160 Abstracts/Lung Cancer 12 (1995) I I3- I60

of doctors wanted surgery while 39% wanted chemotherapy and/or radiotherapy. In the scenario of multiple bone metastases, 33% wanted chemotherapy, 77% did not. It was concluded therefore that Japanese doctors choose surgery as the number one treatment modality when all lesions are considered msectable.

Patterns of cats and survival in non small cell lung cancer: 15 years’ erperience in a general hnspitaJ Clerici M, Panvmi D, Toni V, Colombo F, Luporini G, Tinazzi A et al. Mario Negri Institute, Lab. of Cancer Clinical Epidemiology. Pia Erihva 62, 2OI57Mlano. Tumori 1994;80:106-12. Background: Transferring results derived from clinical reseach into practice is particularly difficult in lung cancer where clear indications for treatment are defined only for selected subgroups of patients. Studies on hospital-based lung cancer population could providf data for quantifying this tissue. Patients and methods: This was a follow-up study of consecutive, first-diagnosis cases referred to the in- and outpatient cancer clinics of a large Italian general hospital between January 1975 and December 1990. Data were collected from medical records and recorded on ad hoc standardized forms. Analysis focused on changes in distribution over time of patient-related characteristics, prevalence of specific treatment strategies and survival of the study population. Results: 1345 primary non small cell lung cancer cases were reviewed and I I25 were fully evaluable. In early stages (510/1125,

45%) only 237 patients aetually underwent surgery. In this group surgery increased from 36 to 69% whereas chemotherapy decreased from 58 to 15%. In the advanced group (61511125, 55%) chemotherapy was the preferred treatment but combined modalities tripled over time (from 4 to 12%). No signiticant changes in survival were observed within each group over time. Conclusion: Despite changes in the therapeutic approaches, mortality from lung cancer does not seem reduced over time. Since the proportion of cases that could potentially benefit from ‘active’ treatments is small, for the large majority of patients a switch in clinical research from a cure to a careoriented strategy should be considered.

Psychosocial stress of hroaebial-carcinoma patients and their expectations of oncological indoor aftercare Fischer HH, Freeman CV, Kugelen G. Klinik Sonneneck, Osferstrasse 2, D-25938 l@k aufFoh,: Phys Med Kehabil Kurortmed 1994;4:71-8. 126 patients suffering from bronchial-carcinoma were questioned about their psychosocial stress and their demands on oncological rehabilitation. Thequestiomlaire included78items, whichcouldbeanswemdingrades. 72% of the participants named the reduced physical efficiency as the dominating problem, ranking it in the first position. 63% of the patients classified anxiety and psychological distress in the second place. Consequently the patients expected an intensive medical care as a main point in oncological rehabilitation. only 24% of the patients classify psychological therapy under necessary.