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 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The aim of this prospective study was to evaluate: (1) the role of computed tomographic scanning in predicting chest wall invasion by peripheral lung cancer and (2) the results of operation according to the depth of chest wall involvement and other potential indicators of long-term survival. One hundred twelve patients with non-small cell lung cancer adjacent to the pleural surface who underwent computed tomographic scanning and subsequent thoracotomy were entered into this study. Tumor invasion was confined to the visceral pleura in 53 patients, to the parietal pleura in 18 patients, and to intercostal muscles in 25 patients; invasion extended beyond this layer in 16 patients. The computed tomographic criteria for chest wall invasion were (1) obliteration of the extrapleural fat plane, (2) the length of the tumor-pleura contact, (3) the ratio between the tumor-pleura contact and the tumor diameter, (4) the angle of the tumor with the pleura, (5) a mass involving the chest wall, and (6) rib destruction. The computed tomographic criteria 1 and 3 were significantly related to pathologic findings. Sensitivity was 85% for criterion 1 and 83% for criterion 3, specificity being 87% and 80%, respectively. Long-term survival of patients with T3 disease critically depended on the lymph node state and completeness of resection. The adenocarcinoma cell type and the T4 category were unfavorable prognostic factors. The depth of chest wall invasion did not affect survival, except for extensive rib and soft tissue infiltration. En bloc resection yielded better results than discontinuous resection.
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PMID:Chest wall involvement by lung cancer: computed tomographic detection and results of operation. 184 22

Sixty-one patients with advanced non-small cell lung cancer were randomly allocated to receive vindesine (3 mg/m2, day 1, 8, 15) plus either three cisplatins (35 mg/m2, day 1, 8, 15) or one cisplatin (80 mg/m2, day 1). Among the 61 patients, the number of complete cases treated by the former administration schedule (group A) was 24 and by the latter schedule (group B) was 27. The response rate of group A was 25.0% and that of group B was 22.2%. There was no significant difference between survival curves of group A and B. The median survival times of group A and B were 8.5 months and 7.5, respectively. Regarding the incidence rate of various side effects, no difference was found between the two groups. However, according to the WHO grade of side effects, nausea/vomiting in group A was significantly milder than in group B. The grade of leukopenia in group A showed a tendency to be milder than in group B. In conclusion, in terms of tumor response, vindesine plus three doses of cisplatin was no better than conventional vindesine plus cisplatin chemotherapy, however side effects of the former were slightly less severe.
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PMID:[Comparative study on vindesine plus cisplatin treatment of advanced non-small cell lung cancer--three divided doses (35 mg/m2, day 1, 8, 15) and single dose (80 mg/m2, day 1) of cisplatin. Chiba Lung Cancer Study Group]. 184 21

To evaluate the relationship between DNA ploidy and the clinical stage of the disease or the prognosis, tumor DNA content was determined by flow cytometry in paraffin-embedded specimens obtained surgically from the patients with primary lung cancer. A good correlation in DNA indices between fresh and paraffin-embedded specimens was observed (r = 0.978), although one tumor with DNA near-diploidy was mistaken as DNA diploid in paraffin-embedded specimens. DNA content analysis was carried out for 171 of 178 patients (401 of 427 paraffin-embedded specimens). Of the 171 patients, 155 could be enrolled in the clinical and pathological study, and 118 in the prognostic study. One hundred and nineteen (76.8%) patients had DNA aneuploid patterns that were higher in adenocarcinoma than in squamous cell carcinoma (p less than 0.05) Although the proportion of DNA aneuploidy was not associated with the pathologic stage, a better 5-year survival rate was observed in Group A (DNA diploidy, 62.9%) than in Group B (DNA aneuploidy and DNA peridiploidy, 28.4%; p less than 0.001). Therefore, the DNA content was considered to be an independent prognostic factor for survival in patients with non-small cell lung cancer. To evaluate the relationship of DNA content with histopathologic heterogeneity, the morphologic study was carried out on hematoxylin and eosin stained sections in adenocarcinoma of the lung. Seventeen patients had DNA multiploidy and 10 of 17 tumors with DNA multiploidy showed prominent pleomorphism in histologic morphology. DNA content seemed to be related to histopathologic differences in non-small cell lung cancer. The measurement of DNA content is useful for evaluation of clinical behavior and prognosis of the patients with non-small cell lung cancer.
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PMID:[Studies on flow cytometric analysis of nuclear DNA content in non-small cell lung cancer]. 184 24

