Small cell lung cancer: patterns of care and their influence on survival - 25 years experience of a single Australian oncology unit.

AIM: Evidence supporting improved outcomes for small cell lung cancer (SCLC) in recent decades is limited. This study aimed to identify patterns of care and survival over two time periods; 1 January 1987 to 31 December 1996 (cohort A) and 1 January 1997 to 31 December 2006 9 (cohort B). METHODS: Patients' characteristics, management and outcome data were extracted from the Hospital Cancer Registry and clinical records. Survival analysis was determined using the Kaplan-Meier method and the log-rank test. Factors influencing survival outcome were assessed using Cox proportional hazards regression. RESULTS: The total number of patients was 392 (224 in cohort A, 168 in cohort B). Overall 38% patients in cohort A and 24% in cohort B had limited stage (LS) disease at diagnosis. Combined chemoradiotherapy for LS increased from 5% in cohort A to 65% in cohort B. Overall 19% of patients in cohort A and 24% in cohort B received symptomatic treatment alone (STA). Median survival for LS in cohort B was significantly higher (19.5 months), than in cohort A (11.8 months) (P = 0.03). In extensive stage (ES) disease, median survival was 6.2 months in cohort A and 4.3 months in cohort B (P = 0.7). Variables for poorer outcome were STA, male gender, poor performance status, ES and whether the diagnosis was made in the earlier time period in cohort A. CONCLUSION: Outcomes for LS SCLC have improved with combined chemoradiotherapy, in keeping with worldwide data. The trends may also reflect recent improvements in staging and standardization of treatment. The outcome for ES-SCLC remains poor.

Atmospheric particulate matter and polycyclic aromatic hydrocarbons for PM10 and size-segregated samples in Bangkok.

Air samples of particulate matter (PM) with an aerodynamic diameter less than 10 microm (PM10) were collected from six sites in Bangkok, Thailand, using high-volume air samplers. Daily samples were taken at intervals of 12 days from November 1999 to November 2000. Size-selected sampling using a multislit Andersen size-fractionated cascade impactor was undertaken at one site in central Bangkok to identify particulate size distribution. The annual average PM10 concentration at all six sites exceeded the Thailand National Ambient Air Quality Standard (NAAQS) of 50 microg/m3. The daily PM10 concentrations at heavy traffic roadside areas ranged between 30 and 160 microg/m3. The highest PM10 level occurred during the winter period (November-February), which is the dry season. From our results, which are based on a 1-yr survey, it can be observed that the particulate concentrations are associated with traffic volumes and seasonal factors (temperature and rainfall). The relative importance of size fractions in contributing to PM load is presented and discussed. Twenty polycyclic aromatic hydrocarbons (PAHs) associated with PM have been identified and quantified. The summed PAHs based on the 20 species had an average concentration of 60 ng/m3. Benzo(e)pyrene, indeno(123cd)pyrene, and benzo(ghi)perylene were the major compounds with average concentrations of 8, 10, and 13 ng/m3, respectively. Results indicate that more than 97% of PAHs were found in the small particulate size range of <0.95 microm.