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Non-small-cell lung carcinoma: Current and future therapeutic management
Abstracts/Lung
Cancer
as overall suwwal rates (3 I% and 16%. rcspx,~vely) wcrc ngniticantly alfecled by disease extent. No paoen, with exlcnsiw dascase was progression fret and alive a, 2 years. while “ore lhan half of sfage I and II paoeols were dtscase free and alive a, 5 years Tha retrospectwe analysis performed on a large number of coosecmwe. nonrandomi,cd patients soggesls rha,. a, leas, in palwznls wilh lmrncd dtseasc. I, is possible to achwc favorable long-,crm resubs usmg ,rca,“cn, tadorcd to dwase ex,e” Noncthclcss. ,he d~sappom,mg rcsubs commont~ achieved m the trealmen, of small tell lung cancer s,roo& suppon the need for either prospectwe. randamucd studies lo confirm rcccml~ reponed ,“provcd resulls or new pdn sludrcs wah mvcs,nga,non 01 entirely mnova,we approaches
Carboplatin plus VP-16 with simultaneous radiotherapy in the treatment of non-small cell lung cancer Imamka K, Kcdama A, Okamoto Y, Izurmyama K. Sakaguchi T . Kono M De,,om,mr o, Rodrologv. Kobe “mvers,,y Schoo, of hkdrcrne. Kobe Jpn J Cl” Radml 1995.40 123-7 Ten parvents w,h non-small cell lung cancer were ,rea,ed by concorren, chemorad,o,herapy The protocol consas,s of spti, course rad~o,bcrapyandsimoltanwoschemo,herapy (carboplaon ptusVP-IL) All patients ,olera,ed well th,s treatment wuh no life-,hreatening co”&a,tons and trea,men, duraoon was shortened mmpared to Lha, of sequential cbcmoradiolherapy. Response m,e was 50% (CR: I. PR, 4). median survival Lime was 12.8 months and I-year survival rale was 20%. The major foxicity was teocqxma, wilh WHO grade 4 leocopenia m 3 pa,ien,s and grade 3 in 3 patienti Tbls pro,oml was consuiered 10 be,olerableandeEs,~vefor,he,reaunen,of~n-smallnll lun8caoocr
Treatment results and local recurrence patterns of limited small cell lung cancer lzum~yama K. Imanaka K, Okamota Y, Kodama A, Sakaguchi T . Kono M Depormenr o/Radrologv Kobe Onrversi~ School of Medtcine. Kobe Jpn J Clin Radml t 995;40 117-22. Twenty six pauents with limiled nagc small cell tong cancer were treated mth sequential chcmo-radiotherapy. Tbe overall response rate was 96% (CR 23%). the MST was IS months am, fhe 2-year s”-“ivat rate wris 35%. melve palients (46%) developed local recuneoce Six ofthem occurred within the radialion field. fiveou,ofthe field and one a, the margin of ,ht field. lo CR cases. there was no recurrace within the field As nsponse “teof the Ve&mx, for ncunence was low (50%). adequale lhempy is necessary for CRat initial treatment 10 ~“prove ,he surwval rme
Other treatment modalities Laser bronchoscopic
therapy
for lung cancer
,995:22-179-84 Laser endoswplc lherapy bar now achnvt status as an e,Tcc,~\c trcamenl mod&y for lung cancer The usefulness of Nd-YAG tiscr as pallialwe wealmen, for obstructive lrachedxonchml ,u”ors has been recognized Our experience consisted m 205 YAG laser cases. mcluding 184 obstroclive ,“cheobronchual ,u”ors. and ,he airway gauge was improved m 88.3%. On the “her hand. the etTcc,iveners of photodynamic lherapy (PDT) usmg pholofrm as a pholoscnsinzer was demons,“,ed m ourms,~,ution m 1979 forthe Lrea,“en,oflongcancers. and increasmg a,,en,ton has focused on ,hls new ,rea,“en, ,echmquc Over ,he pas, decade. 2 I I paoems wilh central lung cancers. mcludmg 66 cases of early-s(age lesions. have been tread a, Tokyo Medical College Hospital. and a complete remission “,e 0165.2% was achxved We gave an overview of laser endoseopic therapy. mcludmg NCYAG laser treatmen, and photodynamic Ihcrapy. for lung cancer as well as an evaluation of ,he e~ezuvencss ofrheu: lherapies
