare to be a vahmble treatment akemative for local paIliation. However, the relatively bigb number of complications at follow-up warrants further investigation to estlblish the optimaI benefit to be derived fromhigh dose rate hmcbytherapy treatmeaat of locally advuvxd stage III hunors.

Combined treatment modalities

Multimodal therapy of small cell lung - in TNM stages I through IIIa Muller LC, Salzer GM, Huber H, Prior C, Ebner I, Fmmmhold H et al. II Univ. Klinik fur Chirurgie, Abteilung fir 7horaxbirurgie. Anichstraw 35, A-6020 Innsbruck. Am llmrac Surg L992;54:493-7.

Since 1977, Innsbruck University Hospital has beeD employing a multimodal therapy concept for small cell bronchial carcioomas ie