RETROSPECTIVE ANALYSIS OF THE TREATMENT OF PATIENTS WITH SMALL-CELL LUNG-CANCER SHOWING POOR PERFORMANCE STATUS

To assess the feasibility of treatments for patients with small cell l ung cancer (SCLC) showing a poor performance status (PS, Eastern Coope rative Oncology Group; ECOG 3 or 4), we retrospectively reviewed the o utcome for 13 SCLC patients showing poor PS treated at the National Ca ncer Center Hospital between January 1984 and May 1994. The main facto rs which contributed to poor prognosis were superior vena cava (SVC) s yndrome, massive pleural effusion, tracheal stenosis due to lymph node swelling, pericardial effusion and pulmonary fibrosis (causing dyspne a in combination), brain metastasis resulting in neurological disturba nce, cachexia, Eaton-Lambert syndrome causing muscle weakness, retrope ritoneal lymph node metastasis causing abdominal pain, peritoneal effu sion due to abdominal lymph node swelling, vertebral metastasis causin g paraplegia, and dermatomyositis/polymyositis (DM/PM) causing muscle weakness. All of the patients received chemotherapy with or without ra diotherapy. The PS of 8 patients improved with treatment, but no impro vement was seen in 5. We analyzed these 13 patients and considered the treatments for those with poor PS. Chemo-radiotherapy was tolerable i n SCLC patients showing PS 3, and improved their PS if severe conditio ns or combined disease did not arise concurrently. It was further sugg ested that PS 4 patients with severe conditions or combined disease sh ould not be given the treatments.