- Email: [email protected]
Laser therapy for endobronchial tumours
150
There was no difference between the effects resulting from power densities of 400 and 500 mW/cf, nor were there differences in the reactions behveen squatnous cell carcinoma and adenocarcinonta.The amount of tumor that could be removed at the end of the treatment bmnchoscopy, the amount of reobstmction by secretions and exudate seea at toilet bronchoscopy, and the furs1percentdecreaeein obstruction at the end of toilet bronchoscopy were proportional to the light dose. Because the ftnal percentage decressc in obstruction plateaued at light doses of 400 to 500 J/cf and there was no statistically significant difference behveen 400 and SOUJ/cf,we recommend using P power density of500 mW/cfand P light doseof J/cfduring photodynamic therapy.
Laswtherapy for endobmnchial tumours Chakmverty SC, Rafferty PR. X-Roy Lkpmmwu, Newcask General Scott Med J Hospital. Westgate Road, Newcastle-upon-l)we. 1992;37:141-3. Endobronchial laser therapy has been performed at Knightwood Ho#al, Glasgow since 1983. During the period 1983 to 1990, 62 patients undsnvmt a total of 149 laser treatmeats. The principal iodildiuticms for therapy were tncheoarinal sttidor (24%), dyspncea due to bnmckial occlttsion (60%) and haemoptysis (13%). Squamous carcinoma accounted for 80 % of the lesions. Over 75 I of patients bad already received some form of prior therapy (mdiotbempy 71%,chemothsnpy8%,surgiulrssectionll%).Lssertherspyreduccd strider in 67% of patients with tracheal and cainal h~mours and produced symptomatic impmvement in 72 %of patientswith bronchial obstmction but without evidence of lobar collapse. Haemoptysis was cattrolled in all but oneof pz&tts treated. Two patients (3.2%) died during laser treatmentfollowing severe haemorrhage.
Reviews The evolving role OFsystanic therapy in cxmiof the lung Hamf DJ, Devine S, Ibde DC, Voke_sEE. Dept. of RadiationlCellular Gncology. University of Chicago, 5841 S Maryland, Chicago, IL 60637. Semin Gncol 1992;19 SuppI 11:72-87. Locally advanced lung cancer curies a poor prognosis, and its treatment continues to challenge medical, radiation. and surgical oncologists. Whilesystemic chemotherapyhas improved tlw8utvival of patients with small cell lung cancer (SCLC), the role and timing of tbomcic mdiotberapy has not been clearly defined. The roles of chemotherapy and radiotherapyappear to be reversed in the treatment of locally advsoaxl non-small cc.11lung cancer (NSCLC). The routine use of tboracic radiotherapyhas bea shown to improve local control after sur~ew without affectina Survival, due to a b&h incidence of with chemotherapy in NSCLC. Nevertheless, the results of recent clinical trials in both SCLC and NSCLC are encouraging and support continued investigation. These studies and the results of recent pilot studiesarggest~acloseriategntionofchemotberspyMdrPdiotbenpy (concomitant chemoradiotberapy) may be aecessary for further improvement in outcome. This review will present the tesults of recent studies in systemic therapy of lung cancer and the evidence supporting concomitant chemomdiotherapeutictreatmentof this disease. h4a@nant mesotbelioma: Diagnostic and mmagment strategies for 1992 Vogelrang NJ. Section of Ifemato&gy/Oncology. Dcpanmcrtl of Medicine, UniwrsiYy of Chiengo, 5841 S Maryhnd, Chicogo. IL 60617. semin oncol 1992;19 Suppl 11:64-71. Malignant me.sotheliomaof the pleural and petitcmealsurfaces is epidemiologically liaked to ctwidolite, P long. thin, and rigid form of
Absiracts / Lung Cancer IO (1993)
123-150
asbes~whoseusehnsbd~ti~lycurt 25 years. The iocidence of disease.may have peaked around 1984 and maynowbedeclining. Thehighest incidenceofdiseaseo inelderly white me0 (75 years old). The histology of meaotheliomais classically biphosic, with both epithelioid and s.srcomatous areas present. Independentpathologic review can be useful, and P variety of special stains should be used, if diagnosis is unclear. Electron microscopy and setumcsrciwembrymicPntigezllevelsareolsousefu1.Surgicpltfea~ts have been difficult, but 3-year survival rates range from 15% to 36%. Unfortunately, only about 20% of all diagnosed patientsare candidates for aggressive surgical appmaches. Radiotbempy likewise has bxn disappointiog, although occasionally useful. Lastly, 13 single-agent chemotherapy trials conducted ott 302 patients using 10 different commercially available drugs have failed to identify a consistently effectiveagent. Combinationchemothernpybasalsonotpmveneffective and, therefore innovative new approaches are needed.
