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High frequency electrical knife through fibrebronchoscope in treatment of tracheal tumor with large airway obstruction
124
Combined Modality Therapy
nuclei staining with DAPI followed by fluorescence microscopy. Both of 14-member macrolides enhanced chemotherapeutic agent-induced apoptosis of wild type (wt) p53 carrying NSLC cells whereas 16member macrolides did not. Fourteen-member macrolides increased the level of p53 in NSLC cells with wt p53 whereas these agents decreased the level of bcl-2 in the cells. On the contrary, in p53 null H358 cells, neither anticancer agent alone nor combination of 14member macrolide and anticancer agent induced apoptosis. Then we evaluated the effect of macrolide antibiotics on the expression of CD95 in NSLC cells. Chemotherapeutic agents induced the cell surface CD95 and CD95 mRNA expression in wt p53 NSLC cells. Combination treatment of 14-member macrolide and anticancer agent enhanced these effects. Pretreatment with antagonistic anti-CD95 antibody did not inhibit the 14-member macrolide plus anticancer agent-induced apoptosis in wt p53 NSLC cells. Finally, we evaluated the effect of p53 antisense oligonucleotide on the apoptosis enhanced by the combined treatment, and we observed that the enhanced apoptosis was inhibited by pretreatment with p53 antisense oligonucleotide. These results indicate that 14-member macrolides enhance the anticancer agent-induced apoptosis in NSLC cells by p53 dependent, CD95independent fashion.
complications of surgery were related only after major surgical interventions (pneumonectomy) and are in the range of an accepted international standard (6.8%) and frequency of postoperative complications was significantly correlated with exploratory thoracotomy and pneumonectomy as compared with Iobectomy. Survival: with a median follow-up of 15 months [2-60], overall survival was 40% at 23 months. Prognostic factors for survival (univariate analysis) were: weight loss (<5% vs. >5%: 60% vs. 12%), performance status (0-1 vs. 2: 62% vs. y 22%), clinical stage (I vs. II vs. IIh 60% vs. 56% vs. 32%), pathological stage (I vs. II vs. IliA vs. IIIB: 93% vs. 56% vs. 16% vs. 10%), histology (carcinoid vs. squamous vs. large cell vs. adenocarcinoma: 71% vs. 48% vs. 32% vs. 20%), residual disease (R0 vs. R1 vs. R2: 55% vs. 21% vs. 0%) and treatment strategy for stage III patients (neoadjuvant chemotherapy surgery vs. initial surgery: 51% vs. 17%). Conclusion: Our results confirm the improvement of prognosis in NSCLC in the last 5 years in Cluj (median survival 21 months, in 161 resected patients), mainly due to a better quality of the surgical act and a more effective pluridisciplinary approach.
14-•
A.H.K. Djang. Jamestown, New York 14701, USA
High frequency electrical knife through fibrebronchoscope in treatment of tracheal tumor with large airway obstruction
G.Q. Wang, M.J. Xie, F. Chi, Y. He. Guangzhou Institute of Respiratory Disease, Guangzhou, P.R. China From May 1985 to June 1999, high frequency electrical knife (HFEK) Through fibrobronchoscope was used to treat the large airway obstruction by tracheal tumor in 28 patients (Cystuc adenoid carcinoma: 17, Squamous cell carcinoma: 8. Undifferentiated small cell carcinoma: 1. and neurinoma: 2). Most of the tracheal tumors were Inoperable because of extensive lesions or poor lung function. Olympus B F B B3R, B F p 30 Type or Pentax B F 15 P Type fibrobronchoscope, Olympus UES or PSD-10 high frequent electricity producer with a home-made electrical and CD-5P knife were used. After 81 time of HFEK cautery of tracheal tumors, all patients showed remakable improvement in lung function and exertional dyspnea. HFEK is valuable in relieving dyspnea in patients with large airway obstruction by tracheal tumor. After endoscopic cautery to release the tumor obstruction of trachea, it is often necessary to add radiotherapy and chemotherapy (26 malignant cases used) to get betteer results. In our series 5 patients had stents inserted to maintain the potency of trachea.