Lasers in hroncho-pulmonary cancer Moghissi K Go& and District Hospital, Woodland Avenue, Go&. Nor,h “vrnbwsrde DN14 6R.X Radml Oncot 1994:28:359~ In a IO year period laser pholomdmtion was used in 687 padems
f3 (1995)
8f-I04
wth lung cancer Pabenls are grouped raking into acwwlt the w of laser employed and then treatment method An overall majority of 628 received yttrium alummiom game, (YAG) laser oeaonen, m 3 subgroups: la) 350 patien(s tilh inoperable broncho.pul”onary cancer and sa,bsmo,tat in,“-lomi,,al &m,ion rscewed a total of750 ,reat”en, sessions. lb) 99 paoents had operable co” lesmns which were excised by YAG laser fotlowng standard limited lhomwtomy Ic) 179 patients had laser wined lung resecdon. Group 2 consisted of59 paltents with inoperable extensive tong cancer who recewed bronchoscopic photodynamic therapy (PDT) having been presensitized 24.48 hours prior to radiation with 630 nm red light. All patients who underwen, endoscopic ,rea,“en, (group la and group 2) had symptom rehefas a result ofthe bronchial desobbtcmtion. There was M prccedure related monalay Patents undergoing YAG tasernramen, had moreimmediate relref whilst those receivmg PDT had better long-,enn results with survival of over 36 months compared with 25 months for group la paliems. 3 pa,ien,s died in the combined groups lb and Ic. There was no morality in the 99 patients who had local laser excision of turnour We conclude that lasers have considerable potential m hronchopulmonary ,~“ours allowing both palliation and economx lung rexctnon PDT has curative potential in some tomoors
Unconventirl therapy of lung cancer Jung! WF Gesundhellsdeporremenf, Moosbnqgsrrosse II. CH-9001 Sr. Go//en. Atemwegs-Lungeokr. 1995,Zl 19-23 Unproven. unconventmnal or alternative methods are used increasingly m incurable diseases wth hmwd therapeuoc poss~bd~t~es. Thw IS detimtely ,me for lung cancer. especmlty the non-smallsell types These melhods are often conneaed with equally unproven Iheoties of tumongenests and douhlrul diagnosoc :+s,s Selected unproven melhods recommended for rhe treatment oflunp. cancer are dxussed. There is no dlc, agams, lung cancer. bu, ,here are promnng results of telliaw orevemnon wi,h wtamm A The definilive proof of effefenlve adJuvan, treatmen, w,h misllelce preparauons IS s,di tacking lscador 8s well as the ‘,mmunmodula,or’ Polyerga had no aclwity compared 10 placebo in advanced non-smalliell lung cancer Also for various other alleged ‘bmlogx response modr8ers’ (Ney-Tumor”. Factor AP 2, ATC of Klehr. AHIT of Kiev) chmcal eIfucy has no, been proven so far The grealest risk of lhcse melhods is to “ass ,he onen smgular chance of tong-time remtssnon or cure, i.e by radut surgery Proven harmless methods may be tolerated as addmve supportwe lherapy
.
Reviews Recent advances in radiotherapy for non-small cell lung cancer Xan Howe P Service de Rodiorherape, lnsrihrlJ&s Border, Bruxelles. Rev Med Brux 1995;16: 14-9. P.adlo,herapy is a lccoregiooal form of treatmen,. Several recen, stod~es have clearly outlined the major impact on long ,erm sunwal of local tumor conuol. and the impmaoce of sweral parameters of the radiation treaoneo,: dose. frac,iona,ion and treatment quality D~fferen, approaches are under investigatmn to improve 1,s effectiveness cndobronchial brachythcrapy, conformal radiotherapy. modified fractionated radmtion schedules and combined mcdalihes.