Lung cancer is the major cause of cancer mortality. Locally advanced (Stage III) disease constitutes 30 to 40% of the entire group of non-small cell lung cancer (NSCLC). Surgical resection offers the best opportunity for cure, but resection of disease is possible in only a minority of patients with Stage IIIa disease. Even among patients who have "successful" surgery systemic relapse is common, and the 5-yr survival after complete resection is only 30%. Preoperative (neoadjuvant) chemotherapy is under investigation in an attempt to improve the bleak outcome of patients with Stage IIIa NSCLC. Preliminary trials have shown that this approach is feasible: neoadjuvant treatment can be administered with moderate toxicity and in most cases without compromising the possibility for surgical resection. In some instances, neoadjuvant treatment has produced pathologic complete responses, and in others it has decreased tumor bulk so that inoperable patients became surgical candidates. Whether this latter phenomenon has an impact on survival is unknown. Therefore, the role of neoadjuvant treatment for locally advanced lung cancer will not be known until properly designed randomized trials are conducted.
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PMID:Critical analysis of neoadjuvant therapy for Stage IIIa non-small cell lung cancer [corrected]. 184 70

Alternating radiotherapy and chemotherapy increases tumor cure rates in some animal models with reduced normal tissue damage compared to sequential use of these modalities. To test this concept in non-small cell lung cancer, 23 patients with predominantly Stage IIIB disease were treated on a Northern California Oncology Group pilot study of alternating radiotherapy and high dose cisplatin. Radiotherapy consisted of 6000 cGy delivered in three separate 10-day courses of 200 cGy/fraction/day during weeks 1 and 2, 5 and 6, and 9 and 10. High dose cisplatin, 100 mg/m2 in 3% saline, was administered on weeks 3 and 4, 7 and 8, 11 and 12, and 15 and 16. The response rate in 22 eligible patients is 73% (16/22) with four complete responses and 12 partial responses. Feasibility of this approach is demonstrated by 20/22 patients completing radiotherapy and a median of 2.5 courses of chemotherapy administered. Median survival time is 14.2 months (range 2-40+ months). One- and 2-year survival rates are 64% (14/22) and 41% (9/22), respectively. Hematologic, renal, and radiation-related toxicities were significant but manageable. We conclude that rapid alternation of radiotherapy and a high dose intensity cisplatin regimen is feasible in Stage IIIB non-small cell lung cancer, with a high response rate and acceptable toxicity. The long-term impact on local control and survival remains unclear, although preliminary survival data are encouraging in this poor prognosis population. Further studies of this concept are warranted.
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PMID:Rapidly alternating radiotherapy and high dose cisplatin chemotherapy in stage IIIB non-small cell lung cancer: results of a phase I/II study. 185 Jul 19

Forty-five patients with non-small cell lung cancer were treated in a phase II trial with menogaril 200 mg/m2 IV every twenty-eight days by a one-hour infusion. One partial response was noted while twenty-two patients had stable disease (51%). Progressive disease was noted in the remaining twenty-two patients. There was one fatal complication due to pancytopenia and pneumonia. Otherwise, the drug was reasonably well tolerated. At this dosage and schedule, menogaril has no substantial anti-tumor activity for patients with non-small cell lung cancer.
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PMID:Phase II evaluation of menogaril (NSC-269148) in non-small cell lung carcinoma. A Southwest Oncology Group study. 185 Nov 43

The establishment of reliable preclinical test is essential for the reasonable clinical trial. As a methodology for the screening of new active anticancer agents, disease oriented strategy using human tumor cell lines has been proposed in USA. The important questions in DOS are to determine the representative cell lines of specific cancer and it is also extremely important to decide the numbers of cell lines used for the screening. CPT-11, topoisomerase I inhibitor, developed in my country has been demonstrated to be active against lung cancer cell lines compared with mice tumors such as S-180 and P-388. However, no compound is demonstrated to be clinically active so far by this methodology. The criteria for the application of clinical trial are obscure and each drug company decides empirically by themselves. We have proposed to use PEI (predictive efficacy index) for the prediction of antitumor activity of new compounds. The clinical effect of new platinum analogue well correlated with this value. We have conducted phase II trial of 5-FU + LV against NSCLC without no prior chemotherapy. No responder was observed in the trial. Augmentive effect of leucovorin on the cytotoxicity of 5-FU and FdUrd was examined in vitro against NSCLC and colon cancer cell lines. Leucovorin stimulated the cytotoxicity of both drugs only against colon cancer cell lines. We tried to predict the response rate of new platinum derivative based on the data of bioassay of patient's serum administrated with platinum compounds. The predicted response rates of 254-S were 57-67% and 16-27% against SCLC and NSCLC, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Preclinical trials from the standpoint of clinical trials]. 185 17

