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Preoperative radiotherapy in the combined treatment of lung cancer patients
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Combined treatment modalities Preoperative radiotherapy in the combined treatment of lung cancer patients. Trakhtenberg AKh, Kiseleva ES, Pitskhelauri VG et alResearch Institute ofOncology, Moscow. Neoplasma 1988:35:459-65. The results of a cooperative study on combined treatment and preoperative radiotherapy in 478 lung cancer patients were analyzed. Intensivefractionatedradiotherapywasgivenatdosesof4GyforSdays, the total dosage thus attaining 20 Gy. 218 patients received combined treatment, 260 patients were treated only surgically. A comparison of
the 5-year survival rates of Stage I and II patients did not show any advantage in favor of the used therapeutic modality. The combined treatment with preoperative radiotherapy, however, improved the survival rates of Stage III patients with non-small cell lung cancer. The 3year rate in these patients was 49.4% and the S-year rate was 29.2%. while those found in the patients treated only surgically were 28.1% and 15.8,respectively. Inall patients withregionalmetastases theeffectiveness of the treatment was higher when the combined method was employed.
Other treatment modalities
Long-term survival after endobronchial fire during treatment of severe malignant airway obstruction with the NP:YAG laser. Demon RA, Dedhia HV, Abrons HL, Jain PR, Lapp NL, Teba L.PulmonaryDisease Section,Division ofCriticalCareMedicine. West Virginia University Medical Center, Morgantown, w. Chest 1988;94: 1086-g. We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor in which an endobronchial fm OCcurred. The patient survived without complications of the tire and was followed-up un til death over 22 monthsafter the fue. The events leading to the fire are presented and recommendations provided to prevent similar occurrences. Arterial oxygen saturation during Nd:YAG laser photoresection of endobronchial tumors under local anesthesia. Use of intermittent supplemental oxygen with pulse oximetry guidance. Schiffman PL, Wilhelm J, Parisi RA. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Medicine and Dentistry of New Jersey. New Brunswick, NJ 08903. Chest 1988;94:1300-1. Although Nd:YAG laser photoresection of endobronchial lung tumor can result in significant arterial oxygen desaturation, oxygen snpplementation during procedures is often limited due to fear of intrabronchial combustion. We gave intermittent pulse supplemental oxygen to tenpatientsduring26laserpmceduresperformedunderlocalanesthesia using SaO, measured by a pulse oximeter as a guide. In four proccdmes (15.4 percent), severe oxygen desaturation contraindicated performing or completing laser phototherapy. In the remaining 22pro.x4lures (84.6 percent), laser photoresection was safely and successfully performed withoutincident.Thus,pulseoximetryisavaluabletoolandintermittent oxygen supplementation with pulse oximeter guidance an effective technique for maintaining adequate oxygenation during laser photoresection. Management of endobronchial tumors: a comparative study. McCaughan JS Jr, Hawley PC, Walker J. Laser Medical Research Foundation, Columbus, OH. Semin Surg Oncol 1989;5:3847.
Between September 1982 and July 1987 we treated 102 patients with endobronchial or endotracheal disease with one or a combination of the following modalities: CO, laser, Nd:YAG laser, and photodynamic therapy (PDT). Many patients had multiple treatments and treatment sites. In all, 259 Nd:YAG treatments were performed on 154 sites in 80 patients, 118 PDT treatments were performed on 87 sites in45 patients, and nine CO, treatments were performed on nine sites in nine patients. Of the 71 patients who died, 19 lived longer than 6 months, and seven liver longer than 1 year. A total of I I patients have survived for more than 1 year, including four who are still alive 18,22,33 and 54 months after treatment. Five patients achieved a status of ‘no evidence of disease’, and at autopsy, two others had no evidence of disease to the treated site. All seven of these patients were treated with PDT only. There were no intraoperative deaths or cases of intraoperative bleeding or smoke with PDT. Eight patients died from pulmonary hemorrhage 2 to 9 weeks after treatment. Four had been treated with Nd:YAG therapy alone and four with PDT alone. Evaluation of the survival rate in this study must consider that this therapy involves severely ill padents with a high potential for irmaoperative or perioperative fatality. Some patients who were near death before treatment have enjoyed quality survival for over 1 year.