Non-small-cell lung carcinoma: Current and future therapeutic m”I*gecment B&in KT. Cur@ R. Dcporrmml ofRadmoon Oncologr 746 Jefinon Avenue. Scranton. PA 18510 Drugs 1995:49 362-75. Non-small-celt lung cancer INSCLC) IS one of ,hc “os, common ~lignancies~ndevetopedcounlnesandaccountsior mdhonsofdea,hs worldwde The inadence of NSCLC conclaws w,h smokmg mbacco and is bkely 10 “crease m those countries w,h mcrcasmg per capna tobacco NSCLC IS pantcularly assocnled wtth morbiduy - in ,he US several pubbshcd chmcal scuda invotvmg a vanery of mlensive surgical. chemolheragewc and radmthcrapeutic ,n,erven,,ons have produced only a 10% S-,car survnal New lechnologtes and breakthroughs in ,rea,“cn, nowilhslandtng. ,hc curre”, emphasis I” clm,cal trials IS 10 refme and op,~“,se avadablc lhempies 10 maxim&e palien, disease-free and overall surwval These accrmng multi-mslllmional chmcal lnats may o,Tcr surglcat rcscc,m~~ wh or wilhou, nmdJuvant Iherapy. mutlmgem chemotherapy. and/or
consump,,on of
Cancer
as overall suwwal rates (3 I% and 16%. rcspx,~vely) wcrc ngniticantly alfecled by disease extent. No paoen, with exlcnsiw dascase was progression fret and alive a, 2 years. while “ore lhan half of sfage I and II paoeols were dtscase free and alive a, 5 years Tha retrospectwe analysis performed on a large number of coosecmwe. nonrandomi,cd patients soggesls rha,. a, leas, in palwznls wilh lmrncd dtseasc. I, is possible to achwc favorable long-,crm resubs usmg ,rca,“cn, tadorcd to dwase ex,e” Noncthclcss. ,he d~sappom,mg rcsubs commont~ achieved m the trealmen, of small tell lung cancer s,roo& suppon the need for either prospectwe. randamucd studies lo confirm rcccml~ reponed ,“provcd resulls or new pdn sludrcs wah mvcs,nga,non 01 entirely mnova,we approaches
Carboplatin plus VP-16 with simultaneous radiotherapy in the treatment of non-small cell lung cancer Imamka K, Kcdama A, Okamoto Y, Izurmyama K. Sakaguchi T . Kono M De,,om,mr o, Rodrologv. Kobe “mvers,,y Schoo, of hkdrcrne. Kobe Jpn J Cl” Radml 1995.40 123-7 Ten parvents w,h non-small cell lung cancer were ,rea,ed by concorren, chemorad,o,herapy The protocol consas,s of spti, course rad~o,bcrapyandsimoltanwoschemo,herapy (carboplaon ptusVP-IL) All patients ,olera,ed well th,s treatment wuh no life-,hreatening co”&a,tons and trea,men, duraoon was shortened mmpared to Lha, of sequential cbcmoradiolherapy. Response m,e was 50% (CR: I. PR, 4). median survival Lime was 12.8 months and I-year survival rale was 20%. The major foxicity was teocqxma, wilh WHO grade 4 leocopenia m 3 pa,ien,s and grade 3 in 3 patienti Tbls pro,oml was consuiered 10 be,olerableandeEs,~vefor,he,reaunen,of~n-smallnll lun8caoocr
Treatment results and local recurrence patterns of limited small cell lung cancer lzum~yama K. Imanaka K, Okamota Y, Kodama A, Sakaguchi T . Kono M Depormenr o/Radrologv Kobe Onrversi~ School of Medtcine. Kobe Jpn J Clin Radml t 995;40 117-22. Twenty six pauents with limiled nagc small cell tong cancer were treated mth sequential chcmo-radiotherapy. Tbe overall response rate was 96% (CR 23%). the MST was IS months am, fhe 2-year s”-“ivat rate wris 35%. melve palients (46%) developed local recuneoce Six ofthem occurred within the radialion field. fiveou,ofthe field and one a, the margin of ,ht field. lo CR cases. there was no recurrace within the field As nsponse “teof the Ve&mx, for ncunence was low (50%). adequale lhempy is necessary for CRat initial treatment 10 ~“prove ,he surwval rme
Other treatment modalities Laser bronchoscopic
therapy
for lung cancer
,995:22-179-84 Laser endoswplc lherapy bar now achnvt status as an e,Tcc,~\c trcamenl mod&y for lung cancer The usefulness of Nd-YAG tiscr as pallialwe wealmen, for obstructive lrachedxonchml ,u”ors has been recognized Our experience consisted m 205 YAG laser cases. mcluding 184 obstroclive ,“cheobronchual ,u”ors. and ,he airway gauge was improved m 88.3%. On the “her hand. the etTcc,iveners of photodynamic lherapy (PDT) usmg pholofrm as a pholoscnsinzer was demons,“,ed m ourms,~,ution m 1979 forthe Lrea,“en,oflongcancers. and increasmg a,,en,ton has focused on ,hls new ,rea,“en, ,echmquc Over ,he pas, decade. 2 I I paoems wilh central lung cancers. mcludmg 66 cases of early-s(age lesions. have been tread a, Tokyo Medical College Hospital. and a complete remission “,e 0165.2% was achxved We gave an overview of laser endoseopic therapy. mcludmg NCYAG laser treatmen, and photodynamic Ihcrapy. for lung cancer as well as an evaluation of ,he e~ezuvencss ofrheu: lherapies
