Abstracts/ Lung Cancer 12 (1995) 113-160 159

Lung cancer - Development, diagnosis, therapy, prognosis Zochbauer S, Krajnik G, Huber H. Universitalsklinikfurlnne~Med. I, Wahringer Gurtel 18-20, A-1090 Ken. Wien Klin Wochenschr. 1994;106:431-47. Lung cancer is the most frequent cause of death from cancer in men. In addition its prevalence among women is currently rapidly increasing. Main risk fbctors are smoking, exposure to asbestos and genetic factors. Current screening methods do not allow early detection and, hence, lung cancer is usually diagnosed at an advanced stage. The stage of the disease affects survival. In non-small cell lung cancer the probability of 5-year survival for patients is about 43% with stage I, 23% with stage II, 17% with stage III A and 2% with stage III B disease. Surgery plays a major role in patients with non-small cell lung cancer in stages I, II and maybe III A. In small cell lung cancer the probability of S-year survival is about 10% for patients with limited disease and less than 1% for patients with extended disease. Although surgery plays a role in stage I to stage III A, chemotherapy remains the most important mode of therapy in small cell lung cancer. In stages I to IIIA, however, combined treatment modalities might improve outcome of the patients with small cell lung cancer.

A clinical therapeutic results on small cell lung cancer Kim EH, Lee SH, Huh WY, Kim HS, Jo JU, Kim MA et al. Department of Internal Medicine, Pnzsbylen’an Medical Center: Chonju. Tuberc Respir Dis 1994;41:262-9. Backgmund: A clinical study was carried out on 153 new cases with small cell lung cancer registered at Presbyterian Medical Center, Chonju during the 7 years from 1986 to 1992. They were analyzed by sex and age distribution, symptoms and signs, classification of stage and site and its treatments. Especially an effort was made to compare the overall survival time between limited stage and extensive stage. Methods: Among 806 lung cancer patients diagnosed by biopsy or cytologic evaluation for the 7 years, 153 patients was shown small cell lung cancer. These 153 cases was analyzed retrospectively through patient’s records, letters or telephones. Results: The results of evaluation of small cell lung cancer are as follows. Over 85 percent of the small cell lung cancer patients were over 50 years of age and prominent clinical features were cough (86.30/o), sputum (75.8%) and dyspnea (54.9%). One hundred and tie patients (68.7%) was staged to have limited stage. Mean survival time of the chemotherapy and chemoradiotherapy in limited stage has siginficant difference and its survivals are 5.3 months and 15.0 months. Patients whose disease was staged as limited, regardless of whether or not chemotherapy was administered, had a median survival time of 10.9 months, compared with 4.8 months for those with extensive stage. Conclusion: Lung cancer is one of the malignant diseases tend to increase gradually in Korea and proven to be the most common cancer next to the gastric cancer among various cancers in males found at the Presbyterian Medical Center in the past seven years. This report is a retrospective view of the clinical therapeutic results of the small cell lung cancer patients. Especially at the limited stage, the combined therapy revealed higher survival rate than the chemotherapy alone. For a more accurate evaluation, a prospective view. without any bias, of patients selected at random is needed.

Small cell lung cancer treatment Lebeau B, Schuller h4l? Service de Pneumoiogie. HopitaISainl-Antoine. 184, Rue du Faubowg-Sain~-Antoine, 7SOI2 Paris. Rev Med Inteme 1994;15:423-7. In small cell lung cancer, the main treatment modality is chemotherapy, combinated with early thoracic radiation therapy for patients with

complete response. The treatment of relapse with chemotherapy is efficient. The precocity of the response after initiating multimodality treatment is the main prognosis factor. The prophylactic cranial irradiation reduce the frequency of brain metastases, but has no significant effect on survival. Patients with very limited small cell lung cancer (TNM stage I and II) can be managed by surgery. Association with colony stimulating factors can lessen the severity of neutmpcnic ;t”d infectious episodes. The mle of maintenance therapy by interferon 0 in clinically disease free patients is suggested.

*atmeat of lung cancer in 1994 Vmcent M. Service de Pneumologie, Unite de Cancerologie Boracique, Ch: Hosp. SaintJoseph - &in&Luc, 9Rue Ptvfesseur Grignad, 69365 Lyon Cedex 07. Med Hyg 1994;52:1350-2. Slight advances have been realized recently in lung cancer treatment. 5 t0 10% Of patients treated for localized small-cell lung cancer with chemo-radiotherapy are still living 5 years later; but in metastatic disease prognosis has not improved. In locally advanced non-small-cell lung cancer, chemotherapy has proven its value in association with radiotherapy and sometimes surgery in the hope of a cure. Similarly chemotherapy alone impmva survival in metastatic non-smallcell lung cancer. A prospective multidisciplinary management based on TNM is recommended.

Future directions in the treatment of non-small cell lung cancer Shepherd FA. Totunto Hospital, 200 Elizabeth St, Toronto, Ont MSG 2C4. Semin Oncol 1994;21:Suppl4:4862. Lung cancer is now the leading cause of cancer-related mortality for both men and women in North America. Non-small cell lung cancer (Nscw aczmmts for 75% to 80Y0 of all primary lung tumors. Although the survival rate for patients with NSCLC remains poor, recent advances in our knowledge of the pathophysiology and biology of lung cancer have paved the way for the development of new, more effective therapeutic interventions. This paper reviews the current status and future prospects for the management of NSCLC, inchniing adjwant therapy following surgical resection for stages I, II, and IIIA disease; induction chemotherapy for locally advanced stages IIIA and IIIB disease; chemotherapy for advanced stage IV disease; and biologic response modifiers, including interferons, interleukins, colony- stimulating tkctors. and monoclonal antibodies.

Miscellaneous

Japanese doctors’ preferred treatment choices for their hypothetical q oo- small cell lung cancer: Bow tbey would wish to be treated Motohiro A, Himta N, Komatsu H, Yanai N. Department of .%gety, National Minamiftkuoka Chest Hosp., 4-39-1, Yakatabam, Minami- ku, Fukuoka 815. Lung Cancer @eland) 1994; 11:43-50. We conducted a trial to clarify what Japanese clinical doctors think about the present status of therapy for non-small cell lung cancer, as well as to clarify which problems are still unresolved. One-hundred five Japanese doctors who treat lung cancer patients were asked how they would choose to be treated, if they suffered from non-small cell lung cancer. Six scenarios were presented and the doctors had to choose one treatment method for each of the six scenarios. Adjuvant chemotherapy or radiotherapy after complete resection, increase with progression of the pathological stage. Ninety-three per cent of Japanese doctors wanted surgery, even ifmediastinal lymph node metastaxs were present. In the scenario of only one distant metastasis to the brain, 44%