Combination chemotherapy with vindesine-ifosfamide-cisplatin (VIP) in locally advanced unresectable stage III and in stage IV non-small cell lung cancer: a phase II trial

The efficacy and toxicity of a regimen adding ifosfamide to the more classical cisplatin-vindesine combination was studied in patients with advanced non-small cell lung cancer. Sixty-four good performance patients with inoperable stage III or stage IV were treated with VIP: vindesine 3 mg/m2 days 1 and 8, ifosfamide 1200 mg/m2 and platinum 30 mg/m2 days 1, 2 and 3, repeated every 4 weeks, up to a maximum of six cycles. Response rate, clinical data and radiological tests were rigourously reviewed by a panel. Overall response rate was 39% (95% confidence interval, 27%-51%) with three patients achieving a complete response; response rate in stage III was 48%. Median survival was 9 months. Toxicity consisted mainly of bone marrow toxicity and nausea/vomiting, but was manageable. There was no renal toxicity greater than grade 2, four severe infections, but no treatment-related deaths.

CONCLUSION

VIP as mentioned above is very active in good performance patients with advanced non-small cell lung cancer. Its activity, together with its manageable toxicity--without severe renal or pulmonary toxicity--makes it an attractive candidate for induction chemotherapy.

Computed tomography of the rectum with water as contrast agent

The use of intrarectally administered plain tap water as a contrast medium for CT scan of the rectum and sigmoid combined with iv iodine contrast medium was prospectively studied in 28 patients. This method allowed correct demonstration of mural wall abnormalities in all patients and therefore represents a simple, inexpensive, and efficient modality for CT study of the rectum and sigmoid.

Computed tomography of the stomach with water as an oral contrast agent: technique and preliminary results

Computed tomography of the gastric wall after ingestion of 500-700 ml of pure tap water, followed by rapid intravenous injection of contrast medium, was performed on 24 patients with known gastric tumors. Computed tomography detected the wall abnormality in 22 of 24 cases (91%). Local gastric involvement was correctly predicted in 20 of these patients. Tumoral ulceration was only diagnosed in two of 13 proven ulcerated tumors. General acceptance and tolerance of tap water as a gastric contrast medium was good in all patients. No side effects occurred.