Comparison of alternating to nonalternating chemotherapy regimens for non-small cell lung cancer.

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.

Trial of droperidol as an antiemetic in cisplatin chemotherapy.

A trial of droperidol as an antiemetic was undertaken during 48 courses of cisplatin chemotherapy in 31 patients with cancer. The optimal loading dose was 10 mg iv, with a maintenance dose of 4 mg iv every 2 hours for four additional doses. Beyond this level, cardiovascular side effects became problematic.

Attitudes of house officers toward a hospice on a medical service.

A hospice program (HP) was established on the medical service at the Denver Veterans Administration Medical Center (DVAMC) for the care of the terminally ill cancer patients and to integrate such care into house staff training. A two-bed inpatient unit was managed by an intern, a resident, and the attending physician with the aid of a multidisciplinary team. During the program's first year, 29 patients were cared for with an average inpatient stay of 26 days. Twenty-nine out of a possible 33 house officers returned questionnaires evaluating their hospice experience. Twenty-eight respondents felt that the hospice program was appropriate in a teaching hospital. Over half indicated improved awareness of the psychological problems of their patients and families. Two-thirds of the house staff members felt that the HP changed their approach to pain control and made them more comfortable in dealing with terminally ill patients. From this study, it can be concluded that a hospice program can be successfully integrated into an active medical teaching service.

Cyclophosphamide, vincristine, lomustine, cisplatin, and doxorubicin in the treatment of non-small cell lung cancer.

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.