ABSTRACT
Forty-seven patients with stage III lung cancer from four institutions in the Denver area were entered in a study comparing two regimens of chemotherapy. The patients were randomized into two groups: Group A received lomustine, cyclophosphamide, vincristine, cisplatin, and doxorubicin monthly; Group B received the five-drug regimen on Months 1, 3, and 5 and received 5-FU by constant infusion, methotrexate, and mitomycin on Months 2, 4, and 6. The age, extent of disease, Karnofsky score, prior therapy, and average number of chemotherapy courses received in each group were comparable. The median survival in Group A was 265 days and in Group B was 163 days (P greater than 0.25). There does not seem to be an advantage in survival in patients who are treated with the eight-drug regimen over the five-drug regimen.
Subject(s)
Adenocarcinoma/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Small Cell/drug therapy , Carcinoma, Squamous Cell/drug therapy , Lung Neoplasms/drug therapy , Adenocarcinoma/mortality , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/mortality , Carcinoma, Small Cell/mortality , Carcinoma, Squamous Cell/mortality , Drug Administration Schedule , Female , Humans , Male , Middle Aged , Neoplasm Metastasis , Random Allocation , Time FactorsABSTRACT
Fifty-four patients (47 of whom were evaluable) with non-small cell lung cancer were treated with a five-drug regimen consisting of cyclophosphamide, vincristine, lomustine, cisplatin, and doxorubicin. Six complete and 16 partial responses were achieved, for an overall response rate of 47% (22 of 47 patients). Response by cell type was as follows: epidermoid carcinoma, 41% (seven of 17 patients); adenocarcinoma, 42% (eight of 19); and large cell carcinoma, 64% (seven of 11). Response in patients with limited disease was 48% (11 of 23 patients) and in patients with extensive disease, 46% (11 of 24). Previously untreated patients had response rates of 53%, versus 22% in those with prior therapy.
Subject(s)
Antineoplastic Agents/administration & dosage , Lung Neoplasms/drug therapy , Adenocarcinoma/drug therapy , Adult , Aged , Carcinoma, Small Cell/drug therapy , Carcinoma, Squamous Cell/drug therapy , Cisplatin/administration & dosage , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Drug Therapy, Combination , Humans , Lomustine/administration & dosage , Male , Middle Aged , Vincristine/administration & dosageABSTRACT
Pulmonary artery hypertension is a frequent complication of severe chronic obstructive pulmonary disease (COPD). A study was undertaken to determine whether analysis of the chest radiograph can reveal the presence of pulmonary artery hypertension in COPD. Sixty-one men with COPD (forced expiratory volume in 1 second 0.97 +/- 0.35 liters, mean +/- SD) underwent right heart catheterization, and in 46 the mean pulmonary artery pressure was elevated (greater than 20 mmHg). Plain chest radiographs of the 61 patients and 42 normal control subjects were evaluated. The right descending pulmonary artery (RDPA) was enlarged (greater than 16 mm) in 43 of 46 patients (93%) with an elevated mean pulmonary artery pressure, and the left descending pulmonary artery (LDPA) diameter also was enlarged (greater than 18 mm) in 43 of 46. Combined increased RDPA and increased LDPA diameter measurements permitted correct diagnosis in 45 of 46 patients (98%) with pulmonary artery hypertension, including all 26 a mild elevation of mean pulmonary artery pressure (21-30 mmHg). There was a significant correlation between pulmonary artery pressure and both RDPA and LDPA measurements. Analysis of RDPA and LDPA diameters on the plain chest radiograph is a sensitive and accurate method of detecting the presence and severity of pulmonary artery hypertension in COPD.