Clinical manifestation and survival of patients with small-cell lung cancer.

OBJECTIVE: To assess the clinical manifestation, diagnostic investigation, treatment, and survival of patients with small-cell lung cancer (SCLC). DESIGN: Retrospective study. MATERIAL AND METHOD: Patients with histologically and/or cytologically proven SCLC, adequate medical record for clinical history, and survival between January 1, 1999 and December 31, 2003, were reviewed. The stage of disease at presentation was based on the Veterans' Administration Lung Cancer Study Group (VALSG) staging system of limited-stage and extensive-stage disease. RESULTS: One hundred and sixteen evaluative SCLC patients were enrolled in the present study. SCLC was common in elderly men who smoked. Major symptoms were cough 81%, weight loss 72%, and dyspnea 67%. Hoarseness and superior vena cava syndrome (SVC syndrome) were present in 18% and 17% respectively. Forty-nine patients (42%) presented with limited-stage disease and 67 (58%) with extensive-stage disease. Thirty patients (26%) received chemotherapy alone, 23 patients (20%) received radiotherapy alone, 33 patients (28%) received combined chemoradiotherapy, and 30 patients (26%) received supportive treatment. A chemotherapy regimen of cisplatin combined with etoposide was used in 61 of 63 patients (97%). The overall response to chemotherapy was complete remission in 12 cases (19%), and partial response in 20 cases (32%). The median survival of limited-stage disease was significantly better than those with extensive-stage disease (44 weeks vs. 22 weeks). Patients with chemotherapy treatment had significantly improved median survival in both limited-stage and extensive-stage disease. CONCLUSION: More than half of the SCLC patients presented in extensive-stage disease. The majority of the patients were treated with systemic chemotherapy. Patients with limited-stage disease had better response to chemotherapy and better survival than those with extensive-stage disease.

Clinical manifestation and survival of patients with non-small cell lung cancer.

A retrospective study of clinical manifestations and survival of patients with non-small cell lung cancer (NSCLC) in Sonklanagarind Hospital between 1995-98 was undertaken. There were 209 evaluable NSCLC patients enrolled in the study. NSCLC was common in elderly men who smoked. Major symptoms were cough 74.9%, weight loss 61.6% and dyspnea 54.6%. Chest pain and hemoptysis were presented in only 31.3% and 29.2% respectively. Adenocarcinoma was found in 109 patients (52.1%) , squamous cell carcinoma in 71 patients (34.0%), and large cell carcinoma in 8 patients (3.8%). Only 28 patients (13.4%) were in stage I or II. Surgery was performed in 18 cases (8.6%). Radiation for palliative treatment was used in 74 cases (35.4%). Fifty-four patients (25.8%) received chemotherapy. Forty-two patients received mitomycin, vinblastine and cisplatin regimen (MVP). The response to treatment comprised 3 cases (7.1%) with complete response, and 9 cases (21.4%) with partial response. The survival of the patients in stages I and II was lower than reported from Western countries but in stages III and IV the survival was comparable. Chemotherapy tended to improve survival in advanced stage NSCLC.