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Query: UMLS:C0242379 (lung cancer)
 71,905 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twelve patients with advanced primary lung cancers associated with malignant pleural effusion were treated with intrathoracic instillation of recombinant interleukin-2 with or without in-vitro-sensitized cells. Two cases achieved complete response, and 7 partial response. The adverse effects seen in the protocol were marginal, and the protocol was well-tolerated and feasible. Furthermore, 4 cases were treated with the combination of systemic chemotherapy and adoptive immunotherapy. Of these, 3 cases responded well to the therapy and have shown a complete response for more than 20 months, indicating that adoptive immunotherapy together with chemotherapy might be a beneficial treatment for advanced lung cancer patients.
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PMID:Treatment of advanced primary lung cancer associated with malignant pleural effusion by the combination of immunotherapy and chemotherapy. 826 10

Several options are available for treatment of malignant pleural effusions in patients with non-small-cell lung cancer. Repeat thoracentesis may be appropriate for the patient with limited survival and a slowly recurrent effusion. Pleurodesis with a sclerosing agent administered via a chest tube is the most widely used therapy, though controversy exists as to which drug produces the best results. Pleuroperitoneal shunting remains an option for those patients whose lung is trapped by tumor. Video-assisted thoracoscopy is likely to change the treatment patterns of malignant pleural effusion. Thoracoscopic pleurectomy can be performed with minimal morbidity. Alternatively, sclerosing agents such as talc can be easily and uniformly introduced into the thoracic cavity under thoracoscopic control. Future therapy is likely to entail a diagnostic thoracentesis followed by a definitive thoracoscopic procedure.
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PMID:Current and future therapy for malignant pleural effusion. 838 Jan 36

Pleural effusions are common in the setting of lung cancer. A pleural effusion associated with lung cancer is an ominous finding, but a small percentage of patients are candidates for curative surgery. The clinician must establish whether the effusion is malignant, excluding the possibility of curative surgery; paramalignant, which may or may not exclude surgery; or whether it is unassociated with cancer. When a malignant pleural effusion is diagnosed, the clinician must decide on the most appropriate form of palliation for the symptomatic patient. In the symptomatic patient with a reasonable life expectancy and pleural fluid pH of more than 7.3, chemical pleurodesis appears to be the most effective and least morbid therapy.
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PMID:Pleural effusion in lung cancer. 838 63

We have developed an intraoperative intrapleural treatment with the use of distilled water combined with cisplatin for carcinomatous pleuritis found at thoracotomy in patients with non-small-cell lung cancer. In the in vitro experiment, three different cell lines were used as a model of malignant pleural effusion. Cell growth was examined after a 3-day culture, which was preceded by exposure of the cells to cisplatin in either phosphate-buffered saline solution or distilled water for 1/2 to 5 minutes. The growth inhibition of tumor cells after hypotonic cisplatin treatment was significantly greater than after treatment with saline solution and cisplatin. Tumor that was obtained by resection of non-small-cell lung cancer was used as a model to demonstrate decreased viability of the tumor after exposure to hypotonic cisplatin. The viability of the tumor in a 6-day culture, preceded by exposure to hypotonic cisplatin (50 micrograms/ml) for 10 minutes, was markedly decreased. Intraoperative intrapleural hypotonic cisplatin was instilled in seven patients with pleural carcinomatosis without side effects and with control of pleural dissemination and pleural effusion for 6 to 29 months.
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PMID:Hypotonic cisplatin treatment for carcinomatous pleuritis found at thoracotomy in patients with lung cancer. In vitro experiments and preliminary clinical results. 838 66

We examined the phenotypes of lymphocytes in the pleural cavity of 23 lung cancer patients without malignant effusion. The ability of those lymphocytes to develop lymphokine-activated killer (LAK) activity and the regulation of LAK by pleural cavity macrophages were also compared with their counterparts in the peripheral blood. Mononuclear cells (MNC) were obtained simultaneously from the blood and by lavage of the pleural cavity of patients with lung cancer. The proportion of the T-cell subset of HLA-DR+ cells was significantly higher in the pleural cavity than in the peripheral blood, but the proportions of CD3+ and CD8+ cells in the pleural cavity were similar to the corresponding proportions in the blood. The proportions of CD4+ and CD16+ cells were lower in the pleural cavity than in the blood. The LAK activity could be developed by MNC from the pleural cavity following incubation with interleukin 2 (IL-2), but the LAK activity of pleural cavity MNC was significantly less than that of peripheral MNC. Pleural cavity lymphocytes alone also developed LAK activity following incubation with IL-2. Pleural macrophages from the patients were regulated to augment in vitro induction of LAK activity by IL-2 from autologous blood lymphocytes and pleural cavity lymphocytes. Lymphocytes in the pleural cavity without malignant pleural effusion could be developed by LAK activity and this activity was augmented by pleural cavity macrophages. The LAK activity developed by pleural cavity lymphocytes was significantly lower than that developed by peripheral blood lymphocytes. However, they can change their population to include cells with higher activities on exposure to IL-2 against the invasion of lung cancer cells into the pleural cavity. Thus, the population of lymphocytes in the pleural cavity of patients with lung cancer without malignant pleural effusion was different from that in malignant pleural effusion.
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PMID:Phenotypes and lymphokine-activated killer activity of pleural cavity lymphocytes of lung cancer patients without malignant effusion. 840 92

