The combination of streptozocin and doxorubicin is superior to the current standard regimen of streptozocin plus fluorouracil in the treatment of advanced islet-cell carcinoma. Chlorozotocin alone is similar in efficacy to streptozocin plus fluorouracil, but it produces fewer gastrointestinal side effects than the regimens containing streptozocin. It therefore merits study as a constituent of combination drug regimens.

One hundred ninety-one patients with pathologically confirmed, locally unresectable adenocarcinoma of the stomach (57 patients) and pancreas (91 patients), were randomly allocated to therapy with 5-fluorouracil (5-FU) alone, 600 mg/m2 intravenously (IV) once weekly, or radiation therapy, 4,000 rad, plus adjuvant 5-FU, 600 mg/m2 IV, the first three days of radiotherapy, then follow-up maintenance 5-FU, 600 mg/m2, weekly. Forty-three patients (22%) could not be analyzed because of ineligibility or cancellation, thus 148 patients were evaluable. The median survival time was similar for both treatment programs and for both types of primary carcinoma, and was as follows: gastric primary carcinoma, 5-FU, 9.3 months; 5-FU plus radiotherapy, 8.2 months; pancreatic primary carcinoma, 5-FU, 8.2 months; 5-FU plus radiotherapy, 8.3 months. Substantially more toxicity was experienced by patients treated with the combined modality arm than by those patients receiving 5-FU alone. Severe or worse toxicity experienced by patients with gastric primary carcinoma treated by 5-FU was 19%, and the combined modality arm was 31%. The toxicity experienced by patients with pancreatic primary carcinoma treated with 5-FU was 27%, and the combined modality arm was 51%. Significant prognostic variables included: weight loss in stomach-cancer patients; and performance status, degree of anaplasia, and reduced appetite in pancreas-cancer patients.

This report is based on responses to a mailed questionnaire from 927 patients with lung cancer (730 men, 197 women), or their next of kin, and information obtained from the Saskatchewan Cancer Foundation Tumour Registry. Women were diagnosed at an earlier mean age than males (means +/- SE, 63.5 +/- 0.85 years versus 67.6 +/- 0.37 years, P less than 0.001), a finding which was consistent for each major histologic type. Women were more frequently diagnosed before age 60 years (42.0%) than were men (25.6%) (P less than 0.001). Female patients were significantly more likely to be lifetime nonsmokers of cigarettes than male patients (23% versus 3.7%, P less than 0.001). Among current smokers, women started smoking at an older age (19.3 +/- 0.69 versus 16.5 +/- 0.21 years, P less than 0.001), smoked for fewer years (41.0 +/- 1.2 years versus 47.4 +/- 0.57 years, P less than 0.001) and smoked slightly fewer cigarettes per day than male patients (23.6 +/- 1.0 versus 26.7 +/- 0.63, P less than 0.05). Similar results were found for the duration of the smoking habit and number of cigarettes smoked among exsmokers. When current smokers and exsmokers were combined, the distribution of pack years by gender was significantly different. A higher percentage than expected of women as compared to men, are clustered in the lower pack-year categories (P less than 0.0003). No occupational exposure or familial factors which might act in synergism with cigarette smoking were identified. Thus, women developed primary lung cancer at an earlier age while smoking for fewer years than men.