Medical Oncology and Tumor Pharmacotherapy

, Volume 9, Issue 3, pp 119–137 | Cite as

The impact of surgery on the multidisciplinary treatment of bronchogenic small cell carcinoma

  • Wolfgang Theuer
  • Oleg Selawry
  • Karl Karrer


Recent results of studies on patients with SCLC treated by surgery with curative intent followed by adjuvant chemotherapy demonstrate a definite progress in comparison to non-surgical-treatment programs for patients with comparable stage of disease. Of 186 randomized patients enrolled for the multicenter cooperative ISC-Study I and II, 76 patients with stage pT1-3N0M0 received surgery for cure followed by chemotherapy and selective radiotherapy to the brain. The projected 4 year crude survival rate by September 1991 was 57 %. In 27 of 43 patients with stage PT1-3N2M0, the tumors were completely resected, resulting in a 4 year survival rate of 32%. The survival curve for both groups of patients shows a sharp bent at 27 months postoperatively, whereafter the survival curves take a plateau-like course.

These promising results were confirmed by several other groups. They are in favour of initial surgery for resectable tumors, followed by postoperative chemotherapy, while patients on preoperative chemotherapy followed by adjuvant surgery showed less favourable results.

Key Words

Small cell lung cancer initial surgery Adjuvant chemotherapy Elective cranial irradiation 


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  1. 1.
    Weissler J C, Nicod L P, Toews G B: Pulmonary natural killer cell activity is reduced in patients with bronchogenic carcinoma.Am Rev Resp Dis 135(6), 1353–1357 (1987).PubMedGoogle Scholar
  2. 2.
    WHO: The World Health Organization histological typing of lung tumours. 2nd Ed.Am J Clin Pathol 77, 123–136 (1982).Google Scholar
  3. 3.
    Hirsch F R, Matthews M J, Aisner S, Campobasso O, Elema J D, Gazdar A F, Mackay B, Nasiell M, Shimosato Y, Steele R H, Yesner R, Zettergren L: Histopathological classification of small cell lung cancer. Changing concepts and terminology.Cancer 62, 973–977 (1988).PubMedGoogle Scholar
  4. 4.
    Karrer K, Denck H, Karnicka H, Drings P, Salzer G M, Orel J, Liao M, Sun Y, Thermann M, Chen D, Lattuneddu A, Zimmermann G, Berkarda B, Osada H, Bruno M, Eckers-berger F, Hata E for the ISC-Lung Cancer Study Group: Multimodality treatment starting with surgery for cure of small cell bronchial carcinoma (SCLC), in Salmon S E (ed):Adjuvant Therapy of Cancer, Proc. 6th International Conference on the Adjuvant Therapy of Cancer, Tuscon, AZ, March 7–10, Vol.VI, pp. 154–161. W B Saunders Company, Philadelphia (1990).Google Scholar
  5. 5.
    Ginsberg R J, Karrer K: Surgery in small cell lung cancer: a consensus report.Lung Cancer 5, 139 (1989).Google Scholar
  6. 6.
    Hermanek P, Scheibe O, Spiessl B, Wagner G (eds): UICC: TNM-classification of malignant tumours. 4. fully revised edn., Springer-Verlag, Berlin (1987).Google Scholar
  7. 7.
    Spiessl B, Beahrs P H, Hermanek P, Hutter R V P, Scheibe O, Sobin L H, WagnerG (eds): UICC: TNM-Atlas. Illustrated guide to the TNM/pTNM-classification of malignant tumours. 3rd edn. Springer-Verlag, Berlin (1989).Google Scholar
  8. 8.
    Stahel R A, Ginsberg R, Havemann K, Hirsh F R, Ihde D C, Jassem J, Karrer K, Maurer L H, Osterlind K, Van HoutteP: Staging and prognostic factors in small cell lung cancer: a consensus report.Lung Cancer 5, 119–126 (1989).Google Scholar
  9. 9.
    Miller A B, Fox W, Tall R: Five-year follow-up of the Medical Research Council comparative trial of surgery and radiotherapy for the primary treatment of small celled or oat-celled carcinoma of the bronchus.Lancet 2, 501–505 (1969).PubMedGoogle Scholar
  10. 10.
    Mountain C L: A new international staging system for lung cancer.Chest 89, 233 (1986).Google Scholar
  11. 11.
    Selawry O S: Monochemotherapy of bronchogenic carcinoma with special reference to cell type.Canc Chemother Rep 4, 177–188 (1973).Google Scholar
  12. 12.
    Selawry O S, Hansen H H: Lung Cancer, in Holland J F, Frei E, III (eds):Cancer Medicine, pp. 1473–1518. Lea and Febiger, Philadelphia (1973).Google Scholar
  13. 13.
    Aisner J,et al. Roleof chemotherapy in small cell lung cancer: A Consensus report of the LASLC-workshop.Cane Treatm Rep 67, 37–43 (1983).Google Scholar
  14. 14.
    Turrisi A T, Glover D J: Thoracic radiotherapy variables: influence on local control in small cell lung cancer limited disease.Int J Radiation Oncol Biol Phys 19, 1473–1479 (1990).Google Scholar
  15. 15.
    Massen W, Greschuchna D: Small cell carcinoma of the lung - to operate or not? Surgical experience and results.Thorac Cardiovasc Surgeon 34, 71–76 (1986).Google Scholar
  16. 16.
    Herfarth C: Aspects of surgical oncology.Eur J Surg Oncol 16, 275 (1991).Google Scholar
  17. 17.
    Buyse M: Randomized clinical trials in surgical oncology.EurJSurg Oncol 17, 421 (1991).Google Scholar
  18. 18.
    Karrer K, Shields T W, Denck H: The importance of surgical and multknodality treatment for small cell bronchial carcinoma.J Thorac Cardiovasc Surg 97, 168–176 (1989).PubMedGoogle Scholar
  19. 19.
    Skipper H E, Schabel FM, Jr. : Quantitative and cytogenetic studies in experimental tumor models, in Holland J F, Frei E, III (eds):Cancer Medicine Table XII-3-7, p. 648. Lea and Febiger, Philadelphia.Google Scholar
  20. 20.
    Osterlind K: Surgery in small cell lung cancer: some quantitative aspects.Lung Cancer 6, 84–85 (1990).Google Scholar
  21. 21.
    Cox D: The contribution of statistical methods to cancer research.Cancer 67, 2428 (1991).PubMedGoogle Scholar
  22. 22.
