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Radiotherapy

The superior vena cava syndrome as energy case in radiotherapy Beck C. Be&rich W. Bauknecht A, Schnabel K. Abteilungfur Strahlen- therapie. Rudiulogisck Universttatsklinik. D-6650 HombwglSo~r.

Strahlenther Onkol 1990;166:798-802.

Between 1983 and 1988 90 patients with bronchial neopla.smS needed emergency irradiation to treat superior vena cava syndrome. Pathohistologically verified were 30 cases with squamous cell carci- noma, twelve with adenodarcinoma, live cases wtth large cell carci- noma, 30 with a small cell carcinoma, and non-differentiated in five others. No histologicalexamination was carried out in eight cases. In 30 patients distant metastases were evident at the initial diagnosis. The averagedurationoffollow-upwas 118&y~.Thesurvivalcourseproved to be independent of histopathological grading, previous treatmem and age. Similarly no influenceof the fractionation employed could be seen. Very important to the prognosis however, were the stage of disease, the Kamofsky index, and dependent on that+ the total reference dose applied. Patients with a Kamofsky index of 50% or lower survived on averaged only 17 days

Radiosensitivityofdifferenthuman tumorlinesgrownasxenografts determined from growth delay and survival data Schwacbofer JHM. Hcogenhout J, Kal HB. Koedam J, Van Wezel HPN. Department of Radiotherapy, University Hospttol. P.O. BOX

YIOl,6SOO HB Ni/megen. In Vivo 1990.4:253-Ct. Four human tumor lines were grown as xenografts in nude mice to

determine whether xenografts derived from dtfferent types of tumors would show tumor-type dependent differences in response to single- dose irradiation, and whether these differences, paralleled clinical behavior. Xenografts from a neuroblastoma, a squamous cell carci- noma, a melanoma and a lung adenccarcinoma were studied in terms of growth delay and tumor control dose (TCD&. To exclude an im- munoreaction of the host in the radiation response of the tumor xenografts, the tumor lines were tested for their growth in immunosuppressed Wistar rats. No differences in growth of xenografts in either immuncde- licient mice or immunosuppressed rats were observed. Both growth delay and local tumor control as expressed by cure correlated well with clinical behavior of the tumor types of origin. This study demonstrates that radiosensittvity of different human tumor lines can be evaluated in terms of growth delay and tumor control dose, when they are grown as xenografts. To exclude immune reactions, proper controls should be mcluded. The sensitivities established from these evaluations parallel clinical behavior, thus offering a tool for analysis of human tumor radiosensitivity of histologically different tumor types.

Combined treatment modalities

Adjuvant, specific, active immunotherapy for resectabk squamous cell lung carcinoma: A 5.year survival analysis Takita H. Hollinshead AC, Adler RH, Bhayaua J. Ramundo M, Modcow- its R et al. Deportment of Thoracic Surgery and Oncology, Rowe11

ParkConcerlnstiture.666EfmStreet.5u~lo.NY 14263.JSttrgOnCOl 1991;46:9-14.

In 1976 Stewart et al. (Annals of the New York Academy of Sciences 277:436-466) reported the effectiveness of adjuvant specific active immunotherapy of lung carcinoma in improving the postoperative survivalofstage I lungcarcinomapatients in aphase study using lung carcinoma-associated antigen (TAA) and complete Freund’s adjuvant (CFA). A phase III study was then designed by the authors to see the effects of specific active immunotherapy compared to the conventional management (no treatment) and IO nonspecific tmmunotherapy. From 1976to 1981.85 patients wtth resectabIe(stagesIand II) squamous cell lungcarcinoma wereentered intoarandomized study: 1)controIgroup; 2) specific immunotherapy group-three monthly doses of 500 pg Of TAA emulsified with CFA; 3) nonspecific immunotherapy group-three monthly doses of CFA emulsitied m saline. All the patients in the study receivedskintests wuh 1OOpgoCthesameTAAusedfortheimmunoth- erapy. Recently,a5-yearfollow-upofall the patients becameavailable:

The life table 5-year survival of group 1 was 34%. of group 2 was 75% andofgroup3 was53%.Themediansuivalsfor thethreegroups were group 1.38 months;gmup2,106months; andgroup3.71 months. The difference was significant at P = ,007 (Cox-Mantel test).

