397

patients with small cell lung cancer who are unsuimble for more toxic

chemotherapy.

Second-line chemotherapy in small cell lung cancer Anderscn M, Kristjansen PEG, Hansen HH. Deporrmenf of OncdogY. Rigshospitolet. Blegdamsvej 9, 2100 Copenhagen. Cancer Treat Rev 3990;17:427-36.

The literature on second-line chemotherapy in small cell lung Cancer

(SCLC) for the period 1979-1989 is reviewed. The reports consisted mainly of Phase II type studies and comprised a total of 987 patients with relatively few patients per study. The information was frequently

incomplete with regard to duration of response on first-line chemother-

apy, length of any drug-free interval and duration of response on second-line chemotherapy. The overall second-line response rate was

30%, but only 5% were complete responses (CR). The response rates obtained by Ihe combination of cisplatinum (P) and VP-16 (E) or

reinduction therapy were 45% and 64% (medians), respectively. These

rates were superior to regimens consisting of supposedly non-cross-

resistant agents. With P and E not given in combination, the response

rates were less than 20%.

Sequential chemotherapy in good-prognosis patients with small- cell lung center Twelves CJ, Goldman I, Ash CM, Souhami RL, Harper PG. Spiro SG,

et al. Clinical Oncology Unit, Guy’s Hospital, St. Thomas Street. London SE1 9RT. Cancer Chemother Pharmacol1991;28:139-41.

A sequential combination chemotherapy regimen was evaluated m

23 patients with small-cell lungcancer(l6, limited disease; 7,extensive

disease). All patients had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1, normal serum sodium and

albumin levels and alkaline phosphatase values of < I .5 times the upper

limit Of normal. Treatment comprised ifosfamide and either vindesine

Or vincristine given on weeks 0,2 and 4; cisplatin and etoposide given

on weeks6,9and 12:anddoxorubicinandmethotrexategivenon weeks

I5 and 17. The overall response rate at the end of chemotherapy was

91% andthecompleteresponserate was43%. Treatmentwasgenerally

well tolerated and the delivered dose intensity was 83% of that pro- jected.Mediansurvivalwas54weeks,with4patients(17%)beingalive 2 years after the completion of therapy.

A phase II study of ifosfamide and a(2b)-interferon in advanced non-small-cell lung cancer Lind MJ, Gomm S, Simmonds AP, Ashcroft L, Kamthan A, Gurney H,

et al. Department of Clinical Oncology, Newcastle General Hospital,

Westgate Road, Newcastle upon Tyne, NE4 6BE. Cancer Chemother

Pharmacol 1991;28:142-4.

A total of 45 patients with advanced non-small-cell lung cancer were treated with a combination of I.5 g/m* ifosfamide given on days l-5

every3 weeksforfourcottrses with3 millionIUa(2b)-interferon(Intron

A) given S.C. three times a week for 12 weeks. Nineobjectiveresponses

were seen, including two compIete responses (CRs) and seven partial

responses (PRs). Haematological and non-haematological toxicities

were generally mild and did not necessitate discontinuation of therapy.

Phase II study of ACNU in non-small-cell lung cancer: EORTC study 08872

Planting ASTb, Ardizzoni A, &tape J, Giaccone G, Scagliotti G,

Splinter T.A.W et al. Department ofMedico Oncology. Dr. Daniel den Hoed Cancer Center, Greene Hilledijk 301. 3075 EA Rotterdam.

Cancer Chemother Pharmacol 1991;28:145-6.

A total of 62 patients with metastatic or locally advanced non-small-

celllungcancerwereenteredin aphaseIIstudyofACNU. Initially, the

drug was given i.v. at a dose of 100 mp/m’every 6 weeks, but due to

observed haematological side effects in chemotherapy-pretreated pa- tients, the dose was lowered in this group to 75 mgfm’. We observed one complete response in a subject exhibiting multiple lung metastases and a partial response in two patients, one showing brain metastaseS and one

who experienced local disease recurrence. The toxicity of ACNU

mainly consisted of bone marrow suppression especially thrombocy- topenia. with one toxic death occurring due to intracerebral haemor- rhage. We concluded that at this dose and on this schedule, ACNU has

limited activity in non-small-cell lung cancer.

Mitomycin C, teniposide, and cisplatin combination chemotherapy for advanced non-small-cell carcinoma of the lung Giaccone G, Iberti V, Donadio M, Testore F. Department of Oncology,

Free University Hospital, De Boelelaan 1 I1 7, NL-1081 HV Aouter- dam. Cancer Chemother Pharmacol 1991;28:147-9.

A total of 45 patients with advanced non-small-cell lung carcinoma

weretreated withacombinationofcisplatin, teniposide,andmitomycin

C. Mostsubjectsexhibitedgoodprognostic factors@erformancestatus, O-1; minimal weight loss; locoregional disease). Toxicity consisted

mainly of myelosupprewon and nausea and vomiting. Four patients

died of sepsis due to chemotherapy-induced leukopenia. The response

ratewas 39.5%. with nocompleteresponsesbeingobserved: the median

duration of pamal responses was 23 I days and median survival was 243

days. Although the response rate and durations of both response and survival were comparable with those obtamed using other cisplalin-

containing regimens, myelotoxicity was rather pronounced m the present study. Farther studies of teniposide in this type of combination

are not warranted

Radiotherapy

A new applicator, positionable to the center of tracheohronchial lumen for HDR-IR-1924terloading of tracheohronchial tumors Fritz P, Schraube P, Becker HD, Loffler E, Wannenmacher M, Pastyr

0. Radiologische Universitatsklinik, Schwerpunkt Strahlentherapie. Im Neuenheimer Feld400, D-6900 Heidelberg. Int J Radiat Oncol Biol

Phys 1991:20:1061-6.

A new bronchial applicator for afterloading irradiation is introduced

which can be positioned to the center of the tracheobronchial lumen.

The central position in the lumen leads to a clear improvement of dose

distribution. The applicator is built on the principle of a coaxial tube.

Parts of the outer cover can be expanded to baskets and effect a distance

of the radiation source from the bronchial mwosa or tumor surface, and

at the same time, expend a relief of extreme contact doses. No obstruc- tion of the respiratory system through the positioning device will be

caused. The positionable bronchial applicator seems to be suitable for

reducingcomplicationscausedthrough highconractdosesand irregular dose distributions and may be able to improve the results of endolumi-

nal radiotherapy.

lnoperableendobronchial obstructing lung carcinoma treated with combined endobronchial and external beam irradiation Cotter GW, Herbert DE, Ellingwood KE. Department of Radiology,

Division ofRadiation Oncology, University of South Alabama College of Medicine, 307 University Blvd. Mobile, AL 36688. South Med J

1991;84:562-5.

Thirty patients with symptomatic inoperable endobronchlal ob- structing lung cancer received combined external beam radiotherapy

and temporary endobronchial iridium Ir 192 implants. External beam

irradiation doses ranged from 57CO to 6600 cGy. Patients were given

two to four temporary iridium Ir 192 implants for endobronchial

radiotherapy. Individual implant doses ranged from 500 to 1500 cGy.

Total implant doses ranged from 1125 to 3OtXl cGy. Total treatment

doses ranged from 7080 cGy to lO,OCKl cGy. Seventy-seven percent of

patients had a complete local endobmnchial response to treatment, and 13% had a partial response. Ninety percent of patients experienced an improvement in their performance status using an Eastern Cooperative OncologyGroup(ECOG)scale. Survival from theendoftreatmentwas

39%atlyearand2l%at2years,withthemediansurvivalat IOmonlhs. The data from this study indicate that this form of treatment of