Fiber-optic bronchoscopy showed a diagnostic accuracy rate of 100 % but played a poor therapeutic role with a case resolution of 10.7 %. Rigid bronchoscopy was the main technique, permitting the removal of the tracheobronchial foreign body in 97.2 % of patients.

Background: So far there are few published data on optimal duration of chemotherapy in patients with advanced non small cell lung cancer (NSCLC) We designed a phase III trial to compare 4 cycles vs 6 cycles of chemotherapy using a standard combination. Primary endpoint is overall survival (OS). Secondary endpoints included time to progression (TPP), overall response rate (ORR), one-year survival (1y -S) and safety. Methods: Randomization was stratified by stage (IV vs IIIB) and performance status (0/1 vs 2). Patients received gemcitabine 1250 mg/m 2 , day 1 and 8 + Carboplatin, AUC 5, day 1, every 21 days. Eligibility criteria: age > 18 years, histologically proven NSCLC, weight loss < 10%, no brain metastasis, adequate renal, hematological, hepatic functions and informed consent. The efficacy analysis (OS, TTP, 1y-S) will be performed on intent to treat basis. Results: Between October 2002 and December 2004, 220 pts were enrolled. Arm A -4 cycles (n=110) and Arm B -6 cycles (n= 110) were well-balanced for patient characteristics: median age (A/B): 64,7 vs 63,9 yrs; male/female (A/B) 86/24 vs 86/24; IIIB/IV (A/B) 24/86 vs 29/81; PS 0,1 vs 2 (A/B) 90/20 vs 91/19; adenocarcinoma (A/B) 59 vs 57; squamous (A/B) 35 vs 37. ORR and toxicity was evaluated in 204 pts (7.2% pts were not evaluated). ORR% (43,8 vs 47,3); median number courses (3,5 vs 4,8). Grade 3/4 toxicities included neutropenia (10,2% vs 13,6%); thrombocytopenia (3.1% vs 5,2%); anemia (1,0% vs 2,1%). All grades of nausea/vomiting (14,2% vs 16,8%). Fifteen pts (Arm A) and sixteen pts (Arm B) have had a second line therapy (docetaxel) after disease progression. At Jan/2007, 107 at each arm died. Time to progression was not statistically different between the two treatment arms (p=0.077). Median time to progression was 4 months (95% CI: 3.2-4.8 months) for patients randomized to 4 cycles and 5 months (95% CI: 3.8-6.2 months) for patients randomized to 6 cycles. Overall survival was statistically different between the two treatment groups (p=0.047) and favourable to 6 cycles. Median survival was 7 months (95% CI: 5.9-8.1 months) for 4-cycles regimen and 12 months (95% CI: 9.8-14.2 months) for 6-cycles regimen. When compares patients according to the number of cycles they really received and according to the randomisation regimen assigned: 79 patients in 4 cycles and 65 in 6 cycles. Time to progression and overall survival was statistically different between the two treatment groups (p=0.018) and favourable to the regimen of 6 cycles Conclusions: Overall survival rate was statistically different between 4 vs 6 cycles. TTP, ORR and One year survival was not statistically different. In patients without progression or major toxicity during chemotherapy, we recommend six cycles in first line chemotherapy.

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The case of an 18-year-old man with a tumor of the left lateral ventricle is reported. The mass was observed to be contiguous with the choroid plexus but could be totally removed. Pathological examination disclosed an inflammatory pseudotumor. The authors review the literature on this lesion and related disorders involving the central nervous system and stress the need for a morphological differential diagnosis. Inflammatory pseudotumor should be considered in any case of intraventricular tumor.