Abstracts/Lung Comer 13 (1995) 81-104

prognostic factors on survival m palien& with inoperable locoregional non-small cell lung cancer The study was performed on a group of 239 pa,ientstirha medmnageof69 years, 225 men. and 14wo”en. Patients were treated with external radmlkrapy mthcut (184) or w,,h (55)

i I serws bf 3.000 ffiy. 2 sales of respcmvel; 3.00” cGy and 2.5bil cCy. or 3 series of, rcspecl~vcly 3.MM cGy. 2.500 cGy, and 2.000 cGy. each series in IO fmctmns and 2 weeks. scparakxl by a 4- week mtcrval) Umvanate analysis was done by life-lablc analysu and log- rank Ics,. “ult~anate analysts by the Cos Proponional Harards model The overall survival a; I. Z.-and 3 years was 36%. I I%. and 4%. Surv,\al was not s,gnilicantly inIluenced by locali/al,on of the tumor. gradmg. dmtance ,o the carma. growth pa,tern. dmmcler. part”1 or l~lal atclectas~ lymph node mvasmn or stage No srgnrIican, ddTcrcncc m survival was found between patients who received oni) radmthcmpy and those treated wrth a mmbmalion ofradmlhempy and chcmolhcrap) Unrvanate analysis showed stgniIicant better survival m pahen& wllh squamous cell epithchoma. pauenls wlthou, pleural clIiusmn. paltcnls younger than 7j years and &ems rece,v,n, h,ghcr radratmn doses Multivanate an&is showed dose of radialmn (P < (HII) and pleural eIfusion (P = 03) to be independent prognostic factors

Experience in preoperative radiotherapy for no” small cell lung

cancer (NSCLC) Zharkov V, Demidchik Y, Kurchin V, Moiseev P. Deporlmnenr for Thorooc Surgery. Cancer Reseomh hs,r,u,e. PO. Lesnoc-2, 223052 Minsk. Radio1 Oncol 1994;28:382-5.

Four hundred and thirty lung cancer pat,ents were drawn “to mnd”nizedst&yofthcitiuced hypcrglyce”ia(IH)asaradimendt,ur for preoperative large fmclmn uradiation: 2 I7 patients underwenl IH carried out on the 1st. 3rd. and 5th days or radiotherapy by the I.V. inf&ionof40%glucore: 213 piems wzreenmlkdin,he mntrol group There were ,he following cntena for the patants’ enmlment into ,he prolocol: males. age younger than 66 years, cTI-3NO-2M0, histologically proved NSCLC. no contraindications for surgely and IH The preoperat,ve irradiation was carried cut by a total dose of 20 Gy, delivered ,n fwe 4-Gy fracuons per week. using 20 MeV equipment. Surgery was carried out three days tier radiotherapy Palients with pNI-pN2 rece,ved add,t~onally postoperative radmtherapy 30-36 Gy, 2 Gy per fraction. In stage IIIA. pa,ien,s‘ survival was significantly higher for IH compared wilh the mntrol group the maban survival war 2.0 f 0 3 years tn the study group vs I I f 0 23 in ,he conlrol group (P ~0 05) Theduratmn ofsurv,vald,~ereds~gni~canlly for the second year of follow up (50 0 + 6 0 vs 32 3 f 4 6%. P < 0 05) For the fiRh year the surv,val rates were 29.2 t 5 2 for the study group VI 17.2 * 4 2%,n,hecon,rolgroup;,nN2pa,,ents 23.9t43vs IO 3*3.4%(P < 0 05)

The role of radiotherapy in lung cancer treatment. Report from

Slovenia Debevec M. lnsl,,ure of Oncology Zalosko 2, 61105 LjubQano Radio1 Oncol 1994;28:376-81.

Bockg,wnd. In order to evaluate the mle of radiotherapy in lung cancer tt&nent in Slovenia. 276 ptstrealed in 1988 at the Institute of Oncology m Ljubljmm were invest&&d Patients andmethods. There were 253 males and 23 females, aged 3 l-83 yrs (media,, 59); 6 pa had cl,nical St. 1. 19 St. II. 78 St. Illa 65 St. IIlb and 108 DIS had St. IV lung cancer Distant “etastatic sites were as follows: generalised in 29 pts, bone in 32, brain in 21, liver in9 andotherorgansin 14 pts. Of267 histologiutlly confirmed lung cance”. I26 were squamous. 62 small- cell. 44 large-cell, 23 adenocarcinomas. and 12 others (mixed. unspecified). Perfonnancz status (Kamofsky) was assessed as >70 in 199.50-70 in 57 and ~50 in 20 pu. primary therapy was: RT in 189. RT + ChT in 44, OP + poslop. RT in 20. OP + ChT in 2. ChT in 14, and solely sv”Dtmna,ic in 7 CU. In 253 pts treated by RT, tumor dorc was >5.&cG; (= radical) in 88. palliadve in 156. and only initial in 9 pts. RT as the onlv method of treatmen, was applied hxo-regionally (and supraclavic&y) in 135, to local + dis&,,t “etastases in 8. only “etastaSeS ,,I 43, whereas m 3 pts lint 10 distant “etas,ases and later on lo the lung. Resrdrs. By the end of ,993,7/276 (2.5%) pu were still alive. One-year survival of all treated pts was 25% and -year 9% Of 75 pts irradmted loco-regionally with radical doses, 49% smvwed one year, 17% two years. and 3% 5 years. There was a significant d&rence in (he sblvival according fo ,umour dose @ < 0.001) and

performance status (p < O.OOl), but mne with reference to clinical stage I-lllb (p < 0. I) and histology @ < 0. I). Treatment response was assessed ailer locoregional radmtion in 79%. and afler radiation of metastases in 70% of cases. Conclusrons. Radiotherapy has proved beneficial for the maJonty ofour patients in terms of life quality and short term su~val.