Miscellaneous Survival for lung canter in northen Italy Snot M, GnttpG, Qpocaccia R, Verdexbin A, Micheli A, Speciale D et al. Divisione di Epidemiologia, Istituto Nazionak Tutnon’, Via Venaian 1.20133 Milww. Cancer Causes Control 1992;3:223-30. From the population covered by the Lombardy Cancer Registry (nortbem Italy). all 2,259 lung cancerpatientsdiagnosed from 1976 to 1981 wear.followed tbmugh 30 November 1989. The lsogtb of follow-up ranged from eight to 13 years. A special investigation on long-term survivors showed thatP negligible proportion (0.01 percent) of etxxs occur in detmmining life status when an active follow-up is adopted. Age, stage, and hi&type were found to be statistically significant, independent, prognostic factors in multivariate analysis both by the Cox model and by P model considering the relative survival. Observedsurvivalwos29percentatoneyeprnfterdiagnosis. 13percent at hw years, eight percentat three years, five percent at five years and hvo percent at 10 years. Survival decreased with age., but the.youngest patientsofbothsexesshowedlowersurvivnlco~withi~~ly aden&c&o& showed the highest survival (38 percent and 33 percentat one year. respectively); small cell carcinomas showed the poorest prognosis (one-year survival. 23 percent). Beyond the second year atIer diagnosis, differences between histotypeabecame slighter. Survival according to stage showed P decreasing patternfrom limited to advanced Nmors, one-year figures being 41 percent for localized Nmors, 27 percent for regional metastasis, and three percent for distant metastasis. Relative survival in Vuesc was compared with that reported by other cancer registries in Western countries: tke variability noted could be related to different modalities of registration and to different distribution of clinical and demogmpbic factors. Viovs and new fmm Meibomw, the Sitb World Conference an LunSW GiawmeG, VsnZamiwijkN.Depanmet~rpmnnrnto/Onmlogy. FreeVniversily Haspiral, Lk Roekkan 1117. 1018 Hv Amstenbn. Eur Rsspir J 1992;5:10236. The Sixth World Conference on Lung Caacer was held in Melboww, Awbalia, 10-14 November 1991, in the well-equipped World Confetwxe Center, by the tivex Yarm. About 1,OW participants came tiom alI over the world. and almost 700 s were presented. The scientific and social programme were both extretwly stimulating end perfectly organized. tha& to D. Bal and the organizing committee, from the Mcahlm Cancer Cater io Melboumc.
There was no difference between the effects resulting from power densities of 400 and 500 mW/cf, nor were there differences in the reactions behveen squatnous cell carcinoma and adenocarcinonta.The amount of tumor that could be removed at the end of the treatment bmnchoscopy, the amount of reobstmction by secretions and exudate seea at toilet bronchoscopy, and the furs1percentdecreaeein obstruction at the end of toilet bronchoscopy were proportional to the light dose. Because the ftnal percentage decressc in obstruction plateaued at light doses of 400 to 500 J/cf and there was no statistically significant difference behveen 400 and SOUJ/cf,we recommend using P power density of500 mW/cfand P light doseof J/cfduring photodynamic therapy.
Laswtherapy for endobmnchial tumours Chakmverty SC, Rafferty PR. X-Roy Lkpmmwu, Newcask General Scott Med J Hospital. Westgate Road, Newcastle-upon-l)we. 1992;37:141-3. Endobronchial laser therapy has been performed at Knightwood Ho#al, Glasgow since 1983. During the period 1983 to 1990, 62 patients undsnvmt a total of 149 laser treatmeats. The principal iodildiuticms for therapy were tncheoarinal sttidor (24%), dyspncea due to bnmckial occlttsion (60%) and haemoptysis (13%). Squamous carcinoma accounted for 80 % of the lesions. Over 75 I of patients bad already received some form of prior therapy (mdiotbempy 71%,chemothsnpy8%,surgiulrssectionll%).Lssertherspyreduccd strider in 67% of patients with tracheal and cainal h~mours and produced symptomatic impmvement in 72 %of patientswith bronchial obstmction but without evidence of lobar collapse. Haemoptysis was cattrolled in all but oneof pz&tts treated. Two patients (3.2%) died during laser treatmentfollowing severe haemorrhage.
