[Identification of a limited form of small cell lung cancer among 103 patients pre-selected for chemotherapy combined with surgery].
Between Nov. 1981 and Nov. 1987 103 patients preselected for chemotherapy combined with surgery, therefore with local extension within homolateral mediastinal lymph nodes, with no signs of remote metastases, PS greater than or equal to 70, with no contraindication for resectional surgery including pneumonectomy, no diabetes, no prior treatment underwent first staging. Staging included: case history, physical examination, full blood count, biochemical tests (alkaline phosphatase, SGOT, GGTP, LDH), CEA, X-ray assessment including CT scan of the chest, bronchoscopy, peritoneoscopy, liver scan (US was not routinely used at the beginning), bilateral bone marrow trephine biopsy, and bone scan. Staging was discontinued when secondaries were detected in one, the more so as in two organs or systems (25 pts), and/or bronchoscopic contraindication for thoracotomy (11 pts), and this group of patients was out of the study. To 67 patients chemotherapy was given and after 3 courses these patients were reevaluated. In 21 patients PD, NC or CR was found. Forty six patients with PR underwent supplementary staging procedures: CT of the brain, CT of the upper retroperitoneal space and liver. Metastatic sites were found in 7 patients. Limited disease was identified in 39 patients. Limited-stage disease can be determined only after exclusion of extensive disease on the ground of: case history, physical assessment, X-ray of the chest (PA + lateral) + CT chest scan, bronchoscopy with biopsy or cytology, and outside the chest: 1. bone marrow trephbine biopsy and bone scan--bone marrow and skeleton, 2. CT head scan--brain, 3. CT abdominal scan--upper retroperitoneal space and liver.
Lewiński
T
T
Kliniki Chirurgii Onkologieznej, Instytutu im. Marii Skłodowskiej-Curie w Warszawie.
Zuławski
M
M
Mioduszewska
O
O
Dziukowa
J
J
Szymendera
J
J
Kozłowicz-Gudzińska
I
I
Smorczewska
M
M
Kodur
E
E
Maryniak
R
R
Pietraszek
A
A
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008168:Lung / Q000473:pathology*; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy / Q000379:methods; D010347:Patient Care Planning; D011182:Postoperative Care
Wyodrebnienie postaci ograniczonej drobnokomórkowego raka płuca w grupie 103 chorych wstepnie wyselekcjonowanych do chemioterapii w skojarzeniu z chirurgia.