Treatment Of Inoperable Lung Cancer Research Articles

The relevance of the treatment of lung tumors in small domestic animals and the prospects for the use of targeted therapy for EGFR and ALK/ROS1 mutations on the example of clinical data from humane and veterinary medicine

In the period from 2020 to 2023 was conducted a retrospective study of animal disease histories with lung neoplasia. 43 animals (15 dogs and 28 cats) were included in the study. Neoplasms were identified by instrumental and histopathological methods. Malignant lung tumors have different histological structure, differ in clinical course and treatment results. Surgery is the method of choice for dogs and cats with primary lung tumors. In humans, the surgical method is one of the main methods of treating lung cancer (LC). Since in 70% of cases LC develops without clinical signs, most cases of the trachea, bronchi and lung tumors are detected at IV stage not only in animals, but also in humans, which makes radical surgery impossible. The development of molecular biology methods leads to the development of new treatment methods based on the use of more effective antitumor drugs. One of the innovative methods of cancer treatment is targeted therapy. Molecular-oriented drugs block the growth of cancer cells by interfering with the mechanism of action of specific target molecules necessary for carcinogenesis and tumor growth. In veterinary medicine, surgical and chemotherapeutic methods of treatment are mainly used, while the latter does not show sufficient effectiveness. At the same time, in humane medicine for the treatment of lung cancer widely use targeted therapy, the effect of which is more accurate and effective. There is not much information in the available literature on the use of targeted therapy in animals and there are practically no studies on the treatment of inoperable LC in cats, which makes it relevant to conduct clinical studies on the use of targeted drugs in companion animals.

SC05.04 Lung Cancer Vaccines: An Update

SC05.04 Lung Cancer Vaccines: An Update

New Approaches to Radiotherapy as Definitive Treatment for Inoperable Lung Cancer

The standard curative approach for the treatment of inoperable non-small cell lung cancer (NSCLC) is definitive radiotherapy. Advanced treatment techniques have been developed that maximize radiation dose delivery to the tumor while minimizing the dose to critical surrounding structures. These radiation therapy techniques include three-dimensional conformal radiotherapy, intensity modulated radiation therapy, stereotactic body radiotherapy, and particle beam radiotherapy. Biological imaging with (18)F-FDG-PET and other novel tracers in development have shown the potential to improve target delineation and patient selection for curative treatment. Tumor motion control with respiratory gating techniques and image-guided radiation therapy are recent developments that provide the radiation oncologist with accurate tumor localization on the treatment machine. This review article summarizes the literature on these topics and other state-of-the-art radiation therapy techniques in the management of inoperable NSCLC.

Receiving a diagnosis of inoperable lung cancer: Patients’ perspectives of how it affects their life situation and quality of life

Lung cancer is a disease with many biomedical and psychological symptoms. The diagnosis and treatment of lung cancer induces adverse effects. Having an inoperable lung cancer there are few possibilities of being cured. Management of patients with inoperable disease is directed at relieving local or systemic symptoms. The purpose of this study is to describe how it affects the patients’ life situation and quality of life. Data was collected by qualitative interviews where the patient's lived experiences were articulated. Twenty-three Swedish patients diagnosed and starting palliative treatment for inoperable lung cancer were interviewed. The interviews were audio-taped and transcribed verbatim. Data were interpreted trough interpretive phenomenology. Six themes were identified that were important for the informants’ experience of their life situation and quality of life. The themes were: Experience of uncertainty; including time of waiting and thoughts, experience of hope; about a prolonged life, network as support; being treated as the person they are thoughts of death; is there time to conclude their lives?, feelings of shame and guilt; they have caused the disease by themselves and next of kin reactions; sadness, guilt, worries and anger. These six themes gave a structure presenting the essence: Living as usual. Maintaining independency and integrity were important, as well as maintaining status, being treated as the person they always had been and that they experience that they had a meaning to fulfill in life. They were living as usual.The findings of this study point out the importance of improving the care of people afflicted with lung cancer, as well as promoting support for the next of kin, since they are significantly important for these patients’ experiences of quality of life. This knowledge and understanding will be useful for development of interventions and guidelines for treatment.

Is there an association between anxiety and breathlessness in patients receiving treatment for inoperable lung cancer?

