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evaluated in this regard, symptoms were
present in 27 of 55 (49%); the cancers were
in stage III at presentation in 51%. Outcome
was related to sym~tomatology and to lung
cancer stage. The median survivals for
symptomatic and asymptomatic patients were 6
and 25 months, respectively (p < 0.001); the
median survivals for patients with stage I,
II, and III lesions were 26, 9, and 6
months, respectively (p < 0.05). Post-
thoracotomy management after surgical-
radiation therapy of upper airway cancers (n
= 22) was inordinately challenging because
of pre-existing impairment of the upper air-
ways. We have reached the following
conclusions: (i) Patients with upper airway
cancer are at high risk for lung cancer of
all cell types. (2) When multiple airway
cancers occur together, the prognosis is
poor; nonetheless, cure of each cancer can
be achieved if it is
adequately treated. (3) When
cancers occur synchronously,
threatening cancer should be
(4) When the option exists,
completely and
multiple airway
the more life-
treated first.
the lung cancer
should be treated before the upper airway
cancer to avoid the impact of previous ir-
radiation and/or treatment of the upper air-
way cancer upon post-thoracotomy management.
Influence on Nandrolone Decanoate on Weight
Loss in Advanced Non-Small Cell Lung Cancer.
Chlebowski, R.T., Herrold, J., All, I. et
al. Department of Medicine, UCLA School of
Medicine, Torrance, CA; U.S.A. Cancer 58:
183-186, 1986.
The short term addition of nandrolone
decanoate to combination chemotherapy given
to patients with unresectable non-small cell
lung cancer was evaluated in a randomized,
prospective trial. Patients were treated
with doxorubicin 50 mg/m 2 intravenously,
cyclophosphamide 300 mg/m 2 intravenously,
CCNU 50 mg/m 2 orally, vincristine 1.4 mg/m 2
intravenously, with and without cisplatin 50
mg/m 2 intravenously, all given every 28
days. In addition, patients were randomized
to receive either nandrolone decanoate 200
mg intramuscularly weekly for 4 weeks or no
additional therapy. Patient age, disease ex-
tent, performance score, and pretreatment
weight loss were similar in the two treat-
ment arms. Objective antitumor response
frequency was comparable on both treatment
arms with median survival somewhat longer
for patients receiving the androgen (median
survival 5.5 months without and 8.2 months
43
with nandrolone decanoate). There was a
trend for less severe weight loss on the
nandrolone decanoate arm (average weight
loss 0.8 + or - 0.15 kg versus 0.21 + or -
0.18 kg, respectively), with half as many
patients experiencing weight loss on
nandrolone decanoate (25% versus 12%). A
separate concurrent study has demonstrated
decreased free testosterone levels in 66% of
patients with advanced cancer studied prior
to chemotherapy treatment, therefore, fur-
ther prospective studies in which pretreat-
ment testosterone levels are used to guide
androgen administration are needed to define
more precisely a role for androgen replace-
ment therapy in non-small cell lung cancer.
Acute Myelogenous Leukemia Following Com-
plete Remission of Small Cell Carcinoma of
the Lung.
Yu, P.P., Waxman, J.S., Chahinian, A.P. et
al. Department of Neoplastic Diseases, Mount
Sinai Hospital, New York, NY, U.S.A. Med.
Pediatr. Oncol. 14: 100-103, 1986.
The treatment of patients with small
cell carcinoma of the lung (SCCL) with com-
bination chemotherapy and radiation has
dramatically improved survival in the past
decade. With this increased survival, long
term complications of therapy are becoming
apparent. We report a patient who died of
acute myelogenous leukemia (AML) while in
complete remission from SCCL. Review of the
literature indicates that there may be an
increased incidence of AML following
successful induction of complete remission
in patients with SCCL.
Effect of Discontinuation of Periodical
Roentgen Screening of the Population on Mor-
bidity and Mortality of Hospitalized Bron-
chial Carcinoma Patients.
Kraan, J., Van Der Wal, A.M., Sluiter, H.J.
Academisch Ziekenhuis, Afd. Longziekten,
9713 EZ Groningen, Netherlands. Ned.
Tijdschr. Geneeskd, 130: 1281-1284, 1986.
1982 saw the end of the periodical
radiological screening of the population for
pulmonary tuberculosis, which used to be of
great importance for the early diagnosis of
lung cancer. In this study, two groups of
patients hospitalized for diagnosis and
treatment of lung cancer were analysed and
followed up. The diagnosis of bronchial car-
cinoma had been made for the discontinuation
of the screening in the first group (n =
50), and after its cessation in the second