[Chemotherapy of small cell carcinoma of the lung in relation to lymph node metastasis and extending pattern of tumor].
Chemotherapeutic effects on the lymph node metastasis were studied in relation to the predominancy of T or N factor, extending patterns of tumor, histologic subtype, and cytologic characteristics, using cyclophosphamide, vincristine and 5-FU. N2, N3, N4 indicate ipsi-lateral, contra-lateral mediastinal, and supra-clavicular node, respectively. Chemotherapy was equally effective to the lymph node metastasis regardless a degree of progression, but survivals depended on the progression. Predominancy of both primary tumor (T) and involved lymph node (N) was analysed on chest X-rays. The Deffer response was observed in Type N than in Type T. Extending patterns of primary tumor were classified on X-ray films according to Suzuki's criteria: a longitudinal submucosal spreading along the bronchus (I): infiltration beyond the bronchial wall, extending to the depth, and fusing into a mass (III): and intermediate (II). In type I, the tumor was seen like an assembly of clubs extending along the bronchial tree, and Type III tumor showed a mass-like shadow with relatively high density and clear margin. Overall response rates were remarkably higher in Type I and lower in Type III. Type I was more frequently accompanied by large lymph node involvement than Type III. The highest response rate was obtained in Type I with N-predominancy and the lowest in Type III with T-predominancy. Responses to chemotherapy of lymph node metastasis depended upon these extending patterns. A half of Type III cases were polygonal cell type, which showed the lowest response rate in our institute. Regarding to cytologic classification by Horai, 67% response of good was found in Type I and 65% of response poor in Type III. These biological characteristics are considered to be a useful indicator for the selection of treatment modalities.
D018288:Carcinoma, Small Cell / Q000188:drug therapy* / Q000473:pathology; D003520:Cyclophosphamide / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005472:Fluorouracil / Q000008:administration & dosage*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008207:Lymphatic Metastasis; D011379:Prognosis; D014750:Vincristine / Q000008:administration & dosage*
D014750:Vincristine; D003520:Cyclophosphamide; D005472:Fluorouracil