Bronchoscopic use of the neodymium-yttrium-aluminium-garnet laser for lesions of the trachea and bronchus. Clarke CP, Jackson KA, Moreland M, Coles JR, Ball DL. Peter MacCallwn Cancer Institute. Melbourne, Vie. 3000. Med J Aust 198% 150:260-2. The neodymium-yttrium-aluminium-garnet laser has proved to be.a useful tool for the management of endobronchial lesions. Between October 1.1986 and October 31, 1987.31 patients received 41 laser treatmentsatthePeterMacCallmnCancer Institutemainly forbmnchial obstruction, haemoptysis or persistent cough. Good symptomatic relief was obtained in the majority of patients with no operative mortality and a moderate morbidity. When the endobronchial lesions is malignant, concurrent radiotherapy is needed to prevent the early recurrence of the cancer.
Reviews Fifty-year trend in incidence rates of bronchogenic carcinoma by cell type in Olmsted County, Minnesota. Beard CM, Jedd MB, Woolner LB, Richardson RL, Bergsnalh EJ,MeltonLJ III.Depanment ofHealthSciencesResearch, Mayo Clinic and Foundation, Rochester, MN 55905. J Natl Cancer Inst 1988;80:1404-7.
An earlier report suggested that incidence rates of primary bronchogenie carcinoma had leveled off for men in Olmsted County, MN. Extension of that study to cover 50 years in this midwestem community now shows that lung cancer incidence continues to increase in both sexes,withratesinwomenappro&chingthosefoundinmen20yearsago. This increase was seen for all cell types of bronchogenic carcinoma.
Combined treatment modalities Preoperative radiotherapy in the combined treatment of lung cancer patients. Trakhtenberg AKh, Kiseleva ES, Pitskhelauri VG et alResearch Institute ofOncology, Moscow. Neoplasma 1988:35:459-65. The results of a cooperative study on combined treatment and preoperative radiotherapy in 478 lung cancer patients were analyzed. Intensivefractionatedradiotherapywasgivenatdosesof4GyforSdays, the total dosage thus attaining 20 Gy. 218 patients received combined treatment, 260 patients were treated only surgically. A comparison of
the 5-year survival rates of Stage I and II patients did not show any advantage in favor of the used therapeutic modality. The combined treatment with preoperative radiotherapy, however, improved the survival rates of Stage III patients with non-small cell lung cancer. The 3year rate in these patients was 49.4% and the S-year rate was 29.2%. while those found in the patients treated only surgically were 28.1% and 15.8,respectively. Inall patients withregionalmetastases theeffectiveness of the treatment was higher when the combined method was employed.
