Limited resection of lung cancer.

AIM: Follow-up results after a limited resection (segmentectomy, wedge resection of lung) are represented in this paper according to the TNM classification and histological type of tumour. METHODS: Since 1980 until 1997, 1173 patients (pts) with lung cancer were treated surgically. 42 (36 males and 6 females) of them underwent a limited resection of lung. Distribution of pts according to the TNM classification was: T1N0 was found in 12 pts and T2N0 in 11 pts, T2N0 in 11pts, T2N1 in 7 pts, other 12 pts had N2. Sqamous cell carcinoma was in 19 pts, Adenocarcinoma in 13 pts, Small cell carcinoma in 9 pts, one pt--Carcinosarcoma. After the operation 9 pts received radiation therapy, 9 pts--chemotherapy. RESULTS: The best follow-up results were in pts with T1-2N0 who received adjuvant therapy: median survival was 45.7 months. The pts, treated only surgically, lived 36.7 months. The pts with N2 lived only 9 months. CONCLUSION: 1. A limited resection of lung with lymph nodes dissection can be performed only in cases T1-2N0. 2. In cases with N0 of undifferentiated carcinoma (anaplastic, small cell) adjuvant therapy ought to be given after operation. 3. In cases of N1, N2 we recommend adjuvant therapy regardless of histological type of tumour.

Oral ifosfamide/mesna versus intravenous ifosfamide/mesna in non-small-cell lung cancer: a randomized phase II trial of the EORTC lung cancer cooperative group.

BACKGROUND: Chronic oral administration of anticancer drugs may offer therapeutic advantages. PATIENTS AND METHODS: A total of 68 patients with advanced non-small-cell lung cancer, not previously treated by chemotherapy, were randomized to receive either ifosfamide given orally (OSI) at a dose of 1 g/day for 14 days every 4 weeks, or as a 1-hour intravenous infusion (IVI) at a dose of 1.6 g/m2/day for 5 days every 4 weeks. According to the route of ifosfamide administration, patients received either mesna i.v. or mesna film-coated tablets for uroprotection. RESULTS: Eight patients were found to be ineligible for the study and therefore excluded for all analyses. Thirty-three patients received IVI, and 27 patients OSI. One patient randomized to OSI died before treatment was initiated, leaving 59 patients fully evaluable for toxicity. Hematological toxicity was less severe for patients on OSI, but CNS toxicity was reported more frequently on OSI (39%; 12% grade III/IV), than on IVI (15%; 9% grade III/IV), which caused the premature close of the study. Other non-hematological adverse events were of modest clinical significance and comparable in both arms. Forty-nine patients were considered evaluable for response: in the IVI arm, 5 (17%) of the 29 evaluable patients obtained a partial remission, and 7 patients a no change (24%). In the OSI arm, 2 (10%) of the 20 evaluable patients obtained a partial remission, and 11 (52%) a stable disease. CONCLUSIONS: Both arms have some activity in non-small-cell lung cancer; while OSI was less myelosuppressive than IVI, it was associated with a higher incidence of CNS toxicity. Oral administration of ifosfamide, in the schedule and daily dose tested here cannot be recommended.