    Verter J: How much data should we collect in a randomized trial?Stat in Med 9, 103–113(1990).Google Scholar
  23. 23.
    Ulsperger E, Shields T W, Karrer K: The role of surgery in small cell lung cancer.Lung Cancer 6,73–83 (1990).Google Scholar
  24. 24.
    Ing A, Murdoch C, Glanville A, Hartnett B, Jenkins C, Rutland J, McCaughan B, Aroney R, Page J, Yuille P, Breslin A: Primary lung cancer-experience with a multidisciplinary approach.Lung Cancer 7 (suppl.), 53 (#190) (1991)Google Scholar
  25. 25.
    Chiba W, Ikeda S, Adachi M, Yamamoto Y, Sawai S, KonishiT, Matsubara Y: Significance of ex tended resection for T3 and T4 lung cancer.Lung Cancer 7 (suppl.), 75 (#271) (1991).Google Scholar
  26. 26.
    Mitsui K, Akaogi E, Onizuka M, Morita R, Ishikawa S, Kionshita T, Yamamoto T, Ishibashi O, Ogata T, Hori M:Results of extended operation for advanced lung cancer.Lung Cancer 7 (suppl.), 77 (#277) (1991).Google Scholar
  27. 27.
    McCaughan B C, Wilson M K, Kennedy C: Limited resection for stage I carcinoma of lung.Lung Cancer 7 (suppl.), 75 (#272) (1991).Google Scholar
  28. 28.
    Ichiba S, Shimizu N, Ando H, Teramoto S: Surgical treatment for small sized (2 cm or less in diameter) peripheral type lung cancer lesions.Lung Cancer 7 (suppl.), 74 (#268) (1991).Google Scholar
  29. 29.
    Rea F, Sartori F, Calabro F, Loy M, Erroi L, Bortolotti L, Toniolo L: Sleeve lobectomy for lung cancer.Lung Cancer 7 (suppl.), 84 (#305) (1991).Google Scholar
  30. 30.
    Niwa H, Masaoka A, Yamakawa Y, Iizuka M: Surgical therapy for apical invading lung cancer by different approaches according to tumor location.Lung Cancer 7 (suppl.), 74 (#266) (1991).Google Scholar
  31. 31.
    Chen D: Surgical treatment of lung cancer in patients over 60 years of age.Lung Cancer 7 (suppl.), 70 (# 252) (1991).Google Scholar
  32. 32.
    Denk W, Karrer K: Combined surgery and chemotherapy in the treatment of malignant tumours.Cancer 14, 1197–1204 (1961).PubMedGoogle Scholar
  33. 33.
    Denk W, Karrer K: Modellversuch einer Rezidivprophylaxe des Karzinoms.Wien Klin Wochenschr 67, 986 (1955).Google Scholar
  34. 34.
    Karrer K, Humphreys S R, Goldin A: An experimental model for studying factors which influence metastasis of malignant tumours.Int J Cancer 2, 213–223 (1967).PubMedGoogle Scholar
  35. 35.
    Karrer K, Pridun N, Denck H: Chemotherapy as an adjuvant to surgery in lung cancer.Cancer Chemother Pharmacol 1, 145–159 (1978).PubMedGoogle Scholar
  36. 36.
    Karrer K : Adjuvant chemotherapy of postsurgical minimal residual bronchial carcinomas, in Bonadonna G, MathéG, Salmon S E (eds): Recent results.Cancer Res 68, 246–259 (1979).Google Scholar
  37. 37.
    Gazdar A F, Bunn P A, Jr., Minna J D, Baylin S B: Origin of human small cell lung cancer.Science 229, 679 (1985).PubMedGoogle Scholar
  38. 38.
    Müller K-M, Fiss1er-Eckhoff A:Kleinzelliges Bronchialkarzinom-Pathologische Anatomie Langenbecks Arch Chir Suppl, pp.534-543, Kongreßbericht (1991).Google Scholar
  39. 39.
    Müller K-M, Fissler-Eckhoff A: Pathologie der Lungentumoren, in Drings P, Vogt-Moykopf I (eds): Thoraxtumoren, Diagnostik-Staging-gegenwärtiges Therapiekonzept, pp. 5–24, Ch. 1.1. Springer-Verlag, Berlin (1991).Google Scholar
  40. 40.
    Hirsch F R, Osterlind K, Hansen H H: The prognostic significance of histopathologic subtyping of small cell carcinoma of the lung according to the World Health Organization.Cancer 52, 2144–2150 (1983).PubMedGoogle Scholar
  41. 41.
    Carney D N, Gazdar A F, Bepler G, Guccion J G, Marangos P J, Moody T W, Zweig M H, Minna J D: Establishment and identification of small cell lung cancer cell lines having classic and variant features.Cancer Res 45, 2913–2923 (1985).PubMedGoogle Scholar
  42. 42.
    Mulshine I, Ihde D, Linnoila I,et al. : Preliminary report of a prospective trial of neuroendocrine marker analysis andin vitro drug sensitivity testing in patients with non-small cell lung cancer.Proc Am Soc Clin Oncol,181 (1987).Google Scholar
  43. 43.
    Morstyn G, Rosso A, Carney D N, Karawya E, Wilson S H, Mitschell J B: Heterogeneity in radiation survival curves and biochemical properties of human lung cancer cell lines.J Natl Cancer Inst 73 (4), 801–807 (1984).PubMedGoogle Scholar
  44. 44.
    Dalquen P: Entwicklung und Verlauf des Bronchuskarzinoms.Schweiz med Wschr 117, 1439–1447 (1987).PubMedGoogle Scholar
  45. 45.
    Wagenaar S S on behalf of the members of the EORTC-lung cancer cooperative group: Preliminary results of the pathological review of a small cell lung cancer trial (EORTC 08825).Eur J Resp Dis 70(suppl 149), 63 (1987).Google Scholar
  46. 46.
    Thompson S G, Pocock S J: Can meta-analyses be trusted?Lancet 338, 1127–1130(1991).PubMedGoogle Scholar
  47. 47.
    Jackson-York G L, Davis B H, Warren W H, Gould V E, Memoli V A: Flow cytometric DNA content analysis in neuroendocrine carcinoma of the lung.Cancer 68, 374–379 (1991).PubMedGoogle Scholar
  48. 48.
    George S L: Identification and assessment of prognostic factors.Semin Oncol 15, 462 (1988).PubMedGoogle Scholar
  49. 49.
    Watkin S W, Hayhurst G K, Green J A: Histological subtype of lung cancer is subject to age and sex specific differences.Lung Cancer 7 (suppl), 4 (#014) (1991).Google Scholar
  50. 50.
