[Diagnostic and therapeutic integration in non-small cell lung tumors: preliminary notes].
An interdisciplinary study relative to non-small cell lung cancers was activated in 1990 at the Policlinico A. Gemelli, Rome, Italy. A working group including radiologists, radiotherapists, oncologists, surgeons, respiratory physiopathologists and pathologists defined the goals to reach and the protocols to follow for staging, treatment, and follow-up. A hundred and ninety patients with non-small cell lung cancer were examined: 134 of them, who were in the initial or locally advanced phases, were considered, together with 6 patients with postoperative recurrences. Ninety-three cases were considered to be resectable and therefore operated: the extant 41, considered unresectable/slightly resectable, and the 6 with postoperative recurrences were started on combined chemo- and radiotherapy. Primary tumor (T) and lymph nodes (N) were staged by means of CT. In the evaluation of T in resectable patients, CT exhibited 78.5% agreement with pathology, with a tendency to understaging. In the evaluation of N, CT exhibited 62.4% agreement with pathology, once again with a tendency to understaging. Surgery was exploratory in 4.3% of cases only. Combined chemo- and radiotherapy in unresectable patients and in postoperative recurrences yielded > 50% response in 18/47 patients, that is 40.4% especially relative to the cases treated with carboplatinum in continual infusion. Eight of 18 responsive patients were considered to be resectable and therefore submitted to surgery: in 2 of them histology showed no neoplastic cells. This study, which is still in progress, is aimed at verifying its hypotheses and attaining its prefixed goals.
Marano
P
P
Istituto di Radiologia, UCSC, Roma.
Balducci
M
M
Cellini
N
N
Macis
G
G
Mantini
G
G
Pirronti
T
T
Sallustio
G
G
Trodella
L
L
Turriziani
A
A
Picciocchi
A
A
D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000628:therapy*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D014057:Tomography, X-Ray Computed