A phase II study was conducted to evaluate the feasibility and efficacy of biweekly administration of paclitaxel and gemcitabine in patients with non-small cell lung cancer (NSCLC) who had been treated previously with platinum-based chemotherapy. Paclitaxel (150mg/m²) and gemcitabine (1,000mg/m²) were administered biweekly for at least 4 cycles. Thirty-one patients with a median age of 64 years (39-75 years) were enrolled in this study (stage IIIB/IV : 11/20, PS 0/1/2 : 13/16/2). Partial response was observed in 7 cases (23%), and stable disease was seen in 18 cases (58%). Median survival time was 8.8 months with a one-year survival rate of 41.9%. Hematological toxicities were mild and neutropenia of grade 3 or above was observed in one patient (3%). Non-hematological toxicities were also mild, including neurotoxicity (3%). Biweekly paclitaxel and gemcitabine combination chemotherapy was effective and tolerated well as second-line therapy against NSCLC.

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A shortage of doctors is now an urgent problem on the medical scene in Japan. The current situation of pulmonary doctors in Nagano was analyzed by a questionnaire survey, in which we also estimated the present state of pulmonary medicine in the Jo-Sho region.
We sent out a questionnaire asking about the number of pulmonary physicians, the number of sickbeds, and the types of pulmonary disease patients in nineteen institutions affiliated with our institution. We also evaluated the relative status of pulmonary medicine at the Shinshu-Ueda Medical Center (formerly the National Nagano Hospital).
Thirteen institutions responded to the survey. Ten out of the thirteen institutions felt there is a shortage of pulmonary physicians. The number of patients with pulmonary disease was significantly larger in large institutions (with more than 300 sickbeds). Although the pulmonary division of Shinshu-Ueda Medical Center specializes in pulmonary medicine (95% of inpatients in this division had pulmonary problems), the doctorpatient ratio was the highest among all the large institutions.

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