CYFRA 21-1 was evaluated in 115 untreated patients with malignant pleural effusions (96 with primary lung cancer and 19 with non lung cancer) and 99 patients with benign pleural effusions. The levels of pleural fluid CYFRA 21-1 were from 1 to 385 times higher than those in serum, in all the examined patients. The mean level of pleural fluid CYFRA 21-1 was significantly higher in cancer patients than in patients with benign pleural effusion (96.1 ng/ml vs 26.2 ng/ml, p < 0.001). At 92% specificity for benign pleural effusion (> 50 ng/ml) the overall sensitivity of CYFRA 21-1 in malignant pleural effusions was 69.6%. When the histology was considered the highest sensitivity was found in squamous cell lung cancer (90%), followed by adenocarcinoma cell lung cancer (74%), non lung cancer (54%) and small cell lung cancer (25%). These results indicate that CYFRA 21-1 could be a useful pleural fluid marker in discriminating benign from malignant pleural effusion and particularly from those due to squamous and adenocarcinoma cell lung cancer.
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PMID:Evaluation of CYFRA 21-1 in malignant and benign pleural effusions. 871 50

The objective of the study was to review the natural history of patients with a malignant pleural effusion but without obvious evidence of a primary, to assess the value of investigations used to look for a primary and to assess the response to palliative chemotherapy. This was done by a retrospective study of patients' notes at the Lung Unit, Royal Marsden Hospital, Sutton, Surrey. Improvement in tumour-related symptoms (and duration) on chemotherapy was assessed by the patient before the first course of chemotherapy and following each course using simple descriptive criteria as follows: (1) complete disappearance of symptoms (CR); (2) good improvement in symptoms (PR); (3) minor or no change in symptoms (NC); (4) worse symptoms (PD). Pleural effusion objective response (and duration) according to Hamed definition: success defined as a continued absence of reaccumulation of pleural fluid on all follow-up radiographs; any reaccumulation was regarded as a treatment failure. Overall survival was measured from the date of histological/cytological diagnosis to death. The study included 42 patients, 27 males and 15 females with a median age of 55 years. A primary was found in 15 patients (36%), and considered to be lung cancer. A total of 11/32 (34%) had a thoracic computed tomography (CT) scan with abnormalities compatible with a diagnosis of lung primary. When thoracic CT scan was negative, fibre optic bronchoscopy was always negative (0/13). Abdominal and pelvic CT scan, abdominal ultrasound, pelvic ultrasound and mammograms failed to reveal the primary. Twenty-three patients underwent local treatment and 37 received systemic chemotherapy. A total of 29/37 (78%) patients achieved symptomatic improvement (median duration, 6 months) and 32/37 (86%) an objective response of their pleural effusion on chemotherapy (median duration, 6 months). The median survival of the whole group was 12 months (3-60+ months). In this series the thoracic CT led to a diagnosis of lung primary in 34% of the cases. Other radiological examinations and bronchoscopy were unhelpful. Chemotherapy achieved symptom relief in 78% of patients.
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PMID:How should cancer presenting as a malignant pleural effusion be managed? 879 90

We investigated the intraarterial concentration of CDDP following continuous hyperthermic pleural perfusion (CHPP, 43 degrees C for 30 to 60 minutes) with 100 mg CDDP diluted in distilled water or saline in 6 lung cancers (2 pleural dissemination, 1 malignant pleural effusion, 3 positive wash cytology), 2 metastatic lung cancer (from breast cancer, 1 rhabdomyosarcoma with pleural dissemination), and 1 metastatic pleural tumor (adenocarcinoma, unknown origin). The level of CDDP was 9.16 to 24.1 micrograms/ml (average 16.1) in perfusion fluid, 0.3 after 5 minutes, 0.41 to 0.85 after 60 minutes and 0.15 to 0.27 (average 0.22) after 24 hours. There were no severe side effects nor any difference in effects by dilution fluid between distilled water and saline. Only 1 patient suffered pleural effusion after this treatment. The results suggested that CHPP with CDDP diluted by saline was effective for prevention and treatment of pleural dissemination.
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PMID:[Clinical treatment with cisplatin (CDDP) in pleural cavity for carcinomatous pleurisy--study of intraarterial concentration]. 885 92

Recent advances in endoscopic equipment and refinement of thoracoscopic techniques and increased experience with thoracoscopy have expanded the application of this procedure for lung cancer. Thoracoscopic treatment for malignant pleural effusion, sampling of hilar and mediastinal lymph nodes, wedge resection of the lung and thoracoscopic lobectomies and pneumonectomies have been reported in many institutes. Our findings demonstrate the feasibility of performing major video-assisted thoracoscopic pulmonary resections with less postoperative morbidity. This report describes present role of video-assisted thoracoscopic surgery for early lung cancer.
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PMID:[Thoracoscopic surgery]. 896 58

Metastasis is the major obstacle in cancer therapy. Lung cancer is divided into 4 histological groups, such as small cell carcinoma, squamous cell carcinoma, adenocarcinoma and large cell carcinoma, representing different clinical behaviors. Novel metastasis models of human lung cancer cells to the liver, kidneys and lymph nodes were established in SCID mice depleted of NK cells. In the model under study, small-cell carcinoma cells mainly formed lymph-node metastases, while squamous cell carcinoma cells mainly metastasized to the liver and kidneys. Moreover, adenocarcinoma cells formed lung metastases and malignant pleural effusion. These findings suggest that our model reflects clinical behavior of metastatic lung cancer and is useful for evaluation of antimetastatic modalities.
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PMID:[Novel metastasis model of human lung cancer cells representing different histological types in SCID mice depleted of NK cells]. 906 89


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