    Ulsperger E, Karrer K, Denck H for the ISC-Lung Cancer Study Group: Multknodality treatment for small cell bronchial carcinoma. Preliminary results of a prospective, multicenter trial.EurJ Cardio-thorac Surg 5, 306–310 (1991).Google Scholar
  51. 51.
    Hermanek P, Hutter R V P, Sobin L H: Prognostic grouping: the next step in tumor classification.J Cancer Res Clin Oncol 116, 513–516 (1990).PubMedGoogle Scholar
  52. 52.
    Lu H X, Pater J L, Zee B, Evans W H, Feld R, Coy P, Murray N, Ciampi A: Disease extent influences the impact of other prognostic factors in patients with small cell lung cancer.EurJ Cancer 27 (suppl 2), 188 (#1146) (1991).Google Scholar
  53. 53.
    Splinter T A W, Gaast A, Kok T C: Tumor volume doubling time and survival in small cell lung cancer.Proceedings of ASCO 10, 252 (#868) (1991).Google Scholar
  54. 54.
    Matsumoto T, Terasaki T, Mukai K, Wada M, Okamoto A, Yokota J, Yamaguchi K, Kato K, Nagatsu T, Shimosato Y:Relation between nucleolar size and growth characteristics in small cell lung cancer cell lines.Jpn J Cancer Res 82, 820–828(1991).PubMedGoogle Scholar
  55. 55.
    Sekido Y, Obata Y, Ueda R, Hida T, Suyama M, Shimokata K, Ariyoshi Y, Takahashi T: Preferential expression of c-kit protooncogene transcripts in small cell lung cancer.Cancer Res 51, 2416–2419 (1991).PubMedGoogle Scholar
  56. 56.
    Tirindelli Danesi D, Mecozzi A, Bangrazi C, Mancini M, Modini C: Flow cytometric heterogeneity of primary lung cancer and lymph node métastases.Lung Cancer 7 (suppl), 59 (#216) (1991).Google Scholar
  57. 57.
    Paccagnella A, Danova, Favaretto A, Fiocca R, Bosio L, Ronchetti E, Riccardi A, Mazzini G, Sartore F, Fiorentino M V: Flow cytometric DNA ploidy in lung cancer.Lung Cancer 7 (suppl.), 56 (#203) (1991).Google Scholar
  58. 58.
    Aamadal S, Myklebust A, Beiske K, Jakobsen E, Langholm R, Host H, Fodstad O: Bone marrow metastases in patients with small cell lung cancer detected by morphological and immunological methods.Lung Cancer 7 (suppl.), 57 (#209) (1991).Google Scholar
  59. 59.
    Sagman U, Maki E, Ledesma E, Feld R: A multicentre consensus model for prognostic factors in small cell lung carcinoma.Lung Cancer 7 (suppl.), 58 (#213) (1991)Google Scholar
  60. 60.
    Osterlind K, Ciarnpi A, Dombernowsky P, Hansen M, Hansen O P, Hansen H H: Prognostic factors in small cell lung cancer.Lung Cancer 7 (suppl.), 58 (#211) (1991).Google Scholar
  61. 61.
    Viallard J L, Caillaud D, Kantelip B, Molina C, Dastugue B: Enzymatic determination of serum neuron-specific enolase in small cell lung cancers; utility of the serum neuronspecific enolase/serum nonneuronal enolase ratio.Chest 93, 1225–1233(1988).PubMedGoogle Scholar
  62. 62.
    Jorgensen LGM, Osterlind K, Hansen H H, Cooper E H:The prognostic influence of serum neuron specific enolase in small cell lung cancer.Br J Cancer 58(6), 805–807 (1988).PubMedGoogle Scholar
  63. 63.
    Bork E, Hansen M, Urdal P, Paus E, Holst J J, Schifter S, Fenger M, Engbaek F: Early detection of response in small cell bronchogenic carcinoma by changes in serum concentrations of creatine kinase, neuron specific enolase, calcitonin, ACTH, serotonin and gastrin releasing peptide.Eur J Cancer Clin Oncol 24(6), 1033–1038 (1988).PubMedGoogle Scholar
  64. 64.
    Jorgensen LGM, Hansen H H, Cooper E H: Neuron specific enolase, carcinomoembryonic antigen and lactate dehydrogenase as indicators of disease activity in small cell lung cancer.Eur J Cancer Clin Oncol 25(1), 123–128 (1989).PubMedGoogle Scholar
  65. 65.
    Maimonis P, Hayes D F, Schaffei S, Kufe D: Lung cancer associated protein: development and characterization of a new assay that detects a circulating lung cancer marker.Cancer Res 51, 3838–3842 (1991).PubMedGoogle Scholar
  66. 66.
    Johnson P W M, Pandian M R, Love S, Squires L, Joel S P, Slevin M L: Chromogranin A: a new predictor of survival in small cell lung cancer.Eur J Cancer 27 (suppl. 2), 259 (#1587) (1991).Google Scholar
  67. 67.
    Soresi E, Spinazzi A, Boffi R, Cobelli S, Mantica C, Gramegna G, Scanni A: Clinical value of a multiple biomarker assay in lung cancer.Eur J Cancer 27 (suppl. 2), 266 (#1629) (1991).Google Scholar
  68. 68.
    Zaleska J, Pirozynski M, Kwiek S, Rowinska-Zakrzewska E: Tumour markers in bronchial washings in lung cancer.Eur J Cancer 27 (suppl. 2), 266 (#1630) (1991).Google Scholar
  69. 69.
    Kubota K, Furuse K, Fukuoka M, Nishiwaki Y, Ikegami H, Saijo N, Suemasu K: Prognostic factors in patients with small cell lung cancer.Lung Cancer 7 (suppl.), 53 (#192) (1991).Google Scholar
  70. 70.
    Ruckdeschel J, Linniola R I, Mulshine J L, Kim K, Piantadosi S, Aisner S, Jensen S M, Gazdar A F: The impact of neuroendocrine and epithelial differentiation on recurrence and survival in patients with lung cancer.Lung Cancer 7 (suppl.), 56 (#204) (1991).Google Scholar
  71. 71.
    Joos G, Pinson P, Watripont P, Bruselle G, Pauwels R: A retrospective analysis of serum NSE and CE A in small cell lung cancer.Lung Cancer 7 (suppl.), 59 (#214) (1991).Google Scholar
  72. 72.
