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Summary Twenty-four symptomatic patients with advanced non-small cell lung cancer (NSCLC) were treated with cisplatin-based chemotherapy (mitomycin-C 8 mg m 2q 6 weeks, vinblastine 6 mg m2q 3 weeks, cisplatin 50 mg m-2q 3 weeks). Patients were assessed for symptom relief as well as for objective response.Although only five patients achieved an objective response (21%), 18 patients (75%) reported a complete disappearance or good improvement in at least one of their tumour-related symptoms. The overall symptomatic response rate was 67% with 16 patients feeling better or much better on treatment. The toxicity of treatment (primarily myelosuppression and nausea and vomiting) was mild and hair loss was minimal. The high incidence of symptomatic relief seen in this study, even in the absence of objective response, suggests that moderate dose chemotherapy may have a role in the palliation of NSCLC.

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Simon, a 34-year-old, married, Caucasian male, was first seen in our fracture clinic on 13 October 2003 with a ruptured right tendo-Achilles, sustained while playing football. Given the choice of conservative treatment or surgery, he opted for the latter, which was undertaken three days later.

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