Combined treatment modalities

Results of cancer and leukemia group B protocol 8935: A multiinstitutional phase II trimodality trial for stage IllA (NZ) non-small-cell lung cancer Sugarbaker Dl. Hemdon J. Kohman LJ. Krasna MJ. Green MR Altork, N it al. Dww~on ojT?~orocrc Swge~, Srrghom and Women’s ~osprrol, 75 Franus Sr., Bosron. MA 02115. J Thorac Cardiovasc Surg 1995;109:473-85.

From Dctobcr 1989 to February 1992, 74 pauents with media- stmosmpically slaved IIIA M2) non-smallsell lune cancer from 30 C~GBatTd&d~osp,,als received two cycles of &eszctional cis- pla,,n and nnblastme chemotherapy. Palients with responsive or stable disease underwent standardued surgical resectmn and radical lymphadenenomy Palienls whounderwent resccuon recavedxquenlial adjuvant therapy wi,h two cycles ofasplatin and vmblastme. followed hy thoraac trradmtmn (54 Gy after complcle resection and 59 4 Gy alla mcomplae resection or no resectmn al I .8 Gy per fractmn). There were no radiographlc mmplctc responses lo the ncoadjuvam chemo- therapy. abhough 65 (88%) pa,,en,s had alher a response or no drscar progress”” During rnduamn chemotherapy. d,rax progressed I” seven patienls (9%) S,rty-three pa,,en,s (86%) had cxploralor) thoracotomy. and 46 of those (75%) had reseclahlc lesmns A complele surg,cal resectmn was accomplished ,n n pauenls. and 23 pa,,en,s had an incomplete “sxlmn with &her a disc&d mar8m or d&x& h&es, node resected Opera,rvc”or(ali~ was 3.2%(2/63) In IO I)a,icn,s (22% of the 46 havmg~reseclion) the disease was palhologacally downsraged Therewas IY) mrrelatmn between mdiographrc response to the mduclion chemotherapy and downstagmg at surgical resectmn The full prolocol wascompleted by 33 palicne(45%of&ginl cohort). Ovcrall~urv,val at 3 yea” was 23% Patients undergoing resecbon had stgmficanlly improved survival at 3 years compared with pat,en,s not having resection: 46% for mmplete resection (m&an 20.9 months), 25% for incomplete reszction (median 17.8 months), and 0% for no rcsamn (media,, 8 5 months). Five deaths occurred during the trcalmcm permd A total of I8 of ,he 46 (39%) patients who undcrwcnl rcscc,~on are ather alive and drseasc-iree or have died w,,hout recurrence

Stereotactic radiosurgery with the gamma knife for brain metastases in patients with lung cancer Morikawa T . Takeuchi K. Fujino H. Fukumura M, Kimura M, Fumie H et al DepMmen, ofResp,ro,ory Medmne, Yokohomo Rosor Hosp,lal. 3211 Kozuke, Kouhoku-ku. Yokohama 222. Jpn JThoracDis 1995,33:44- 50.

Belwgn February 1992 and Apnll993. six patients with lung cancer were treated w,,h gamma knife radmsurgery for brain “elasmses Five pabenls had adcnrxarcmoma. and one patient had small cell carcinoma Two pabenls had solitary “etastases. and four patients had mulbpk “emstaszs. Twelve merasmses were treated with the gamma knife (peri- pheral dose between I2 Gy and 25 Gy). ARer “dmsurgery. three complete and eight panial responses were achieved. which resulted ,n an overall response rate of 92% In two pa,,ents, histological studms showed Lhal few vmble cells were surrounded by necrosis Neurological status ,mpmved in all patients, and none died ofcomplications However. four of six patients later developed new intracranial “etastaxs “aide the treatmen, field. Thesedatasugges, that mdiosurgerywth thegamma kmfe ,s effective against brain “elaskaes in patients wdh lung cancer, espaaly when the lcsmns are deep ,n the brain.

Chemotherapy and radiotherapy in stage II-111 non-small cell lung cancer Kanaloglu Z. Alvan A, Cerrahoglu K, Aydilek R, Usken, N. CelikerT AfSB Comlrca Gogus Has, Hostones,. 8,020 Uskudo,: lstoabul. Bull Gulhane Mil Med Acad 1994.36 522-7

Chemotherapy and radmtherapy received 34 stage 11-111 inoperable non-smell cell lung cancer 5 female and 29 male has ages media,, 56.3