    Ferguson M, Skosey C, Hoffman P C, Golomb H M:Sex-associated differences in presentation and survival in patients with lung cancer.J Clin Oncol 8, 1402–1407 (1990).PubMedGoogle Scholar
  73. 73.
    Wolf M, Holle R, Hans K, Drings P, Havemann K: Analysis of prognostic factors in 766 patients with small cell lung cancer (SCLC): the role of sex as a predictor for survival.BrJ Cancer 63, 986–992 (1991).Google Scholar
  74. 74.
    Shimono T, Kusagawa H, Mizumoto T, Namikawa S, Kusagawa M:Surgical treatment of primary lung cancer under 40 years old.Lung Cancer 7(suppl.), 73 (#263) (1991).Google Scholar
  75. 75.
    Fiacchi M, Di Gaetano P, Grazia M, Bini A, Bazzocchi R:Postoperative complications after thoracotomy for lung cancer in the elderly.Lung Cancer 7 (suppl.), 85 (#310) (1991).Google Scholar
  76. 76.
    Chen D: Surgical treatment of lung cancer in patients over 60 years of age.Lung Cancer 7(suppl.), 70 (#252) (1991).Google Scholar
  77. 77.
    McCaughan B C, Wilson M K, Kennedy C: Limited resection for stage I carcinoma of the lung.Lung Cancer 7(suppl.), 75 (#272) (1991).Google Scholar
  78. 78.
    Ichiba S, Shimizu N, Ando H, Teramoto S: Surgical treatment for small sized (2 cm or less in diameter) peripheral type lung cancer lesions.Lung Cancer 7(suppl.), 74 (#268) (1991).Google Scholar
  79. 79.
    Tanaka H, Niwa H, Yamakawa Y, Masaoka A: The risk factor of resected T1 No Mo lung cancer.Lung Cancer 7(suppl.),74(#267) (1991).Google Scholar
  80. 80.
    Gotti G, Paladini P, Maccerini M, Haid M, Di Bisceglie M, Lisi G, Biagi G: Segmentectomy, wedge resection and lobectomy for non small cell lung cancer.Lung Cancer 7(suppl.),85(#312) (1991).Google Scholar
  81. 81.
    Pastorino U, Valente M, Bedini V, Infante M, Tavecchio L, Gherardini G, Ravasi G: Limited resection for stage I lung cancer.Lung Cancer 7 ppl, 85 (#309) (1991).Google Scholar
  82. 82.
    Prakash D, Al-Jilaihawi A N, Ogunnaike H: The role of limited lung resection for bronchogeneic carcinoma.Lung Cancer 7 (suppl.), 82 (#297) (1991).Google Scholar
  83. 83.
    Nakamoto K, Hayashi E, Kawaguchi H, Nii K, Taniguchi K, Tsubota N, Okada T, Katsura H, Fujiwara K, Nakamura K, Maeda M: The role of tracheobronchoplasty for extensive and limited operation against lung cancer.Lung Cancer 7(suppl.), 81 (#294) (1991).Google Scholar
  84. 84.
    Ayabe H, Tagawa Y, Kawahara K, Tomita M: Extended operations for T4 primary lung cancer.Lung Cancer 7(suppl.),73(#264)(1991).Google Scholar
  85. 85.
    Hata E, Miyamoto H, Mitoma Y, Hayakawa K: Systematic bilateral mediastinal dissection and en bloc resection through the median sternotomy.Lung Cancer 7(suppl), 75 (#269) (1991).Google Scholar
  86. 86.
    Miura K, Fukumoto T, Hori T, Yoshizawa K, Morita J:Postpneumonectomy space control withSFß.Jpn J Surg 21(4), 392–394(1991).PubMedGoogle Scholar
  87. 87.
    Uyama T, Monden Y, Sumitomo M, Takahasi K, Kondo K, Sakiyama S, Tanida N, Harada K: The management of postpneumonectomy space with sulfur hexaflourid (SF6) gas prevents deterioration of the opposite lung.Lung Cancer 7 (suppl.), 72 (#257) (1991).Google Scholar
  88. 88.
    Nitta S, Itaoka T, Ohnuki T, Kei J, Yokoyama M, Tahara S, Sone Y, Murasugi M: Simultaneous lung resection and coronary artery reconstruction in patients with lung cancer and ischémie heart disease.Lung Cancer 7(suppl.), 76 (#273) (1991).Google Scholar
  89. 89.
    Chiba W, Ikeda S, Adachi M, Yamamoto Y, Sawai S, Konishi T, Matsubara Y: Significance of ex tended resection forT3 and T4 lung cancer.Lung Cancer 7(suppl.),75 (#271) (1991).Google Scholar
  90. 90.
    Pierce R J, Copland J, Sharp K, Barter C E: Pre-operative risk evaluation for lung cancer resection.Lung Cancer 7(suppl.),59(#217) (1991).Google Scholar
  91. 91.
    NagayamaM, ToyoshimaM, SuganumaHJdaM, Yamada T, Hasegawa J, Satoh A: The significance of coagulation and fibrinolytic parameters in patients with lung cancer.Lung Cancer 7 (suppl.), 57 (#208) (1991).Google Scholar
  92. 92.
    Keller S M, Groshen S, Martini N, Kaiser L R: Blood transfusion and lung cancer recurrence.Cancer 62 (3), 606–610 (1988).PubMedGoogle Scholar
  93. 93.
    Weiden P L: Do perioperative blood transfusions increase the risk of cancer recurrence?Eur J Cancer 26 (9), 987–989 (1990).PubMedGoogle Scholar
  94. 94.
    Watanabe M, Niwa Y, Kobayashi T, Kawamura M, Kato R, Kikuchi K, Kobayashi K, Ishihara T: Autologous blood transfusion for operation of the lung cancer.Lung Cancer 7(suppl), 81(295) (1991).Google Scholar
  95. 95.
    Holsti L R: Combined chemotherapy and radiotherapy in lung cancer.Cane Treat Symp 2, 63–67 (1985).Google Scholar
  96. 96.
    Fernando H C, Goldstraw P: The accuracy of clinical evaluative intrathoracic staging in lung cancer as assessed by postsurgical pathologic staging.Cancer 65, 2503–2506 (1990).PubMedGoogle Scholar
  97. 97.
    Lad T, Thomas P, Piantadosi S: Thoracotomy staging of small cell lung cancer.Lung Cancer 7(suppl.), 56 (#205) (1991).Google Scholar
  98. 98.
