Iribarren
C, Tekawa IS, Sidney S, et al. Effect of cigar smoking on the risk of
cardiovascular disease, chronic obstructive pulmonary disease, and cancer
in men. N Engl J Med. 1999;340:1773-1780
In a cohort
study of 17,774 men, regular cigar smoking was found to increase the risk
of lung cancer independent of other risk factors.
Henschke
CI, McCauley DI, Yankelevitz DF, et al. Early Lung Cancer Action Project:
overall design and findings from baseline screening. Lancet. 1999;354:99-105.
(Editorial: Smith IE. Screening for lung cancer: time to think positive.
Lancet. 1999;354:86-87.
Of 1000 smokers,
malignant disease was detected in 27 by computed tomography (CT) and 7
by chest radiograph. Low-dose CT can greatly improve the likelihood of
detecting small, noncalcified nodules and thus of detecting lung cancer
at an earlier and potentially curable stage.
Lam
S, Kennedy T, Unger M, et al. Localization of bronchial intraepithelial
neoplastic lesions by fluorescence bronchoscopy. Chest. 1998;113:696-702.
In a study of
173 patients, the relative sensitivity of white-light bronchoscopy (WLB)
and fluorescence bronchoscopy compared to WLB alone was 6.3 for intraepithelial
neoplastic lesions and 2.71 when invasive carcinomas were also included.
Vansteenkiste
JF, Stroobants SG, De Leyn PR, et al. Lymph node staging in non-small-cell
lung cancer with FDG-PET scan: a prospective study on 690 lymph node stations
from 68 patients. J Clin Oncol. 1998;16:2142-2149.
A total of 68
patients underwent thoracic computed tomography (CT), positron emission
tomography (PET), and invasive surgical staging. PET plus CT was significantly
more accurate than CT alone in lymph node staging of non-small cell lung
cancer with a sensitivity of 93%, a specificity of 95%, and accuracy of
94%.
Perez
EA. Perceptions of prognosis, treatment, and treatment impact on prognosis
in non-small cell lung cancer. Chest. 1998; 114: 593-604.
A survey to assess the roles and knowledge level of physicians, by specialty,
in the management of non-small cell lung cancer. For stages other than
stage I, there was a wide range of opinion regarding the treatment of
choice and expected impact of treatment on prognosis.
Lancet.
1998;352:257-263. (Editorial: Munro AJ. What now for postoperative radiotherapy
for lung cancer? Lancet. 1998;352: 250-251.)
This meta-analysis
reported on the role of postoperative radiotherapy in the treatment of 2,128
patients with completely resected non-small cell lung cancer. A detrimental
effect was observed in N0 and N1 disease, but no effect was seen in patients
with N2 disease.
Silvestri
G, Pritchard R, Welch HG. Preferences for chemotherapy in patients with
advanced non-small cell lung cancer: descriptive study based on scripted
interviews. Br Med J. 1998;317:771-775.
The median survival
of patients with stage IV non-small cell lung cancer is improved by approximately
3 months with the addition of chemotherapy. When interviewed, some patients
would choose chemotherapy for a survival benefit of as little as 1 week,
while others would not choose chemotherapy even when offered a survival
benefit of 24 months. Most patients would not choose chemotherapy for
its likely survival benefit of 3 months, but they would choose it if it
improved the quality of life.
Turrisi
AT III, Kim K, Blum R, et al. Twice-daily compared with once-daily thoracic
radiotherapy in limited small-cell lung cancer treated concurrently with
cisplatin and etoposide. N Engl J Med. 1999; 340:265-271.
Twice-daily
radiation treatment, given concurrently with cisplatin and etoposide,
significantly improved survival. The median survival was 19 months for
the once-daily group and 23 months for the twice-daily group.
Auperin
A, Arriagada R, Pignon JP, et al. Prophylactic cranial irradiation for
patients with small-cell lung cancer in complete remission. N Engl
J Med. 1999;341:476-484. (Editorial: Carney DN. Prophylactic cranial
irradiation and small-cell lung cancer. N Engl J Med. 1999; 341:524-526.)
Prophylactic
cranial irradiation improves both overall survival and disease-free survival
among patients with small-cell lung cancer in complete remission.
Johnson
BE. Second lung cancers in patients after treatment for an initial lung
cancer. J Natl Cancer Inst. 1998;90:1335-1345.
The risk of
developing a second lung cancer in patients who survived resection of
a non-small cell lung cancer is approximately 1% to 2% per patient per
year. Approximately 50% of these are resectable. Survivors who continue
to smoke have an increased risk of developing a second lung cancer.