326 Abstracts/Lung Cancer 12 (1995) 265-329

fnbalation therapy of interferon-gamma against brouchoalveolar carcinomaofthe lung; a cast report Yano T, Yokoyama H, Ueda T, Inouc T, Asoh H, Ichinose Y J Jpn Sot Cancer Thcr 1994;29:1778-81.

A 46-y-r-old man, who had undergone a right middle-lower lobectomy due to bronchoalveolar carcinoma of the lung, suffered from multiple air-borne metastasis in the residual lungs. The patient was treated with local administration of interferon-gamma @‘N-gamma). The treatment consisted of transbron- choscopic instillation of IFN-gamma (1 x IO6 JRU/20 ml saline) on days 1,4,7 and 10, and inhalation ofaerosolized IFN-gamma (3 x IO6 JRUiday) on days 2.3, 5, 6. 8 and 9. Afler treatment, alveolar macrophsgcs exhibited a high level of cytotoxicity in vitro. The IFN-gamma therapy was repeated every three months. AtIer four cycles of the therapy over a year, tllmors remain stable and good quality of life has been maintained.

Sekctii emboliition af bmncbial rrtery with drug gelfoam in treat- ment of lungcaocer He De-Xin. Tangdu Hospital, Far& Milifory Medical University, Xi-an. Chin J Clin Or& 1994;21:746-8.

Fifteen cases of lung cancer were treated with selective drug gelfoam cmbolization of bronchial artery. It was found that the mass disappeared cxxnpletcly in one patient and diminished in excess of 50% of buck in 5 patients and below 50% in 6 patients. It is concluded that this treatment is one of the effeetivc and safe measure in a multimodal approach treatment of lung cancer. The indication of this treatment was discussed.

Gene therapy for carciooembryooic antigen-producing buman lung cancer cells by cell type-specific expression of herpes simplex virus tbymidioe kinase gene O&i T, Tani0 Y, Tachibana I, Hosoe S, Kumagai T, Kawesc I et al. Depor0nenr of Medicine III, Osaka University Medical School, 2-2, Yomadooka. Suita. Osaka 565. Cancer Rcs 1994;54:5258-61.

A carcinoembryonic antigen (CEA)-producing human lung cancer cell line (A549), a nonproducing human lung cancer cell line (CADG-LC9), and a human uterine cervical cancer (HeLa) were transfected with the herpes simplex virus thymidinc kinase (HSV-TK) gene regulated by 445 nucleotides upstream from the translational start of CEA gene. Fifty % growth inhibitory concentration of ganciclovir (GCV) was 0.57 iM for HSV-TK-transfected A549; relative sensitivity to GCV was more than 1000 times higher compared to the 50% growth inhibitory wneentration of the parental cell line. Both CADO-LC9 and HeLa transfectcd with HSV-TK were still resistant to GCV. There was no difference in either morphology or doubling time behveen HSV-TK-transfccted and parental clones. Injections (i.p.) of GCV resulted in significant regression of HSV- TK-transfected A549 tumors in nude mice. These data show the possibility of gene therapy using the cell type-specific promoter of CEA gene against CEA- producing adenwarcinoma of the lung.

Adjuvaot immunotherapy with intrapleural Streptococcus pyogeocs (OK-432) io lung cancer patients after resection Lee Y-C, Luh S-P, Wu R-M, Lee C-J. Departmen of Surgery. Notional Taiwan Vniwrsi@ Hospiml, No 7 Chung-Shan, So& Road, Taipei 10016. Cancer Immunol Immunother 1994;39:269-74.

A prospective randomized study to evaluate the effect of adjuvant intraplcural OK432 immunotherapy at?er resection of lung tumor was conducted in 93 patients with primary lung cancer. Among them, 46 patients had had intraplcural OK-432 injection, 47 had not. In the meantime, mial measurements of serum immunosuppressive acidic protein, of serum interleukin-2 receptor and of the subpopulation of the peripheral blood cells and lymphocytes were perfomwd in all these patients. Patient chameteristics in these two groups (sex, age, histological type, pathological stage. type of operation, and perfommnce status) were compatible. The results showed that adjuvant intrapleural OK- 432 injection a&x resection had no beneficial effect on a patient’s survival time. Patients who received intrapleural OK-432, had an increase in blood leukocytes, granulocytcs and monocytes and serum immunosuppressive acidic protein level. But the cell numbers of total T cells, suppressor/cytoxic cells, helper/inducer cells and natural killer cells of peripheral blood were decreased

in the OK-432 positive group. Over half of the patients had transient I- or 2- day febrile reactions at?er intmpleural OK-432 injection. It was concluded that neither clinical observation nor immunological monitoring of peripheral blood could demonstrate a beneficial effect from intraplcural OK432 immunotherapy after complete reseelion of the tumor.