    Cole P H, Roszkowski A, Mathews R, Firouz-Abadi A, Johnston N, Dare A: Comparison of N status as determined by preoperative CT and by intraoperative node mapping in 150 patients undergoing resection for carcinoma of the lung.Lung Cancer 7 (suppl.), 56 (#202) (1991).Google Scholar
  99. 99.
    Kristensen S, Aaby C: Mediastinal staging of bronchial carcinoma: Accuracy of computerized tomography and mediastinoscopy.Lung Cancer 7(suppL), 65 (#237) (1991).Google Scholar
  100. 100.
    Wahlers B: Primary staging of carcinoma of the bronchusis computer tomography of the brain necessary?Lung Cancer 7 (suppL), 57 (#207) (1991).Google Scholar
  101. 101.
    Knopp M V, Strauss L G, Bischoff H, Haberkom U, Branscheid D, Doll J, Lorenz W J, van Kaick G: Application of positron emission tomography in the staging of lung cancer.Lung Cancer 7 (suppl), 58 (#212) (1991).Google Scholar
  102. 102.
    Lad T: Mediastinoscopic evaluation of stage IIIA lung cancer: defining a population for pre-operative treatment trials.Lung Cancer 7(suppl) 57 (#206) (1991).Google Scholar
  103. 103.Naruke
    T, Suemasu K, Ishikawa S: Mediastinal Lymph Node Dissection and Its Significance in Surgery of Lung Cancer.Lung Cancer 2, 96 (1986).Google Scholar
  104. 104.Gittlen
    S D, Erozen Y, Wang K P: A new versatile trans bronchial cytology needle for the staging and diagnosis of bronchogenic carcinoma.Chest 94(3), 561–565 (1988).Google Scholar
  105. 105.Ishida
    T, Yano T, Maeda K, Kaneko S, Tateishi M, Sugimachi K:Strategy for lymphadenectomy in lung cancer three centimeters or less in diameter.Ann Thorac Surg 50, 708–713(1990).Google Scholar
  106. 106.
    106.SagawaM, Saito Y, Takahashi S, Usuda K, Karnma K, Sato M, Ota S I, Nagamoto N, Fujimura S, Nakada T, Hashimoto K, Suda H, Im ai T, Saito H: Clinical and prognostic assessment of patients with resected small peripheral lung cancer lesions.Cancer 66, 2653–2657 (1990).PubMedGoogle Scholar
  107. 107.
    Beattie E J, Harvey J C: Screening for lung cancer.J Surg Oncol 46, 1–2 (1991).PubMedGoogle Scholar
  108. 108.
    Ruckdeschel J: Scientists set priorities for lung cancer intervention.J Natl Cancer Inst 83, 815–816 (1991).Google Scholar
  109. 109.
    Connolly C K, Jones W G, Thorogood J, Head C, Muers M F: Investigation, treatment and prognosis of bronchial carcinoma in the Yorkshire Region of England 1976-1983.Br J Cancer 61(4), 579–583 (1990).PubMedGoogle Scholar
  110. 110.
    Schilling C J, Schilling J M: Chest x-ray screening for lung cancer at three British chromates plants from 1955 to 1989.Br J Indust Med 48, 476 (1991).Google Scholar
  111. 111.
    Sobue T, Suzuki T, Matsuda M, Horai T, Kajita A, Kuriyama K, Fukuoka M, Kusunoki Y, Kikui M, Ryu S E, Fujimoto I: Sensitivity and specificity of lung cancer screening in Osaka, Japan.Jpn J Cancer Res 82,1069–1076 (1991).PubMedGoogle Scholar
  112. 112.
    Watanabe Y, Shimizu J, Oda M, Hayashi Y, Ikegaki S, Takashixna T, Kamimura R, Nonomura S: Clinical aspects of early hilar lung cancer.Lung Cancer 7 (suppl), 79 (#287) (1991).Google Scholar
  113. 113.
    Maruyama S, Ando A, Date H, Shimizu N, Teramoto S:Primary lung cancer in young adults under 40 years old.Lung Cancer 7(suppl.), 78 (#283) (1991).Google Scholar
  114. 114.
    Shibayama M, Matsui E, Inoue A, Doi H: Early detection of the central endobronchial tumor by a new imaging technique.Lung Cancer 7 (suppl.), 66 (#238) (1991).Google Scholar
  115. 115.
    Kato H, Konaka C, Okunaka T, Hayata Y: Early detection and localization of lung cancer.Lung Cancer 7 (suppl.), 62 (#223) (1991).Google Scholar
  116. 116.
    Karrer K, Denck H, Pridun N: Combination of early surgery for cure and polychemotherapy in small cell bronchial carcinoma, in Spitzy K H, Karrer K (eds.):Proceedings of the 13th International Congress of Chemotherapy, Vienna. Tom11 (228), 52–60 Egermann, Vienna (1983).Google Scholar
  117. 117.
    Shields T, Matthews M: Adjuvant therapy of small cell bronchial carcinoma.Cancer Treat Rev 11, 331–333 (1984).PubMedGoogle Scholar
  118. 118.
    Ulsperger E, Karrer K: Multimodality treatment for small cell bronchial carcinomas (SCLC), in Banzet P, Holland J F, Khayat D, Weil M (eds.):Proceedings of the third international congress on neo-adjuvant chemotherapy. Springer Verlag, Paris (1991).Google Scholar
  119. 119.
    Paladugu R R, Benfield J R, Pak H Y, Ross R KL Teplitz R L: Bronchopulmonary Kolchitzky ceil carcinomas.Cancer 55,1303–1311 (1985).PubMedGoogle Scholar
  120. 120.
    F A, Ginsberg R J, Feld R, Evans W K, Johansen E: Surgical treatment for limited small-cell lung cancer, the University of Toronto Lung Oncology Group experience.J Thorac Cardiovasc Surg 101, 385–393 (1991).Google Scholar
  121. 121.
    Debevec M, Orel J: Treatment of small cell lung cancer by surgery, chemotherapy, and irradiation.Lung Cancer 7, 339–344 (1991).Google Scholar
  122. 122.
    Zejian L, Hua R, Zhiyong Z, Chengfu S, Letian X, Hongquan Y, Longyun L, Juechu Z, Hongzhen Y, Hongrui L: Treatment of small cell lung cancer.Lung Cancer 7(suppl.), 80 (#290) (1991).Google Scholar
  123. 123.
    Zhou H N, Liu G S, Zeng C G, Chen Y F: Diagnosis and treatment of small cell lung cancer to discuss and consider.Lung Cancer 7(suppl), 71 (#253) (1991).Google Scholar
  124. 124.
