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cells and BCG had no significant effect on overall survival after resection of lung

cancer. It did appear to increase survival in DNCB positive patients.

Adjuvant I.ununotherapy for Non-Small Cell Lung Carcinoma by Levamisole or IK-432. Takeoka, T., Uzawa, S., Takeda, H., Okaya- su, T., Hashimoto, M., Tanabe, T. Hokkaido University, Sapporo, Japan.

A controlled, randomized study has been conducted to assess if levamisole or OK- 432 can increase the postoperative survi- val of non-small cell lung cancer patients. This study was begun in Aug. 1980 and was concluded in July, 1983, with a total of 193 patients. The stage of disease was established after a histological review of resected specimens and of hilar and mediastinal nodes; thereafter, 136 patients

were eligible for the evaluation. Prior to lung resection, patients were

randomized into 3 groups: I), no immunothe- rapy (49 pts), II) 0K-432 (45 pts), and III), levamisole (42 pts).

All patients were given postoperative combination chemotherapy of FAMT (5-FU, en- doxan, MMC and toyomycin) i.v. every 12 weeks, and 200 mg of 5-FU p.o. between the cycles of FAMT as a common protocol

for 2 years. Survival was measured by the Cutler-

Ederer method and the statistical signifi- cance was calculated by a generalized Wil- coxon test and a Cox-Mantel test.

Three year survival was 56% for g~oup I, 66% for group II, and 51% for group III. Neither immunotherapeutic agent resulted in any significant improvement in survival at present. However, data suggest that OK- 432 has beneficial effects in stage I+II patients while levamisole has such effects

in stage III+IV patients.

Combined Photodynamic Therapy and Radio- therapy in the Treatment of Endobronchial

Tumors. Lam, S., Olivotto, I.A., Kostashuk, E.C., LeRiche, J.C., Miller, R.R. Cancer Control Agency of British Columbia and the Vancou- ver General Hospital, Vancouver, B.C.,

Canada. Residual tumor is commonly found follow-

ing radiotherapy (RT) of obstructive endo- bronchial cancer. Thirty-one patients with inoperable endobronchial tumor involving a main stem bronchus, truncus intermedius or lower lobe bronchus received radiothe- rapy by the parallel pair technique (2000- 4800 cGy). Radiologic assessment one month following completion of radiotherapy show- ed that the area involved or obstructed by tumor decreased by a mean of 18 percent for tumors in a main bronchus and i0 per-

cent for tumors in the truncus interme- dius or lower lobe bronchus. Twelve of the

thirty-one patients were rebronchoscoped fol- lowing radiotherapy. All had significant re-

sidual tumor. Twenty-two patients with obstruc-

tive endobronchial tumors were treated with pho- todynamic therapy (PDT) using hematoporphyrin derivative and argon-dye laser. Although re- opening of the obstructed lumen to the bron- chial wall could be achieved, microscopic evi- dence of residual tumor was found in all pa- tients, usually at the site of origin of the tumor. We, therefore, evaluated the use of PDT followed by RT in eight patients. Bronchoscopi- cally, although re-opening of the obstructed lumen to the bronchial wall was achieved after PDT, extrinsic compression of the bronchial wall was a~h~.~ed a~er PDT, extrinsic com- pression of the bronchial lumen from enlarged lymph nodes or peribronchial tumor was present in five patients. RT following PDT resulted in further increase in the luminal diameter.

Our study suggests that residual tumor is common following PDT or RT alone. Combined PDT and RT gives the best result in the local control of obstructive endobronchial tumor.

Photodynamic Therapy with Hematopophyrin De- rivative for Endobronchial Tumors. Regal, A.-M., Takita, H., Antkowiak, J.G., Dougherty, T., Nseyo, U., Boyle, D., Sullivan,

L. Roswell Park Memorial Institute, Buffalo, N.Y.,U.S.A.

The technique used at Roswell Park for endo- bronchial administration of photodynamic the- rapy prior to March 1984 was not consistently effective in reopening the bronchus. Since that time, we have treated 9 patients for a total of 13 treatments. The patient population included 6 males and 3 females, ranging in age from 47 to 78 years (mean - 61.5). In 1 patient, both left upper and left lower lobes were in- volved; whereas, in the other 8 patients, one bronchus was treated. The endobronchial loca- tion of the lesions was right main bronchus (3), right upper lobe bronchus (i), left main bronchus (2), left upper lobe bronchus (3), and left lower lobe bronchus (i). The histology of the diseases treated was both bronchogenic in origin and metastatic. Four were squamous cell carcinoma, 2 undifferentiated carcinoma, 1 small cell carcinoma, 1 renal cell carcinoma, and 1 thyroid follicular carcinoma. One debri- dement bronchoscopy re-established the bronchi- al lumen in i0 out of 13 cases; and, in the remaining 3 instances, two such clean-up pro- cesses were required. Among the 6 patients with the gross appearance of totally occluded bronchi, the roentgenographic findings corre-

sponded in only 4 post-treatments; however, 2 showed objective evidence of increased aeration on chest film. Seven complete (re-establish- ment of 100% of the original diameter of the bronchus) and 4 partial (80-90% of the origi- nal bronchial diameter re-established) response were effected. No deaths were attributable

to photodynamic therapy with hematoporphyrin