The clinical features of 208 patients with large cell anaplastic carcinoma of the bronchus are reviewed. Of the sample 47-6% had disseminated disease at presentation, and 95% were cigarette smokers. The median survival was 6'0 months and five-year-survival was 5-9%.Twenty-seven per cent of the patients had surgical resection of tumour. The median survival of resected patients was 13-0 months and five-year-survival was 21%. Radiotherapy was ineffective in controlling the disease in this series.
Four cases of pulmonary leiomyosarcoma are presented. The characteristic histological features are described with specific reference to the criteria of malignancy. It is suggested that diagnosis by bronchoscopy provides insufficient material for histological grading and open lung biopsy is the diagnostic tool of choice. The available methods of treatment are discussed.
Fifty-six patients with untreated small cell carcinoma of the bronchus were treated with three courses of chemotherapy (cyclophosphamide, vincristine, and procarbazine and methotrexate) and assessed for response. Thirty-one patients (55-4%) were classified as responders; they were given a course of radiotherapy and were then randomly allocated to continued cyclical chemotherapy or no further chemotherapy until relapse. Non-responders to chemotherapy were treated with radiotherapy or palliatively. The median survival was 105 months in responders and 6 months in non-responders (P<001). The one-year survival in responders was 42%. There was no statistical difference in survival between patients treated with continued chemotherapy and those treated at relapse. Sixty-nine per cent of patients experienced no side effects from chemotherapy.Three indicators of non-response to chemotherapy were identified -exercise tolerance at diagnosis, macroscopic liver metastases, and inappropriate ADH secretion.Small cell carcinoma of the bronchus is a disseminated disease in most patients at presentation (Selawry, 1974). After reports of response and improved survival using radiotherapy (Miller et al, 1969), and chemotherapy we have tested whether a combination of chemotherapy and radiotherapy could be used to prolong useful life and whether prognostic factors could be identified.
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