    Kemmer H P, Schmidt B, v Zwehl D5 Reichle G, Macha H N, Achatzy R: Combined modality treatment in patients with small cell lung cancer.Eur J Cancer 27 (suppl. 2), 218 (#1331) (1991).Google Scholar
  125. 125.
    Favaretto A, Paccagnella A, Pappagallo G, Ghiotto C, Rea F, Chiarion-Sileni V, Tomio L, Sotti G, Roberti G, Fiorentino M V: Survival and prognostic factors in small cell lung cancer. Results on 273 patients treated with alternating CT (and surgery for operable pts).Eur J Cancer 27 (suppl. 2), 182 (#1108) (1991).Google Scholar
  126. 126.
    Lad T, Thomas P, Piantadosi S: Surgical resection of small cell lung cancer - a prospective randomized evaluation.Lung Cancer 7(suppl.), 162 (#604) (1991).Google Scholar
  127. 127.
    Gridelli C, Maiorino A, Curcio C, D’ Aprile M, Iannielio G, Brancaccio L, Palmeri S, Gentile M, Cornelia G, Pedicini T, Airoma G, De Placido S, Ferrante G, Bianco A R:Carboplatin plus Epirubicin plus VP-16, concurrent radiotherapy and adjuvant surgery for limited SCLC.Eur J Cancer 27 (suppl. 2), 186 (#1130) (1991).Google Scholar
  128. 128.
    Taniguchi K, Tsubota N, Kawaguchi H, Nakamoto K, Maeda M: Surgical usage of dose intensive chemotherapy with G-CSF; KRN8601 for advanced lung cancer.Lung Cancer 7 (suppl.), 159 (#593) (1991).Google Scholar
  129. 129.
    Rocmans P A, Cappello M, de Francquen P, Jacobovitz D:Feasibility of surgery after chemotherapy.Lung Cancer 7 (suppl.), 83 (#302) (1991).Google Scholar
  130. 130.
    Yamamoto M, Masaki Y, Nishimura H, Yoneda S, Sakura M: Thoracotomy after chemoradiotherapy — a study on 20 lung cancer patients.Lung Cancer 7 (suppl.), 160 (#595) (1991).Google Scholar
  131. 131.
    HaraN, OhtaM, Tomoham K, AkiraM, Asoh H: Influence of surgical resection before and after chemotherapy on survival in small cell lung cancer.J Surg Oncol 47, 53 (1991).Google Scholar
  132. 132.
    H, Semik M: Combined therapy of small cell bronchial carcinoma.Lung Cancer 7 (suppl.), 160 (#598) (1991).Google Scholar
  133. 133.
    Murray N, Coy P, Pater J, Hodgson I, Arnold A, Kostashuk E, Dixon P, Zee B, Sadura A, Ayoub J, Levitt M, Wierzbicki R, Feld R, Payne D, Maroun J, Wilson K: The importance of timing for thoracic irradiation in the combined modality treatment of limited stage small cell lung cancer.Proc ASCO 10, 243 (#831) (1991).Google Scholar
  134. 134.Temperley
    G J, Balbiani L, Brocato N, Sparrow C, Bruno M, Savulsky C, Cervellino J, Pirisi C, Araujo C: Iphos- phamide + 4 Epidoxorubicin +VP16 in the treatment of inoperable small cell lung cancer.Lung Cancer 7 (suppl.), 109 (#402) (1991).Google Scholar
  135. 135.
    Watkin S W, Green J A, Warenius H M, Evans C C:Randomised trial of Cyclophosphamide, Doxorubicin, Vin-cristine (CAV) versus Ifosfamide, Etoposide (IE) in small cell lung cancer (SCLC).Lung Cancer 7 (suppl.), 115 (#423) (1991).Google Scholar
  136. 136.
    Souhami R L, Law K: Longevity in small cell lung cancer.BrJ Cancer 61, 584 (1990).Google Scholar
  137. 137.
    Bleehen N M, Girling D J, Gregor A, Leonard R C, Machin D, McKenzie C G, Morgan D A, Smyth J F, Spittle M F, Stephens R J, Yosef H M: A Medical Research Council phase II trial of alternating chemotherapy and radiotherapy in small cell lung cancer.BrJ Cancer 64, 775–779 (1991).Google Scholar
  138. 138.
    Carlson R W, Sikic B I, Gandara D R, Hendrickson C G, Wittlinger P S, Shields J A, Wong P P, White J E, Meakin C J, McWhirter K M: Late consolidative radiation therapy in the treatment of limited-stage small cell lung cancer.Chest 68, 948–958 (1991).Google Scholar
  139. 139.Bando
    H, Takishita Y, Ogura T, Sone S, Shimizu E, NakayamaT, Doi H, Kobayashi M: Alternating chemotherapy of Cyclophosphamide + Adriamycin + Vincristine (CAV) - Cisplatin + Etoposide (PVP) for small cell lung cancer.Lung Cancer 7 (suppl.), 116 (#430) (1991).Google Scholar
  140. 140.
    Bork E, Sigsgaard T, Nissen K M, Randlev T, Bergman B, Dombernovsky P, Hansen M, Hansen H H: Etoposide and Teniposide in untreated small cell lung cancer.Lung Cancer 7 (suppl.), 121 (#449) (1991).Google Scholar
  141. 141.
    Cassidy J, Semple P, Morde R, Stack B, Banham S, Stewart W P: Ifosfamide, Carboplatin and Etoposide for ‘good prognosis’ small cell lung cancer.Lung Cancer 7 (suppl.), 115 (#426) (1991).Google Scholar
  142. 142.
    Gatzemeier U, Neuhauss R, v Pawel J, Laumen R, Hossfeld D K: Chemotherapy of patients with extensive stage small cell lung cancer with Carboplatin/Etoposide/Vincristine (CEV) vs. Etoposide/Vincristine (EV) - a phase HI trial.Lung Cancer 7 (suppl.), 103 (#377) (1991).Google Scholar
  143. 143.
    Girling D J for the British Medical Research Council Lung Cancer Working Party: Prospective randomised trial of 3 or 6 courses of Etoposide Cyclophosphamide Methotrexate and Vincristine and of 6 courses of Etoposide and Ifosfamide in small cell lung cancer.Lung Cancer 7 (suppl.), 103 (#378) (1991).Google Scholar
  144. 144.