[4•1
Integration of surgery in the pluridisciplinary approach of non-small cell cancer patients improves the outcome
A. loan, T. Ciuleanu, T. Guttman, N. Ghilezan. Oncological Institute CIuj-Napoca, Romania Purpose: To assess the results obtained in stage I to III NSCLC patients, treated with surgery alone or integrated in a pluridisciplinary approach, following the decision taken by the Lung Committee of the Oncological Institute CIuj (OIC). Endpoints: correspondence between clinical and pathological staging, complications of surgery, survival, prognostic factors. Methods and Materials: From January 1994 through December 1998 a prospective nonrandomized study was carried on at OIC, on 161 operated NSCLC patients. The TNM system advocated by the AJCC was used and was determined on CT findings. Although more than half (57%) patients had clinical Iocoregional advanced disease clinical stage Ill-A), surgery was initially performed at 125 pts. and 36 pts. received neoadjuvant chemotherapy (platinum containing regimen) followed by surgical resection. 109 pts. underwent complete surgical resection (R0) and depending on pTN pT3-T4 or/and pN1N2) they received adjuvant therapy. Results: Correspondence between clinical and pathological staging was 70%, with regard to the T category, the agreement between cT vs. pT reached 78% and to the N category, 80%. Lethal
•4-•
Oncolyn causes clinical remission of diffuse malignant pulimonary imesothelioma and other solid tumors in man*
Median survival of malignant diffuse thoracic mesothelioma is less than 6 months. From the time of definitive pathology diagnosis, approximately 90% of the patients are dead within a period of one year. Treatment with surgery, radiation, chemotherapy and a combination of methods has been attempted but is usually unsuccessful Oncolyn is a formulated combination of extracts from three edible plants (US patent) composed mainly of bioflavonoids and polyphenols. It was demonstrated to be clinically effective against cancers of the breast, lung, colon and prostate in mouse and man. In 1999, we used Oncolyn for one terminal pulmonary mesothelioma patient and achieved a clinical remission in 6 months. A terminal disseminated intraosseous lymphoma patient also achieved clinical remission in 6 months with Oncolyn therapy. Both patients are functioning well and working full time as of January 2000. To date, six plant derived anticancer medications (taxol, vinblastine, vincristine, topotecan, etoposide and teniposide) are used extensively in the United States. Others such as camptothecin are evaluated in clinical trials world-wide. Oncolyn was imtially evaluated with the mouse subrenal capsule assay technique for its anticancer activity by itself or in combination with standard chemotherapeutic agents such as Cytoxan, 5FU and Methotrexate. The present poster will depict experiences with Oncolyn for malignant mesothelioma, disseminated intraosseous lymphoma, seminoma with embryonal carcinoma component and carcinomas of the breast, prostate, lung and colon. Illustrative surgical pathology, CT, MRI, nuclear scan, clinical data with tumor markers and photomicrographs will be on display. 6 references and 15 illustrations. *supported in part by a grant from Sante International, USA
•
Synergistic effect of ONYX-015 and chemotherapy on lung cancer cell lines and primary cultures
L. You, C. Yang, C. Clare-Macy, D.M. Jablons. University of California, San Francisco, San Francisco, CA 94115, USA ONYX-015, the mutant adenovirus which has a deletion in the E1B region, has shown tumor-specific cytolysis effect in tumor cells with non-functional p53. In this study, we carried out cytopathic effect (CPE) assays using ONYX-015 on five lung cancer cell lines with known p53 status and seven primary lung cancer cultures. In 6-well plates, cells were infected with either ONYX-015 or with wild-type adenovirus at increasing multiplicities of infection (MOI). For the synergistic effect, the viruses were applied right after chemotherapeutic agents. The plates were stained with crystal violet and then analyzed. Five non-small cell lung cancer (NSCLC) cells were all lysed by ONYX-015. Synergistic