Reviews The evolving role OFsystanic therapy in cxmiof the lung Hamf DJ, Devine S, Ibde DC, Voke_sEE. Dept. of RadiationlCellular Gncology. University of Chicago, 5841 S Maryland, Chicago, IL 60637. Semin Gncol 1992;19 SuppI 11:72-87. Locally advanced lung cancer curies a poor prognosis, and its treatment continues to challenge medical, radiation. and surgical oncologists. Whilesystemic chemotherapyhas improved tlw8utvival of patients with small cell lung cancer (SCLC), the role and timing of tbomcic mdiotberapy has not been clearly defined. The roles of chemotherapy and radiotherapyappear to be reversed in the treatment of locally advsoaxl non-small cc.11lung cancer (NSCLC). The routine use of tboracic radiotherapyhas bea shown to improve local control after sur~ew without affectina Survival, due to a b&h incidence of with chemotherapy in NSCLC. Nevertheless, the results of recent clinical trials in both SCLC and NSCLC are encouraging and support continued investigation. These studies and the results of recent pilot studiesarggest~acloseriategntionofchemotberspyMdrPdiotbenpy (concomitant chemoradiotberapy) may be aecessary for further improvement in outcome. This review will present the tesults of recent studies in systemic therapy of lung cancer and the evidence supporting concomitant chemomdiotherapeutictreatmentof this disease. h4a@nant mesotbelioma: Diagnostic and mmagment strategies for 1992 Vogelrang NJ. Section of Ifemato&gy/Oncology. Dcpanmcrtl of Medicine, UniwrsiYy of Chiengo, 5841 S Maryhnd, Chicogo. IL 60617. semin oncol 1992;19 Suppl 11:64-71. Malignant me.sotheliomaof the pleural and petitcmealsurfaces is epidemiologically liaked to ctwidolite, P long. thin, and rigid form of
Absiracts / Lung Cancer IO (1993)
123-150
asbes~whoseusehnsbd~ti~lycurt 25 years. The iocidence of disease.may have peaked around 1984 and maynowbedeclining. Thehighest incidenceofdiseaseo inelderly white me0 (75 years old). The histology of meaotheliomais classically biphosic, with both epithelioid and s.srcomatous areas present. Independentpathologic review can be useful, and P variety of special stains should be used, if diagnosis is unclear. Electron microscopy and setumcsrciwembrymicPntigezllevelsareolsousefu1.Surgicpltfea~ts have been difficult, but 3-year survival rates range from 15% to 36%. Unfortunately, only about 20% of all diagnosed patientsare candidates for aggressive surgical appmaches. Radiotbempy likewise has bxn disappointiog, although occasionally useful. Lastly, 13 single-agent chemotherapy trials conducted ott 302 patients using 10 different commercially available drugs have failed to identify a consistently effectiveagent. Combinationchemothernpybasalsonotpmveneffective and, therefore innovative new approaches are needed.
Miscellaneous Survival for lung canter in northen Italy Snot M, GnttpG, Qpocaccia R, Verdexbin A, Micheli A, Speciale D et al. Divisione di Epidemiologia, Istituto Nazionak Tutnon’, Via Venaian 1.20133 Milww. Cancer Causes Control 1992;3:223-30. From the population covered by the Lombardy Cancer Registry (nortbem Italy). all 2,259 lung cancerpatientsdiagnosed from 1976 to 1981 wear.followed tbmugh 30 November 1989. The lsogtb of follow-up ranged from eight to 13 years. A special investigation on long-term survivors showed thatP negligible proportion (0.01 percent) of etxxs occur in detmmining life status when an active follow-up is adopted. Age, stage, and hi&type were found to be statistically significant, independent, prognostic factors in multivariate analysis both by the Cox model and by P model considering the relative survival. Observedsurvivalwos29percentatoneyeprnfterdiagnosis. 13percent at hw years, eight percentat three years, five percent at five years and hvo percent at 10 years. Survival decreased with age., but the.youngest patientsofbothsexesshowedlowersurvivnlco~withi~~ly aden&c&o& showed the highest survival (38 percent and 33 percentat one year. respectively); small cell carcinomas showed the poorest prognosis (one-year survival. 23 percent). Beyond the second year atIer diagnosis, differences between histotypeabecame slighter. Survival according to stage showed P decreasing patternfrom limited to advanced Nmors, one-year figures being 41 percent for localized Nmors, 27 percent for regional metastasis, and three percent for distant metastasis. Relative survival in Vuesc was compared with that reported by other cancer registries in Western countries: tke variability noted could be related to different modalities of registration and to different distribution of clinical and demogmpbic factors. Viovs and new fmm Meibomw, the Sitb World Conference an LunSW GiawmeG, VsnZamiwijkN.Depanmet~rpmnnrnto/Onmlogy. FreeVniversily Haspiral, Lk Roekkan 1117. 1018 Hv Amstenbn. Eur Rsspir J 1992;5:10236. The Sixth World Conference on Lung Caacer was held in Melboww, Awbalia, 10-14 November 1991, in the well-equipped World Confetwxe Center, by the tivex Yarm. About 1,OW participants came tiom alI over the world. and almost 700 s were presented. The scientific and social programme were both extretwly stimulating end perfectly organized. tha& to D. Bal and the organizing committee, from the Mcahlm Cancer Cater io Melboumc.