    Kristjansen PEG, Osterlind K, Dombernowsky P, Hansen M, Hansen O P, Bergman B, Hansen H H: A three-armed randomized trial in small cell lung cancer of two induction regimens with Teniposide and Cisplatin or Carboplatin followed by alternating chemotherapy versus alternating chemotherapy.Lung Cancer 7 (suppl.), 121 (#450) (1991).Google Scholar
  145. 145.
    Nikkanan V, Liippo K, Ojala A, Jakobsson M, Järvinen M, Paloheimo S: VAC or VACE with chest irradiation in limited small cell lung cancer. An analysis of a controlled study with a %-year follow-up.Lung Cancerl 7 (suppl.), 152 (#563) (1991).Google Scholar
  146. 146.
    Ohta K, Kurihara N, Kamimori T, Kanazawa H, Wakayama K, AdachiN, Hirata K, Takeda T: Combination chemotherapy with Cisplatin, Ifosfamide and Etoposide for small cell lung cancer.Lung Cancer 7 (suppl.), 121 (#447) (1991).Google Scholar
  147. 147.
    Pujol J L, Demoly P, Gautier V, Romieu G, Dan Aouta M, Stenger R, Parrat E, Tadlaoui O, Marcenac AM, Benahmed S S, Michel F B, Godard P: Phase II study of alternating combination chemotherapy in small cell lung cancer.Lung Cancer 7, 285–294 (1991).Google Scholar
  148. 148.
    Fukuoka M, Furuse K, Saijo N, Nishiwaki Y, Ikegami H, Tamura T, Shimoyama M, Suemasu K, Randomized trial of cyclophosphamide, doxorubicin, and vincristine versus cisplatin and etoposide versus alternation of these regimens in small-cell lung cancer.J Nat I Cancer Inst 83, 855–861 (1991).Google Scholar
  149. 149.
    F, Tamura T, Kojima A, Yamada K, Fukuda M, Nakagawa K, Ohe Y, Sasaki Y, Eguchi K, Shinkai T, Ono R, H ara K, Saijo N: Late toxicities and complications in three-year survivors of small cell lung cancer.Eur J Cancer 27, 427(1991).CrossRefGoogle Scholar
  150. 150.
    Radford J, Ryder D, Dodwell D, Anderson H, Kamthan A, Thatcher N: Predicting septic complications of chemotherapy. An analysis of 328 patients treated for small cell lung cancer without dose reduction after major sepsis.Eur J Cancer 27 (suppl. 2), 183 (#1115) (1991).Google Scholar
  151. 151.
    Karrer K, Shields T: The importance of complete resection in the multimodality treatment of SCLC.Lung Cancer 7 (suppl.).71 (#254) (1991).Google Scholar
  152. 152.
    Hata E, Hayakawa K, Miyamoto H, Hayashida R: Rationale forextended lymphadenectomy for lung cancer.TheorSurg 5, 19–25 (1990).Google Scholar
  153. 153.
    Mountain C F: The biological operability of stage III non-small cell lung cancer.Ann Thorac Surg 40, 60 (1985).PubMedGoogle Scholar
  154. 154.
    Watanabe Y, Shimizu J, Oda M, Hayashi Y, Watanabe S, Tatsuzawa Y, Iwa T, Suzuki M, Takashima T: Aggressive surgical intervention in N2 non-small cell cancer of the lung.Ann Thorac Surg 51, 253–261 (1991).PubMedGoogle Scholar
  155. 155.
    Mastrorilli M, Bragaglia R B, Cipolla D’Abruzzo G, Schiavina M, Busutti L, Zompatori M, Paladini R, Gozzetti G: Actuarial 5-year survival after resection of N2 lung cancer.Lung Cancer 7 (suppl.), 78 (#281) (1991).Google Scholar
  156. 156.
    Valente M, Musumeci R, Tavecchio L, Muscolino G, Pas-torino U, Bedini A V, Ravasi G: Resectable N2 disease according to the predicted location of enlarged mediastinal nodes.Lung Cancer 7 (suppl.), 85 (#311) (1991).Google Scholar
  157. 157.
    Gotti G, Paladini P, Maccherini M, Haid M, Di Bisceglie M, Miraldi F, Biagi G: The survival in different N2 site infiltration in patients operated on for lung cancer.Lung Cancer 7 (suppl.), 86 (#316) (1991).Google Scholar
  158. 158.
    Drings P: Diagnostic procedures in small cell lung cancer (SCLC).J Cancer Res Clin Oncol 116 (suppl. (Part II)), 1033 (#15.21.02) (1990).Google Scholar
  159. 159.
    W, Karrer K: Multimodality treatment including surgery for patients with small cell lung cancer (SCLC).Eur J Cancer 27 (suppl. 2), 182 (#1107) (1991).Google Scholar
  160. 160.
    Greenberg E R, Chute C G, Stukel T, Baron J A, Freeman D H, Yates J, Korson R: Social and economic factors in the choice of lung cancer treatment.N Engl JMed 318, 612–617 (1988).CrossRefGoogle Scholar
  161. 161.
    Frei E HI: Curative cancer chemotherapy.Cancer Res 45, 6523–6537 (1985).PubMedGoogle Scholar
  162. 162.
    Stout R, Burt P A, Thatcher N: Single dose prophylactic cranial irradiation for small cell lung cancer.Lung Cancer 7 (suppl.), 90 (#325) (1991).Google Scholar
  163. 163.
    Twijnstra A, Volovics A, ten VeldeG: Elective brain irradiation in small cell lung cancer.Lung Cancer 7 (suppl.), 92 (#336) (1991).Google Scholar
  164. 164.
    Gregor A: Cranial irradiation in small cell lung cancer.Br J Cancer 63, 13–14 (1991).PubMedGoogle Scholar
  165. 165.
    Kristjansen P E G, Hansen H H: Brain métastases from small cell lung cancer treated with combination chemotherapy.EurJ Cancer Clin Oncol 24(3), 545–549 (1988).Google Scholar
  166. 166.
    Twelves C J, Souhami R L, Harper P G, Ash C M, Spiro S G, Earl H M, Tobias J S, Quinn H, Geddes D M: The response of cerebral métastases in small cell lung cancer to systemic chemotherapy.Br J Cancer 61, 147–150 (1990).PubMedGoogle Scholar
  167. 167.
    Les J S, Murphy W K, Glisson B S, Dhingra H M, Holoye P Y, Hong W K: Primary chemotherapy of brain métastases in small cell lung cancer.J Clin Oncol 7, 916–922 (1989).Google Scholar
  168. 168.