Combined Modality Therapy
nuclei staining with DAPI followed by fluorescence microscopy. Both of 14-member macrolides enhanced chemotherapeutic agent-induced apoptosis of wild type (wt) p53 carrying NSLC cells whereas 16member macrolides did not. Fourteen-member macrolides increased the level of p53 in NSLC cells with wt p53 whereas these agents decreased the level of bcl-2 in the cells. On the contrary, in p53 null H358 cells, neither anticancer agent alone nor combination of 14member macrolide and anticancer agent induced apoptosis. Then we evaluated the effect of macrolide antibiotics on the expression of CD95 in NSLC cells. Chemotherapeutic agents induced the cell surface CD95 and CD95 mRNA expression in wt p53 NSLC cells. Combination treatment of 14-member macrolide and anticancer agent enhanced these effects. Pretreatment with antagonistic anti-CD95 antibody did not inhibit the 14-member macrolide plus anticancer agent-induced apoptosis in wt p53 NSLC cells. Finally, we evaluated the effect of p53 antisense oligonucleotide on the apoptosis enhanced by the combined treatment, and we observed that the enhanced apoptosis was inhibited by pretreatment with p53 antisense oligonucleotide. These results indicate that 14-member macrolides enhance the anticancer agent-induced apoptosis in NSLC cells by p53 dependent, CD95independent fashion.
complications of surgery were related only after major surgical interventions (pneumonectomy) and are in the range of an accepted international standard (6.8%) and frequency of postoperative complications was significantly correlated with exploratory thoracotomy and pneumonectomy as compared with Iobectomy. Survival: with a median follow-up of 15 months [2-60], overall survival was 40% at 23 months. Prognostic factors for survival (univariate analysis) were: weight loss (<5% vs. >5%: 60% vs. 12%), performance status (0-1 vs. 2: 62% vs. y 22%), clinical stage (I vs. II vs. IIh 60% vs. 56% vs. 32%), pathological stage (I vs. II vs. IliA vs. IIIB: 93% vs. 56% vs. 16% vs. 10%), histology (carcinoid vs. squamous vs. large cell vs. adenocarcinoma: 71% vs. 48% vs. 32% vs. 20%), residual disease (R0 vs. R1 vs. R2: 55% vs. 21% vs. 0%) and treatment strategy for stage III patients (neoadjuvant chemotherapy surgery vs. initial surgery: 51% vs. 17%). Conclusion: Our results confirm the improvement of prognosis in NSCLC in the last 5 years in Cluj (median survival 21 months, in 161 resected patients), mainly due to a better quality of the surgical act and a more effective pluridisciplinary approach.
14-•
A.H.K. Djang. Jamestown, New York 14701, USA
High frequency electrical knife through fibrebronchoscope in treatment of tracheal tumor with large airway obstruction
G.Q. Wang, M.J. Xie, F. Chi, Y. He. Guangzhou Institute of Respiratory Disease, Guangzhou, P.R. China From May 1985 to June 1999, high frequency electrical knife (HFEK) Through fibrobronchoscope was used to treat the large airway obstruction by tracheal tumor in 28 patients (Cystuc adenoid carcinoma: 17, Squamous cell carcinoma: 8. Undifferentiated small cell carcinoma: 1. and neurinoma: 2). Most of the tracheal tumors were Inoperable because of extensive lesions or poor lung function. Olympus B F B B3R, B F p 30 Type or Pentax B F 15 P Type fibrobronchoscope, Olympus UES or PSD-10 high frequent electricity producer with a home-made electrical and CD-5P knife were used. After 81 time of HFEK cautery of tracheal tumors, all patients showed remakable improvement in lung function and exertional dyspnea. HFEK is valuable in relieving dyspnea in patients with large airway obstruction by tracheal tumor. After endoscopic cautery to release the tumor obstruction of trachea, it is often necessary to add radiotherapy and chemotherapy (26 malignant cases used) to get betteer results. In our series 5 patients had stents inserted to maintain the potency of trachea.