Lasers in hroncho-pulmonary cancer Moghissi K Go& and District Hospital, Woodland Avenue, Go&. Nor,h “vrnbwsrde DN14 6R.X Radml Oncot 1994:28:359~ In a IO year period laser pholomdmtion was used in 687 padems
f3 (1995)
8f-I04
wth lung cancer Pabenls are grouped raking into acwwlt the w of laser employed and then treatment method An overall majority of 628 received yttrium alummiom game, (YAG) laser oeaonen, m 3 subgroups: la) 350 patien(s tilh inoperable broncho.pul”onary cancer and sa,bsmo,tat in,“-lomi,,al &m,ion rscewed a total of750 ,reat”en, sessions. lb) 99 paoents had operable co” lesmns which were excised by YAG laser fotlowng standard limited lhomwtomy Ic) 179 patients had laser wined lung resecdon. Group 2 consisted of59 paltents with inoperable extensive tong cancer who recewed bronchoscopic photodynamic therapy (PDT) having been presensitized 24.48 hours prior to radiation with 630 nm red light. All patients who underwen, endoscopic ,rea,“en, (group la and group 2) had symptom rehefas a result ofthe bronchial desobbtcmtion. There was M prccedure related monalay Patents undergoing YAG tasernramen, had moreimmediate relref whilst those receivmg PDT had better long-,enn results with survival of over 36 months compared with 25 months for group la paliems. 3 pa,ien,s died in the combined groups lb and Ic. There was no morality in the 99 patients who had local laser excision of turnour We conclude that lasers have considerable potential m hronchopulmonary ,~“ours allowing both palliation and economx lung rexctnon PDT has curative potential in some tomoors
Unconventirl therapy of lung cancer Jung! WF Gesundhellsdeporremenf, Moosbnqgsrrosse II. CH-9001 Sr. Go//en. Atemwegs-Lungeokr. 1995,Zl 19-23 Unproven. unconventmnal or alternative methods are used increasingly m incurable diseases wth hmwd therapeuoc poss~bd~t~es. Thw IS detimtely ,me for lung cancer. especmlty the non-smallsell types These melhods are often conneaed with equally unproven Iheoties of tumongenests and douhlrul diagnosoc :+s,s Selected unproven melhods recommended for rhe treatment oflunp. cancer are dxussed. There is no dlc, agams, lung cancer. bu, ,here are promnng results of telliaw orevemnon wi,h wtamm A The definilive proof of effefenlve adJuvan, treatmen, w,h misllelce preparauons IS s,di tacking lscador 8s well as the ‘,mmunmodula,or’ Polyerga had no aclwity compared 10 placebo in advanced non-smalliell lung cancer Also for various other alleged ‘bmlogx response modr8ers’ (Ney-Tumor”. Factor AP 2, ATC of Klehr. AHIT of Kiev) chmcal eIfucy has no, been proven so far The grealest risk of lhcse melhods is to “ass ,he onen smgular chance of tong-time remtssnon or cure, i.e by radut surgery Proven harmless methods may be tolerated as addmve supportwe lherapy
.
Reviews Recent advances in radiotherapy for non-small cell lung cancer Xan Howe P Service de Rodiorherape, lnsrihrlJ&s Border, Bruxelles. Rev Med Brux 1995;16: 14-9. P.adlo,herapy is a lccoregiooal form of treatmen,. Several recen, stod~es have clearly outlined the major impact on long ,erm sunwal of local tumor conuol. and the impmaoce of sweral parameters of the radiation treaoneo,: dose. frac,iona,ion and treatment quality D~fferen, approaches are under investigatmn to improve 1,s effectiveness cndobronchial brachythcrapy, conformal radiotherapy. modified fractionated radmtion schedules and combined mcdalihes.
Non-small-cell lung carcinoma: Current and future therapeutic m”I*gecment B&in KT. Cur@ R. Dcporrmml ofRadmoon Oncologr 746 Jefinon Avenue. Scranton. PA 18510 Drugs 1995:49 362-75. Non-small-celt lung cancer INSCLC) IS one of ,hc “os, common ~lignancies~ndevetopedcounlnesandaccountsior mdhonsofdea,hs worldwde The inadence of NSCLC conclaws w,h smokmg mbacco and is bkely 10 “crease m those countries w,h mcrcasmg per capna tobacco NSCLC IS pantcularly assocnled wtth morbiduy - in ,he US several pubbshcd chmcal scuda invotvmg a vanery of mlensive surgical. chemolheragewc and radmthcrapeutic ,n,erven,,ons have produced only a 10% S-,car survnal New lechnologtes and breakthroughs in ,rea,“cn, nowilhslandtng. ,hc curre”, emphasis I” clm,cal trials IS 10 refme and op,~“,se avadablc lhempies 10 maxim&e palien, disease-free and overall surwval These accrmng multi-mslllmional chmcal lnats may o,Tcr surglcat rcscc,m~~ wh or wilhou, nmdJuvant Iherapy. mutlmgem chemotherapy. and/or
consump,,on of