Stent-implantation for stenotic malignant trachcobmncbial tumors Keller H, Kreuzcr A, Heller K, Torzsok L. Neumann M. I. Interne Lungenableilung. Pulmologixhes Zenbum. Sonatoriumstrosse 2. A-11 40 Wien. AtC”tWe&-hnge#lkr 1994;20:53942.

The implantation of stcnts in the central tracheobronchial tree for relief of obstruction due to malignant tumors is a palliative method for the recanalisation of narrowed airways. From Januaty 1990 till March 1993 we used this method in I4 patients (I 1 men, 3 women) and inserted 16 stents. The intubation was indicated beeauw of life-threatening narrowing of the trachea or main bronchi causing dyspnea, strider and/or poststenotic symptoms. 2 metallic stents and 14 silicone stats were inserted under general anesthesia using combined rigid and flexible bronchoscopy. There were no complications during intubation. Mean survival was 83,6 days (7 h-209 d). Follow-up showed mucus plugging (3 cases), migration (1 case). dislocation (1 case), reactive fibrous granulation tissue (2 cases), massive tracheal hemorrhage (I case - probably due to tumor progression) and in metallic stents grown of tumor through the wall-stents (2 cases). The implantation of stents is a palliative method to improve quality of life in these patients. The use of metallic stents is recommended in extratracheal/ bronchial compmsion, silicone stcnts were inserted successfully in obstructions involving the distal trachea, carina and main bronchi.

Reviews Thestrategyfortberapyoflungcancer Konska C, Nakajima S, Kate H. Deparbnent of Surgery. Tokyo Medico1 College Hospital, Nishi-shinjuku 6-7-1, Shinjuku-ku, To& 160. J Jastro 1994;6:207-I 5.

In therapy of lung cancer it is important to be decided what type of therapeutic strategy is most appropriate and what kind of results can be anticipated. Selection of type of therapy in primary lung cancer depends on the following factors: Histological type, Location and Stage. The differences of methodology, which is necessary in deciding therapeutic strategy, employed to diagnose and evaluate cases which are X-ray-negative and sputum cytology-positive (rea~tgcnologically occult lung cancer) and cases which reveal abnormal findings on chest X-ray are described. Especially in occult lung cancer cases, with the remarkable improvements that have ban made in the fiberoptic bronchoscope, bronchowopy has become relatively simple to perform and is extremely effective for detailed examination as far as 4th order bronchi for hmwr localization. Surgery treatment is the treatment of choice for lung cancer. Until 196Os, pncumonectomy was a common surgical method for lung cancer, but at&r that period lobe&my and systemic media&al lymph node dissection became standard. As for the survival rate according to pathological stage, out of a total of I ,2 I I resected casts, among stage I and II cases in which the surgical procedure was thought to be curative, the 5-year survival rate were 67.4% and 41.1%, respectively. The 5-year survival rates of stage IIIA and IIIB, on the other hand, were only 14.7% and 0% respectively. In order to improve the survival rate of lung cancer, more ctTorts must be made for early detection of early stage lung cancer cases, and the development of more effective adjuvant therapy is anticipated.

Lung cancer Travis WD, Travis LB, Devesa SS. Pulmono~~ediastinaIPa~o~ Dept., Armed Forces Institufe of Pathologv. Washington. DC 20306-6000. Cancer 1995;75:Suppl:I91-202.

Background. Lung caneer is the most eomman cause of cancer death in the United States, and its incidence has been rising for at least 50 years. Shifts in histologic type and differences in sex and race distribution have accompanied the increased incidence of lung malignancies. Methods Population-based data regarding lung eaneer reported to the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) program for the 15-year period 1973- 1987 were analyzed. Resulrs. Results indicate that from 1973-1977 to 1983- 1987, the age-adjusted rates of lung cancer increased by 30%, with the gain markedly greater in women (70%) than in men (17%). The largest percentage