A phase II photodynamic therapy study in patients with inoperable non small cell lung cancer

177 655

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Enhancement of cytotoxic activity of mediastinal lymphnodes by trans-tracheal injection to the subcarinal lymphnode of recombinant Interleukin-2 (rIL-2). Kazuhiro Tani, Soji Namikewa, Minoru Kusagawa Department of Thoracic Surgery, Mie University School of Medicine, Mie, Japan To enhance the cytotoxic activity of mediastinal lymphwe have nodes of the patients with lung cancer, using injected rIL-2 into the subcarinal lymphnode bronchoscopic needle 2 or 4 days before radical operations. 18 patients received trans-tracheal injection (2@*105 units) and/or intravenous administration (10*105 units/day) of rIL-2 for 4 days. Wediastinal lymphnodes resected at the operations were mesured for natural killer(NK) and Lymphokine-activated killer(LAK) activity of lymphcytes employing 51Cr release assay. Control patients (n=6) without the rIL-2 treatment represented low activity (NK=1.9%,LAK=0.5%). Patients receiving single trans-tracheal injection of at the rlL-2 revealed enhanced cytotoxic activity second day after injection (NK=E.lL,LAK=3.3~~), followed by decreased LAK activity at the fourth day (NK=7.6%, LAK=Z.O%). Patients receiving only intravenous revealed low administration of rIL-2 for 4 days cytotoxic activity (NK-7.85,LAK:Z.OX). Patients treated with a combination of trans-tracheal and intravenous administration of rIL-2 revealed the most potent cytoWe conclude from toxic activity (NK=18.3%,LAK=7.6%). these results that the combination of trans-tracheal and intravenous administration of rIL-2 is an effective therapy to kill micrometastatic cancer cells of which of opposite side were mediastinal lymphnodes undetected preoperatively.

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Twenty-six patients with inoperable non small cell lung cancer (NSCLC) were treated with photodynamk therapy [PDTj. InteMitial tumour Uhuntnation was performed 48 hours after Photofrin II injection, using a cylindrtcal diffuser laser fibre to transmtt red light of 830 nm. wavelength from an Argon-dye laser.A>50?6 impmWMntoftheainvaylrrmenwasregani~as a partial response. For a complete response, negative histology and/or cytology was required. Median follow-up was 8 months.

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All treatments were well tolerated and grade II skin photosensitivIty was seen in 4 patients. PDT could achieve complete responses in patients with small tumour volume. In large tumour volume. local palliation was obtained in the majority of patients. Four pattents died because of puhnonary haemorrhage during follow-up (1.5-8 months), and this was probably related to extralumenal disease. Further study is warranted to define the exact value of PDT in the palltation of locally advanced disease.

A RANDOMIZED STUDY OF A NEW BRM -- SAPYLIN COMPARING WITH CHEMOTHERAPY TREATED ON CANCEROUS PLEUPAL EFFUSION - L. Mei-lin, Z. Jia-mei et al 104 cases of canerous pleural effusion proved by cytology or histology were randomized into 2 groups, 52 cases each, group A, Sapylin was injected into the pleural cavity after fluid tapping,which is a new biological response modifier, a kind of streptococus product, also a simulator of OK 432 and made by Shanghai Institute of Pharmaceutical Industry. Group B chemotherapy regime of MFT(Mitomycin + 5Fu + Thiotepa) or CD(CTX + DDP) was used by the same route. The response rate of group a was 88.5%(46/52), CR was of 36.5% (19/52). Mean time to response was 9.7 days, 72.3% of cases showed its response at the dose of