Combined modality therapy for locally advanced non-small cell lung carcinoma Rccine D. Rowland K. Reddy S. Lee MS. Bonomi P. Taylor S et al. Department of Therapeutic Radiology, Rush-Presbyterian-St. Luke’s

Medical Center. 1653 W. Congress Parkway, Chicago. IL 60612.

Cancer 1990$6:2270-S.

Multi-modality treatment consisting of ctsplatin, VP-16. and 5- lluorouracil chemotherapy given concomitantly with external beam radiation was used to treat 64 patients with locally advanced Stage III non-small cell lung carcinoma. This regimen was used in a preoperative fashion for four cycles in patients considered surgically resectable and with curative intent for six cycles in the remainder of patients. The clinical response rate for the entire group was 84% and the overall local control rate was 74%. The median survival was 13 months with a median follow-up for live patients of 19 months. The actuarial 3-year survival and disease-free survival rates were 30% and 23%. respec- tively. Histologic complete response was 39% and appeared to predict for survival. The 3-year actuarial survival and disease-free survival rates for23 resected patients were6946 and45%, respectively, with the complete histologic responders having disease-free survival of 78%. The pattern of lint recurrence did not appear to differ by histology or presence of lymph nodes in thts subset of patients. The actuarial 3-year survivalanddisease-Creesurvtval rates Corinoperablepatientsreceiving six cycles of treatment were 18% and 23%. respectively. The local control was 67% with the majority of these patients having Stage IIIB disease. The Mountain International staging system appeared to predict for operability, local recurrence, and survival. This concomitant treat- ment regimen is feasible. with the major toxicities being leukopenia. nausea, and vomiting.

Other treatment modalities Nd-YAC laser resection and ‘endoxane’ endobronchial prosthesis in the palliative treatment of tracheobronchial malignant tumors Seitz B, Astoul Ph. Martin A, Fico JL, Boutin C. Service de Pneumolo-

gie. Hopital de la Conception. 147.5oulevard5aille. 13385 Marserlle

Cedex 5. Acta Endox 1990;20: 123-9. The authors report their expenence with laser resecttons and tra-

cheobronchial endoprostheses for the palliative treatment of neoplastic

disease from September 1988 to September 1989. Patient comforL the

number of laser reseclions, and the total cost of palliative treatment can

be improved if the prosthests is Inserted as early as possible.

Elimination of small cell carcinoma of the lung from human bone marrow by monoclonal antibodies and immunomagnetic beads Vredenburg JJ. Ball ED. Department ofMedicine, Dartmouth Medical

School. Hanover, NH 03756. Cancer Res 1990;50:7216-20.

The majonty of patients with small cell carcinoma of the lung (SCCL) have bone marrow involvement detected by monoclonal antt-

bodies (mAb). High dose chemotherapy followed by autologous bone marrow transplantation may improve treatment results for patients with SCCL, but the tone marrow may need to be purged of contaminating tumorceIls.ThisstudyinvestigatesIhereactivityoCapanelofmAbwith two SCCL cell lines and normal bone marrwow and the ability of the

mAb and immunomagnetic beads to eliminate the SCCL cells from a mixture of 90% normal bone marrow cells and 10% SCCL cells. The

mAb and immunomagnetx beads removed 4 to 5 log of SCCL cells in

the model system. The immunomagnetic separation did not signifi-

cantly adversely affect normal hematopoietic progenitor cells, as deter-

mined by bone marrow colony-forming units. The results suggest that

the mAb and immunomagnetic beads could safely and effectively

separate SCCL cells from the bone marrow Corautologous bone marrow

transplantation following high dose chemotherapy.