Cisplatin-5-fluorouracil in small cell lung cancer. A phase II study in 109 patients.

One hundred nine previously untreated patients with small cell lung cancer were treated for five consecutive days with 20 mg/m2/day of cisplatin and 600 mg/m2/day of 5-fluorouracil. One cycle of chemotherapy was administered every three weeks. The patients received a median number of three cycles. Then they were transferred to CAE chemotherapy. A 77% overall response rate (95% confidence interval of 0.70-0.85) was observed after initial cisplatin-5FU treatment. Twenty-three complete responses (21%) and 62 partial responses (56%) were obtained. In cerebral metastases the response rate was high at 91% (21 out of 23), with 43% complete responses. In the limited forms, statistical survival at 1 year was 25%. A Grade 3-4 thrombocytopaenia was observed in 10 patients (9%) and a Grade 2-3 leukopaenia in four patients. Three patients suffered from a Grade 2 cardiac toxicity. The cisplatin-5-fluorouracil combination demonstrates promising initial response rate in small cell lung cancers. Its main interest is in its important action on cerebral metastases and its moderate haematological toxicity.

[Peritoneal pseudomyxoma with pleural metastases. A case report]. / Pseudomyxome péritonéal avec métastases pleurales. A propos d'un cas.

The authors report a case of a 69 year old man with a peritoneal pseudo-myxoma probably secondary to a mucocele of the appendix and complicated by pleural metastases which were nodular, unilateral and asymptomatic. These were discovered on computerised tomography during examination for the recurrence of the peritoneal disease. A study of the histology of the pleural fragments obtained by thoracotomy showed the presence of lesions which were identical to those found in the peritoneal masses.

[Cutaneous necrosis at the initiation of antivitamin K treatment disclosing hereditary protein C deficiency]. / Nécrose cutanée à l'introduction des antivitamines K révélatrice d'un déficit constitutionnel en protéine C.

We report the case of a 57-year old woman whose severe protein C deficiency was revealed soon after oral anticoagulants were introduced into her treatment. Two previous episodes of deep leg vein thrombosis followed by a third episode with suspicion of embolus migration had led to treatment with heparin later replaced by oral anticoagulants. On the 4th day of anticoagulant therapy, she developed skin necrosis of the left calf. A protein C assay showed severe deficiency (19% level as compared with the 70-120% normal levels). The main causes of acquired protein C deficiency were excluded. The first results of a family study demonstrated moderate protein C deficiency in a 30-year old, asymptomatic daughter.