The relationship between the first tumor and the second tumor resected in 8 patients with non-small cell lung cancer was analyzed using deoxyribonucleic acid (DNA) flow cytometry. Of the 8 patients, 6 were clinically diagnosed as having metachronous lung cancers and 2, local recurrent tumors. The mean interval between operations in patients with metachronous lung cancers was 62 months (range, 15 to 128 months). Both tumors showed the same histology in 4 patients and a different histology in 2. In the 2 patients with local recurrent tumors, the interval between operations was 9 months and 39 months. In the analysis of DNA flow cytometry of the first and second tumors in the same patient, the tumors were defined as independent of each other when one tumor showed diploidy and the other, aneuploidy, or when each DNA index of abnormal clones between two aneuploid tumors was different. When both tumors showed diploidy or when at least one DNA index of abnormal clones between two aneuploid tumors was identical, the tumors were defined to be related to each other. According to these criteria, in 5 (83%) of the 6 patients clinically diagnosed as having metachronous lung cancers, the second tumor was classified as independent of the first tumor. On the other hand, in the 2 patients clinically diagnosed as having recurrent tumors, the second tumor was judged to be related to the first tumor. These data suggest that DNA flow cytometric analysis of tumors may be of value in the diagnosis of metachronous lung cancers.
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PMID:DNA ploidy patterns of tumors diagnosed as metachronous or recurrent lung cancers. 189 34

Vinorelbine is a new 5' nor Vinca alkaloid, active by i.v. route, in various types of cancer disease such as non-small cell lung cancer and advanced breast cancer. In order to evaluate the possibility of using this drug for local treatment of cancer, Vinorelbine-loaded bioresorbable polymeric implants were prepared using a copolymer of D,L-lactic and glycolic acids (PLA 37.5 GA 25). According to the manufacturing process, the 1.2-mm-diameter cylindrical rods obtained had a drug content of 1, 5, or 20% (w/w) and released half of their content within about 6 days in vitro. In vivo release in rats was slower, half of the drug being released after about 14 days. A dose-dependent antitumoral effect was observed in mice (solid P388 leukemia model) when implants were administered into or in contact with the tumor. At highest drug loads and when administered soon after tumor implantation, Vinorelbine implants were more effective than i.v. administration (median survival time of treated animals related to untreated controls, greater than 360 versus 188). In dogs, results of toxicity experiments revealed that administration of implants in vital organs must be avoided. On the contrary, s.c. administration was well tolerated. A transient local necrosis was observed in the days following implantation, but normal skin was recovered after about 10 weeks. Thus, a clinical trial was conducted on patients with head and neck cancer; implantation of 20% loaded polymeric implants into the tumor sites succeeded in 8 of 9 patients. The sole failure was attributed to the unusual hardness of the tumor tissue. Except for a local transient inflammatory reaction (easily treated with nonsteroidal antiinflammatory agents), no other sign of toxicity was detected, and patients tolerated the device well. Fourteen days after implantation, patients underwent their planned surgery, and the implants were recovered. Residual drug content varied from 24 to 55%. In all cases, there was a clearly delimited necrotic area around the implant, ranging from 0.5 to 3.5 cm in diameter. In the smallest tumors, necrosis was also observed in the normal tissue inside this area. These results invite further studies to evaluate such drug-loaded polymeric implants.
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PMID:Experimental studies and preliminary clinical trial of vinorelbine-loaded polymeric bioresorbable implants for the local treatment of solid tumors. 191 58

Platelet counts were evaluated in 714 patients with advanced non-small cell lung cancer (N-SCLC), small cell carcinoma of the lung (SCCL), and colon cancer entered to a clinical trial. Patients had not received prior chemotherapy. Platelet counts were not different in patients who had received radiation therapy prior to entry to the study. In comparison to the other tumor types, patients with N-SCLC demonstrated an increased prevalence of thrombocytosis (counts greater than 400,000/mm3), higher platelet counts at the time of entry to the study, higher over all mean platelet counts, relative preservation of high platelet levels during disease progression, and no relationship between platelet numbers and the amount of chemotherapy given. By contrast, platelet counts in patients with SCCL were negatively correlated with the absolute amount of cyclophosphamide and adriamycin given, and declined most dramatically with disease progression and death. Platelet numbers did not correlate with fibrinopeptide A or fibrin split product levels suggesting that disseminated intravascular coagulation or fibrinolysis may have had less influence on platelet numbers than certain other factors. By contrast, significant correlations were found for all three tumor types between platelet numbers and other indicators of bone marrow function including anemia, total leukocyte count, and absolute neutrophil count; and the fibrinogen level. Based upon these findings, we postulate that the host response to malignancy, possibly in the form of production of bone marrow-stimulating cytokines, may play a prominent role in regulation of platelet counts in these (and perhaps other) neoplasms, and that a particularly prominent and persistent degree of marrow stimulation exists in patients with N-SCLC.
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PMID:The platelet count in carcinoma of the lung and colon. 196 50


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