Is there an association between anxiety and breathlessness in patients receiving treatment for inoperable lung cancer?

Brachytherapy in lung cancer.

Brachytherapy, the direct application of a radioactive isotope into the tumor bed, delivers a high dose to the tumor as compared to the surrounding normal tissue. Interstitial brachytherapy, the placement of the isotope into a tumor bed where no lumen exists, has been described but is utilized infrequently in clinical practice. Endobronchial brachytherapy, the placement of the source within the airway lumen, as a boost to conventional external beam radiation has not yet demonstrated improved local tumor control or overall survival as compared to external beam alone in the definitive treatment of inoperable lung cancer. In the palliative setting, brachytherapy can provide prompt relief of obstructive symptoms and hemoptysis in the majority of patients.

Final report of the 70.2 GY and 75.6 GY dose levels of a phase I dose escalation study using three dimensional conformal radiotherapy in the treatment of inoperable lung cancer

Final report of the 70.2 GY and 75.6 GY dose levels of a phase I dose escalation study using three dimensional conformal radiotherapy in the treatment of inoperable lung cancer

The immunomodulating effect of indometacin in the course of chemoradiation treatment for inoperable lung cancer : Kasyanenko IV, Pivnyuk VM, Lisitsa AM, Kovalenko NA, Bagiryan MA. Kavetsky Inst. for Exp. Pathology, Oncology and Radiobiology, Academy of Sciences of the Ukraine, Kiev. Vopr Onkol 1992;38:1183–1187

The immunomodulating effect of indometacin in the course of chemoradiation treatment for inoperable lung cancer : Kasyanenko IV, Pivnyuk VM, Lisitsa AM, Kovalenko NA, Bagiryan MA. Kavetsky Inst. for Exp. Pathology, Oncology and Radiobiology, Academy of Sciences of the Ukraine, Kiev. Vopr Onkol 1992;38:1183–1187

Combined-modality treatment of inoperable lung cancer (iv immunotherapy, chemotherapy, and radiotherapy)

Patients with inoperable non-small cell carcinoma of the bronchus were treated by iv methanol extraction residue of bacillus Calmette-Guérin (MER) followed by combination chemotherapy with methotrexate, doxorubicin, cyclophosphamide, and lomustine (MACC). Radiotherapy was added in patients with localized disease. MER was given iv in four weekly courses. The dose ranged between 0.1 and 0.8 mg/m2/course and was determined according to the skin reactivity to MER. None of the 19 patients treated with iv MER had an objective tumor response during immunotherapy. Five of 16 evaluable patients receiving MACC (31%) achieved partial response. The overall median survival for all 17 patients treated was 11 months according to the protocol. During immunotherapy the following side effects were observed: all patients had fever and chills and most had malaise, nausea and/or vomiting, and headache. Transient abnormalities of liver function tests were found in six patients, and in one patient roentgenographic changes suggestive of lung granulomas were seen. The side effects were more severe during the first course than in the further treatments. Side effects of the MACC combination were comparable to those observed in previously reported studies. Immunological monitoring performed during immunotherapy revealed that iv MER had an unfavorable effect on the immune system. Following four courses there was a decrease in the in vivo skin reactivity to MER and to five recall antigens. Twenty-four hours after the initiation of iv MER there was a tendency for decrease in the lymphoproliferation to phytohemagglutinin, an increase in the indices of the adherent cell suppressor system and the prostaglandin-related suppressor system, and an increase in the percentage of adherent mononuclear cells. No consistent changes in serum lysozyme were found. A transient increase in the total number of peripheral blood leukocytes and a decrease in the number of lymphocytes were noticed 24 hours after iv MER. Taking into account the results of the immunological studies and the overall therapeutic results, we do not feel justified in continuing to use this combined modality treatment.

