Multicenter phase II trial of accelerated cisplatin and high-dose epirubicin followed by surgery or radiotherapy in patients with stage IIIa non-small-cell lung cancer with mediastinal lymph node involvement (N2-disease).

To assess the therapeutic activity of accelerated cisplatin and high-dose epirubicin with erythropoietin and G-CSF support as induction therapy for patients with stage IIIa-N2 non-small-cell lung cancer (NSCLC). Patients with stage IIIa-N2 NSCLC were enrolled in a phase II trial. They received cisplatin 60 mg m(-2) and epirubicin 135 mg m(-2) every 2 weeks for three courses combined with erythropoietin and G-CSF. Depending on results of clinical response to induction therapy and restaging, patients were treated with surgery or radiotherapy. In total, 61 patients entered from March 2001 to April 2004. During 169 courses of induction chemotherapy, National Cancer Institute of Canada (NCI-C) grade III/IV leucocytopenia was reported in 35 courses (20.7%), NCI-C grade III/IV thrombocytopenia in 26 courses (15.4%) and NCI-C grade III/IV anaemia in six courses (3.6%). Main cause of cisplatin dose reduction was nephrotoxicity (12 courses). Most patients received three courses. There were no chemotherapy-related deaths. Three patients were not evaluable for clinical response. Twenty-eight patients had a partial response (48.3%, 95% CI: 36-61.1%), 24 stable disease and six progressive disease. After induction therapy, 30 patients underwent surgery; complete resection was achieved in 19 procedures (31.1%). Radical radiotherapy was delivered to 25 patients (41%). Six patients were considered unfit for further treatment. Median survival for all patients was 18 months. Response rate of accelerated cisplatin and high-dose epirubicin as induction chemotherapy for stage IIIa-N2 NSCLC patients is not different from more commonly used cisplatin-based regimen.

Low nail-plate fixation and early weight-bearing ambulation for stable trochanteric fractures.

Reduction of stable (Evans I and II) trochanteric fractures of the hip is in general a simple procedure. Using a low (145 degrees-150 degrees) nail-plate fixation (McLaughlin) for this type of fracture, early weight-bearing ambulation can be obtained. In the period from 1 January 1978 through 1 May 1982 52 stable trochanteric fractures in 52 patients were treated by low nail-plate fixation. Within 1 week postoperatively, the patients started full weight-bearing ambulation. The functional result was good in 88.2%. Despite the average age of 77.9 years the hospital mortality rate was 1.9%. On the basis of the results mentioned above, it is concluded that the described treatment of stable trochanteric fractures can be considered reliable.

Airless paint-gun injuries of the hand: a report of three cases.

Three patients were treated for airless paint-gun injuries. High-pressure paint-guns have been used by commercial painters for 20 years. The causes of the inflammation are discussed. The importance of early surgical treatment is stressed. This treatment should consist of exploration and complete excision of contaminated tissue. A satisfactory result can be obtained in most cases.