Lung cancer : journal of the International Association for the Study of Lung Cancer
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Randomized Controlled Trial Clinical Trial
Postoperative adjuvant cisplatin, vindesine, plus uracil-tegafur chemotherapy increased survival of patients with completely resected p-stage I non-small cell lung cancer.
To evaluate the efficacy of postoperative adjuvant chemotherapy for completely resected p-stage I non-small cell lung cancer (NSCLC). ⋯ Postoperative PVU chemotherapy is effective for Japanese patients with completely resected p-stage I NSCLC.
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Approximately 25% of patients with malignant pleural mesothelioma (MPM) prove unresectable at surgery and the median survival of stage III MPM is <12 months even after complete resection by extrapleural pneumonectomy. From 1939-2004, a series of sequential clinical trials has been performed at our institution. The surgical procedure has been modified and improved upon, and adjuvant hemithoracic radiation (RT) standardized. ⋯ All received planned adjuvant RT. This combined modality approach is feasible for locally advanced MPM, and initial analysis suggests improved resectability. This experience supports additional studies of induction and multimodality therapy, especially with regimens such as cisplatin and pemetrexed which may be better tolerated and more effective.
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In the treatment of extensive disease of small cell lung cancer (ED SCLC) there is an urgent need for more effective and better-tolerated drug regimens. We report on a prospective phase II trial performed to evaluate the efficacy and safety of a platinum-free regimen--containing topotecan and etoposide--in the first-line treatment of ED SCLC. Between December 1999 and July 2001, 28 chemotherapy-naive patients with ED SCLC were recruited; 9 patients had stage IIIB disease and 19 patients had stage IV disease. ⋯ The combination therapy of topotecan and etoposide is active in first-line chemotherapy for patients with ED SCLC. The regimen showed a tolerable safety profile. Since drug scheduling plays a critical role in the combination of topoisomerase I and II inhibitors, concurrent administration of topotecan and etoposide might increase the efficacy.
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Low dose spiral computed tomography (CT) is a sensitive screening tool for lung cancer that is currently being evaluated in both non-randomised studies and randomised controlled trials. ⋯ The most feasible scenario under which CT screening for lung cancer could be cost-effective would be if very high-risk individuals are targeted and screening is either highly effective or CT screening costs fall substantially.