[4•1
Integration of surgery in the pluridisciplinary approach of non-small cell cancer patients improves the outcome
A. loan, T. Ciuleanu, T. Guttman, N. Ghilezan. Oncological Institute CIuj-Napoca, Romania Purpose: To assess the results obtained in stage I to III NSCLC patients, treated with surgery alone or integrated in a pluridisciplinary approach, following the decision taken by the Lung Committee of the Oncological Institute CIuj (OIC). Endpoints: correspondence between clinical and pathological staging, complications of surgery, survival, prognostic factors. Methods and Materials: From January 1994 through December 1998 a prospective nonrandomized study was carried on at OIC, on 161 operated NSCLC patients. The TNM system advocated by the AJCC was used and was determined on CT findings. Although more than half (57%) patients had clinical Iocoregional advanced disease clinical stage Ill-A), surgery was initially performed at 125 pts. and 36 pts. received neoadjuvant chemotherapy (platinum containing regimen) followed by surgical resection. 109 pts. underwent complete surgical resection (R0) and depending on pTN pT3-T4 or/and pN1N2) they received adjuvant therapy. Results: Correspondence between clinical and pathological staging was 70%, with regard to the T category, the agreement between cT vs. pT reached 78% and to the N category, 80%. Lethal
•4-•
Oncolyn causes clinical remission of diffuse malignant pulimonary imesothelioma and other solid tumors in man*
Median survival of malignant diffuse thoracic mesothelioma is less than 6 months. From the time of definitive pathology diagnosis, approximately 90% of the patients are dead within a period of one year. Treatment with surgery, radiation, chemotherapy and a combination of methods has been attempted but is usually unsuccessful Oncolyn is a formulated combination of extracts from three edible plants (US patent) composed mainly of bioflavonoids and polyphenols. It was demonstrated to be clinically effective against cancers of the breast, lung, colon and prostate in mouse and man. In 1999, we used Oncolyn for one terminal pulmonary mesothelioma patient and achieved a clinical remission in 6 months. A terminal disseminated intraosseous lymphoma patient also achieved clinical remission in 6 months with Oncolyn therapy. Both patients are functioning well and working full time as of January 2000. To date, six plant derived anticancer medications (taxol, vinblastine, vincristine, topotecan, etoposide and teniposide) are used extensively in the United States. Others such as camptothecin are evaluated in clinical trials world-wide. Oncolyn was imtially evaluated with the mouse subrenal capsule assay technique for its anticancer activity by itself or in combination with standard chemotherapeutic agents such as Cytoxan, 5FU and Methotrexate. The present poster will depict experiences with Oncolyn for malignant mesothelioma, disseminated intraosseous lymphoma, seminoma with embryonal carcinoma component and carcinomas of the breast, prostate, lung and colon. Illustrative surgical pathology, CT, MRI, nuclear scan, clinical data with tumor markers and photomicrographs will be on display. 6 references and 15 illustrations. *supported in part by a grant from Sante International, USA
•
Synergistic effect of ONYX-015 and chemotherapy on lung cancer cell lines and primary cultures
L. You, C. Yang, C. Clare-Macy, D.M. Jablons. University of California, San Francisco, San Francisco, CA 94115, USA ONYX-015, the mutant adenovirus which has a deletion in the E1B region, has shown tumor-specific cytolysis effect in tumor cells with non-functional p53. In this study, we carried out cytopathic effect (CPE) assays using ONYX-015 on five lung cancer cell lines with known p53 status and seven primary lung cancer cultures. In 6-well plates, cells were infected with either ONYX-015 or with wild-type adenovirus at increasing multiplicities of infection (MOI). For the synergistic effect, the viruses were applied right after chemotherapeutic agents. The plates were stained with crystal violet and then analyzed. Five non-small cell lung cancer (NSCLC) cells were all lysed by ONYX-015. Synergistic