Clinical Indicators of Prognosis in Unresected Lung Cancer

A prognosis estimate in palliative treatment for inoperable lung cancer is thought to be of value. Performance status is now recognized as being of major importance, but only recently has been consistently available. We examined other simple information not requiring clinical or laboratory tests that is available in the clinical histories of a series of 1,839 patients with unresected lung cancer. Actuarial survivals at 1, 2, and 5 years were 21.9, 7.8, and 2.0 percent, respectively. The median survival rate was 24 weeks. Squamous cell histology and an increasing interval between the first symptoms and diagnosis were associated with a better prognosis. The number of symptoms recorded at the time of assessment had strong negative association with survival; asymptomatic patients had a two-year survival of 26 percent compared with 6 percent or less with four or more symptoms. A similar discrimination is given by Feinstein's index, which combines information on the number and type of symptoms and on the interval between first symptom and diagnosis. The clinical stage was strongly related to survival. Additional statistical analysis showed that the prognostic value of each of the most powerful prognostic factors, the number of symptoms, and Feinstein's index was little altered by the use of data on stage and histology in addition. The data show a range of median survival of 18 to 60 weeks for Feinstein's indices from 6 to 1, suggesting that the symptom index is useful particularly in the relatively well patients and the performance status particularly in those more ill. The combination may be better than either alone, and it is recommended that such information be recorded for all lung cancer patients.

The treatment of inoperable lung cancer by radiotherapy and chemotherapy.

The problems of the combined modality treatment of inoperable lung cancer are discussed in this paper. There is a lack of secure data on optimal radiation dose and fractionation schedules when this is the sole treatment. The problem is compounded in the combined modality situation by the possibility of increased toxicity. Whereas there is effective chemotherapy for small cell carcinoma and evidence for improved results in combined modality treatments, the results of such treatments for non-small cell carcinoma are disappointing. Strategies for improving the results are discussed.

EORTC symposium on progress and perspectives in lung cancer

Lung cancer continues to be a major medical problem; its incidence is still rising and its mortality rate is the highest among all cancer deaths in industrialized countries. The limitations of conventional treatment, surgery, radiotherapy and chemotherapy are well known; however, new orientations have been suggested based on combined modalities. All disciplines involved in cancer therapy have advanced during the last ten years; although specialization is inevitable with increased knowledge, collaboration is absolutely necessary both for adequate treatment diagnosis and staging. The aim of the EORTC* Symposium on Progress and Perspectives in Lung Cancer Treatment held in Brussels in Ma) 1979 was to summarize recent progress, to refine existing concepts, and to present preliminary results of a combined approach to the disease. A number of experts were invited to present keynote lectures on different topics: early detection, D. Sanderson; regional extension, C. Mountain; detection of distant metastases, H. Hansen; staging and prognostic factors, T. Shields; limits of modern surgery, A. Naef; radiotherapy, immunotherapy and chemotherapy as adjuvants to surgery, P. Rubin, R. Baldwin, Y. Kenis; treatment of inoperable lung cancer by radiotherapy or chemotherapy, N. Bleehen and P. Alberto; and small cell anaplastic carcinoma, M. Cohen. The three days that the symposium was held at the Institute Jules Bordet, provided a profitable and interesting experience in evaluation of recent results and in advocating new orientations and further cooperation. The following helped to organize this symposium: P. Van Houtte, P. Rocmans and R. De Jager; D. Eeckhoudt of the EORTC data center provided technical assistance. P. Rubin presented an outstanding lecture and contributed to the publication of selected papers from the symposium.

The role of radiotherapy in treatment of inoperable lung cancer

The results presented here, taken in combination with those of the earlier Oxford lung cancer trial, suggest that radiotherapy has no routine place in the management of inoperable carcinoma of the bronchus except: (a) in the treatment of small-cell carcinomata and (b) in the attempted cure of small, nearly operable lesions. Radiotherapy is of potential value in the palliation of patients with squamous or anaplastic carcinoma only in the treatment of severe hemoptysis, superior vena caval obstruction and possibly bone pain, or as a relatively non-upsetting mode of treatment in those patients in whom social or psychological factors demand immediate, active intervention. As has been previously shown in the Oxford clinical trials, chemotherapy at present offers neither better survival nor better quality of life to patients with inoperable carcinoma of the bronchus than does a policy of no immediate aggressive treatment.

ETHOGLUCIDE IN TREATMENT OF INOPERABLE LUNG CANCER.

ETHOGLUCIDE IN TREATMENT OF INOPERABLE LUNG CANCER.

TRETAMINE IN THE TREATMENT OF INOPERABLE LUNG CANCER

TRETAMINE IN THE TREATMENT OF INOPERABLE LUNG CANCER