    Laparidou S, Skarlos D V, Polizogopoulos D, Barias K, S aman tas E, Panoussaki E, Papavasiliou K: Combination chemotherapy of small cell lung cancer with epirubicin, cyclophosphamide, etoposide and prophylactic cranial irradiation.EurJ Cancer 77 (suppl. 2), 218 (#1332) (1991).Google Scholar
  169. 169.
    Noseda M A, De Marinis F, Migliorino M R, Pallotta G:Cerebral métastases as relapse in SCLC with initial complete response: role of prophylactic brain irradiation.Lung Cancer 7 (suppl.), 155 (#575) (1991).Google Scholar
  170. 170.
    Regan J, Yarnold J, Jones P W, Cooke N T: Palliation and life quality in lung cancer; how good are clinicians at judging treatment outcome.Br J Cancer 64, 396–400 (1991).PubMedGoogle Scholar
  171. 171.
    Smith D B, Newlands E S, Rustin G J S, Begent R H J, Howells N, McQuade B, Bagshawe K D: Comparison of ondansetron and ondasetron plus dexamethasone as antiemetic prophylaxis during cisplatin-containing chemotherapy.Lancet 338, 487–490 (1991).PubMedGoogle Scholar
  172. 172.
    Jones A L, Hill A S, Soukop M, Hutcheon A W, Cassidy J, Kaye S B, Sikora K, Carney D N, Cunningham D: Comparison of dexamethasone and ondasetron in the prophylaxis of emesis induced by moderately emetogenetic chemotherapy.Lancet 338, 483–487 (1991).PubMedGoogle Scholar
  173. 173.
    Tabona M V: An overview on the use of granisetron in the treatment of emesis associated with cytostatic chemotherapy.EurJCancer 26 (suppl. 1), 37–41 (1991).Google Scholar
  174. 174.
    Postmus P E, Smit E F, Berendsen H H, Sleyfer D Th: A feasibility study of testing new drugs for small-cell lung cancer in patients with a poor performance status.Cancer Chemother Pharmacol 27, 490–491 (1991).PubMedGoogle Scholar
  175. 175.
    Elias A D, Skarin A T, Herman T, Hunt M, Ayash L, Wheeler C: Standard dose combined alkylating agents with autologous bone marrow support followed by consolidative radiotherapy for responding small cell lung cancer.Lung Cancer 7 (suppl.), 109 (#399) (1991).Google Scholar
  176. 176.
    Rushing D A, Friedenberg W R, Baldauf M C, Broste S, Gehlsen J A, Kriesel D H, Koontz D P, Rodvold K A:High-dose carmustine and autologous bone marrow reinfusion in the treatment of refractory or relapsed small cell lung carcinoma.Cancer 68, 720–724 (1991).PubMedGoogle Scholar
  177. 177.
    J P, Fouillard L, Douay L, Eugene-Jolchine I, Isnard F, Stachowiak J, Najman A, Gorin N C: GM-CSF instead of autologous bone-marrow transplantation after the BEAM regimen.Lancet 338, 601–602 (1991).Google Scholar
  178. 178.
    Dimetri G D, Griffin J D: Granulocyte colony-stimulating factor and its receptor.Blood 78, 2791–2808 (1991).Google Scholar
  179. 179.
    Crawford J, Ozer H, Stoller R, Johnson D, Lyman G, Tabbaral, Kris M, Grous J, Picozzi V, Rausch G, Smith R, Gradishar W, Yahanda A, Vincent M, Stewart M, Glapsy J:Reduction by granulocyte colony-stimulating factor of fever and neutropenia induced by chemotherapy in patients with small-cell lung cancer.N Engl J Med 325, 164–170 (1991).PubMedGoogle Scholar
  180. 180.
    Metcalf D: Control of granulocytes and macrophages: molecular, cellular, and clinical aspects.Science 254, 529–533 (1991).PubMedGoogle Scholar
  181. 181.
    Manegold C, Green J A, Trillet V N: r-metHug-CSF (G-CSF) with CDE chemotherapy in small cell lung cancer: results from a randomized, placebo-controlled trial,Eur J Cancer 21 (suppl. 2), 183 (#1111) (1991).Google Scholar
  182. 182.
    Pedrazzoli P, Bacciocchi G, Bergamaschi G, Giordano M, Lazzaro A, Robustelli della Cuna G: Effects of GM-CSF and IL3 on small-cell lung cancer cells,Eur J Cancer 27 (suppl. 2), 186 (#1134) (1991).Google Scholar
  183. 183.
    Spinazzé S, Rivoltini L, Bidoli P, Viviani S, Arienti F, Parmiani G, Casali P, Licitra L, Santoro A: Subcutaneous administration of recombinant interleukin 2 in extensive small cell lung cancer in partial remission after induction chemotherapy.Eur J Cancer 27 (suppl. 2), 187 (#1137) (1991).Google Scholar
  184. 184.
    Jett J R: Role of interferon in SCLC.Lung Cancer 5, 281–286(1989).Google Scholar
  185. 185.
    Langdon S P, Cummings J, Ritchie A A, Rozengurt E, Smyth J: Anti-growth factors for the treatment of small cell lung cancer.Eur J Cancer 27 (suppl. 2), 16 (#67) (1991).Google Scholar
  186. 186.
    Thomas F, Keyes S, Taylor J, Moreau J P, Bogden A:In vivo inhibition of human small cell lung carcinoma NCI-H345 with BIM26189 a bombesin antagonist.Eur J Cancer 27 (suppl. 2), 183 (#1112) (1991).Google Scholar
  187. 187.
    Frei E H I: Neo-adjuvant chemotherapy: new approaches involving alkylating agent modulation, in Banzet P, Holland J F, Khayat D, WeilM (eds.):Proceedings of the third international congress on neo-adjuvant chemotherapy. Springer Verlag, Paris (1991).Google Scholar
  188. 188.
    J J, Fidler I J: The biology of tumor metastasis.Semin Oncol 16, 106–115 (1989).Google Scholar
  189. 189.
    Bunn P A, Cullen M, Fukuoka M, Green M, Hansen H H, Harper P, Klastersky J, Le Chevalier T, Sagman U, Splinter T: Chemotherapy in small cell lung cancer.Lung Cancer 5, 127–134 (1989).Google Scholar

Copyright information

© Humana Press Inc. 1992

Authors and Affiliations

  • Wolfgang Theuer
    • 1
  • Oleg Selawry
    • 1
  • Karl Karrer
    • 1
  1. 1.ISC Lung Cancer Study Group, ISC-Study Center, Department of Epidemiology at the Institute of Tumorbiology/Cancer ResearchUniversity of ViennaAustria

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