85

results, however, continue to be unsatis-

factory, since the percentage of patients still surviving after two and three years has increased, depending on the composition of the groups investigated, only to 10-25%. Since long-term survivors are seen only after complete remission, the aim of chemo- therapy, in particular in the group with limited diseame, must always be complete remission.

Bronchial Carcinoma - Possibilities and Limitations of Chemotherapy. Part 2: Non- Small-Cell Bronchial Carcinoma. Schalhorn, A. Medizinische Klinik III, Klinikum Grosshadern der Universit~t M~nchen, D-8000 M@nchen 70, Germany. Fortschr. Med. 103: 453-456, 1985.

The non-small-cell bronchial carcinoma (BC), that is the group of bronchial car- cinomas comprising squamous cell, adeno- carcinoma, and large-cell BC, responds much less favourably to chemotherapy than the small-cell BC. As far as the stage and the technical conditions permit, curative surgery should always be the first aim. If this is not possible, and if curative radiotherapy is no longer practicable, consideration can be given to the use of chemotherapy in the treatment of the non- small-cell BC. The remission rates in excess of 40%, now possible with combinations containing cisplatin, are achieved predomi- nantly in patients in a very good general condition. For this reason, chemotherapy should be attempted only when the patient is relatively young and in a good general state. Response to chemotherapy is very low in patients in a poor general conditi- on and adverse effects are often conside- rable, so that remission, usually only brief, is achieved in merely a small per- centage of these patients. In such patients with advanced non-small-cell BC, the indi- cation of instituting chemotherapy must be very strictly applied, and symptomatic measures must then be given priority.

12, MISCELLANEOUS

Neuronal Antinuclear Antibody in Sensory Neuronopathyl from Lung Cancer. Graus, F., Cordon Cardo, C., Posner, J.B. Neurology and Pathology, Memorial Sloan- -Kettering Cancer Center, Cornell Univer- sity Medical College, New York, NY 10021, U.S.A. Neurology 35: 538-543, 1985.

We found an antinuclear antibody high- ly restricted to nuclei of neurons in two patients with subacute sensory neu- ronopathy complicating oat cell carci- noma of the lung. Serum was tested by indirect immunofluorescence and immuno- peroxidase staining. At low concentrations o~ antibody, only the nuclei of the neu-

rons were stained. At high concentrations,

there was also staining of the nuclei of clial cells and fetal nonneural tissues. The cyto- plasm of most neurons was stained with the im- munoperoxidase method.

Intravascular Bronchioloalveolar T~nour. A 20-Year Survival. Teo, S.K., Chiang, S.C., Tan, K.K. Department of Medicine IV, Tan Tock Seng Hospital, Singa- pore 1130, Singapore. Med. J. Aust. 142: 220- 222, 1985.

An unusual case of intravascular bronchio- loalveolar tumour in a 40-year-old Chinese woman is reported. The woman has survived 20 years after radiological abnormalities were first noted in the lungs. This slowly progres- sing endothelial lung tumour has only recently been recognized as a distinct pathological en- tity.

Bronchoalveolar Lavage and the Immunology of Primary Lung Cancer. Olsen, G.N., Gangemi, J.D. Department of Medi- cine, University of South Carolina School of Medicine, Columbia, SC 29208, U.S.A. Chest 87: 677-683, 1985.

Bronchoalveolar lavage (BAL) is a powerful tool with which the immunology of the lung in health and disease can be studied. This tech- nique has been successfully used to characte- rize humoral and cell-mediated responses in sarcoidosis and a number of other interstitial pneumonitides. In contrast, BAL in patients with lung cancer has resulted in some confusion regarding the extent and type of local and sy- stemic immunity in these patients. This review summarizes some of the data obtained from these patients via BAL, but does not attempt to ex- plain the reported discrepancies. The objective of this review is rather to identify gaps which exist in our knowledge of the environmental factors influencing pulmonary immunity in pri- mary lung cancer.

Risk-Benefit Relationships in Cancer Clinical Trials: The ECOG Experience in Non-Small-Cell Lung Cancer. Simes, R.J. Division of Biostatistics and Epi- demiology, Dana Farber Cancer Institute, Boston, MA 02115, U.S.A.J. Clin. Oncol. 3: 462-472, 1985.

Although there is widespread recognition of the need to critically evaluate risks and bene- fits for patients participating in clinical trials, the actual implementation can be a difficult task. As an illustration of the ana- lytic difficulties, we reviewed the experience of the Eastern Cooperative Oncology Group (ECOG) in advanced (inoperable) non-small-cell lung cancer over the past ten years (1973 to 1983). Of 2,714 ECOG patients analyzed, 15% showed objective tumor response. Median survi- val of all patients was 4.2 months, with ap- proximately one half of patient's survival spent on protocol treatment. Thirty-nine percent of