Other treatment modalities
Long-term survival after endobronchial fire during treatment of severe malignant airway obstruction with the NP:YAG laser. Demon RA, Dedhia HV, Abrons HL, Jain PR, Lapp NL, Teba L.PulmonaryDisease Section,Division ofCriticalCareMedicine. West Virginia University Medical Center, Morgantown, w. Chest 1988;94: 1086-g. We present a case of Nd:YAG laser treatment of nearly total airway obstruction by malignant tumor in which an endobronchial fm OCcurred. The patient survived without complications of the tire and was followed-up un til death over 22 monthsafter the fue. The events leading to the fire are presented and recommendations provided to prevent similar occurrences. Arterial oxygen saturation during Nd:YAG laser photoresection of endobronchial tumors under local anesthesia. Use of intermittent supplemental oxygen with pulse oximetry guidance. Schiffman PL, Wilhelm J, Parisi RA. Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Medicine and Dentistry of New Jersey. New Brunswick, NJ 08903. Chest 1988;94:1300-1. Although Nd:YAG laser photoresection of endobronchial lung tumor can result in significant arterial oxygen desaturation, oxygen snpplementation during procedures is often limited due to fear of intrabronchial combustion. We gave intermittent pulse supplemental oxygen to tenpatientsduring26laserpmceduresperformedunderlocalanesthesia using SaO, measured by a pulse oximeter as a guide. In four proccdmes (15.4 percent), severe oxygen desaturation contraindicated performing or completing laser phototherapy. In the remaining 22pro.x4lures (84.6 percent), laser photoresection was safely and successfully performed withoutincident.Thus,pulseoximetryisavaluabletoolandintermittent oxygen supplementation with pulse oximeter guidance an effective technique for maintaining adequate oxygenation during laser photoresection. Management of endobronchial tumors: a comparative study. McCaughan JS Jr, Hawley PC, Walker J. Laser Medical Research Foundation, Columbus, OH. Semin Surg Oncol 1989;5:3847.
Between September 1982 and July 1987 we treated 102 patients with endobronchial or endotracheal disease with one or a combination of the following modalities: CO, laser, Nd:YAG laser, and photodynamic therapy (PDT). Many patients had multiple treatments and treatment sites. In all, 259 Nd:YAG treatments were performed on 154 sites in 80 patients, 118 PDT treatments were performed on 87 sites in45 patients, and nine CO, treatments were performed on nine sites in nine patients. Of the 71 patients who died, 19 lived longer than 6 months, and seven liver longer than 1 year. A total of I I patients have survived for more than 1 year, including four who are still alive 18,22,33 and 54 months after treatment. Five patients achieved a status of ‘no evidence of disease’, and at autopsy, two others had no evidence of disease to the treated site. All seven of these patients were treated with PDT only. There were no intraoperative deaths or cases of intraoperative bleeding or smoke with PDT. Eight patients died from pulmonary hemorrhage 2 to 9 weeks after treatment. Four had been treated with Nd:YAG therapy alone and four with PDT alone. Evaluation of the survival rate in this study must consider that this therapy involves severely ill padents with a high potential for irmaoperative or perioperative fatality. Some patients who were near death before treatment have enjoyed quality survival for over 1 year.
Bronchoscopic use of the neodymium-yttrium-aluminium-garnet laser for lesions of the trachea and bronchus. Clarke CP, Jackson KA, Moreland M, Coles JR, Ball DL. Peter MacCallwn Cancer Institute. Melbourne, Vie. 3000. Med J Aust 198% 150:260-2. The neodymium-yttrium-aluminium-garnet laser has proved to be.a useful tool for the management of endobronchial lesions. Between October 1.1986 and October 31, 1987.31 patients received 41 laser treatmentsatthePeterMacCallmnCancer Institutemainly forbmnchial obstruction, haemoptysis or persistent cough. Good symptomatic relief was obtained in the majority of patients with no operative mortality and a moderate morbidity. When the endobronchial lesions is malignant, concurrent radiotherapy is needed to prevent the early recurrence of the cancer.
Reviews Fifty-year trend in incidence rates of bronchogenic carcinoma by cell type in Olmsted County, Minnesota. Beard CM, Jedd MB, Woolner LB, Richardson RL, Bergsnalh EJ,MeltonLJ III.Depanment ofHealthSciencesResearch, Mayo Clinic and Foundation, Rochester, MN 55905. J Natl Cancer Inst 1988;80:1404-7.
An earlier report suggested that incidence rates of primary bronchogenie carcinoma had leveled off for men in Olmsted County, MN. Extension of that study to cover 50 years in this midwestem community now shows that lung cancer incidence continues to increase in both sexes,withratesinwomenappro&chingthosefoundinmen20yearsago. This increase was seen for all cell types of bronchogenic carcinoma.