Abstract
There is a high possibility of micrometastases in even a relatively early stage of the lung cancer. Therefore, a combined treatment including chemotherapy is necessary for the treatment of lung cancer. The effect of this treatment has been shown in a small cell lung cancer (SCLC) probably because this type of lung cancer responds very well to chemotherapy.
At present, chemotherapy is essential for the treatment of SCLC. Radiotherapy or operation is thought to be an adjuvant therapy. Although surgical resection to prevent local relapse of SCLC seems to be effective, it is limited to patients with stages I and II and controversial in patients with stage III. Prophylactic cranial irradiation (PCI) is also a controversial issue. We think that PCI should not be performed in patients with stages I and II achieving CR.
The most effective treatment for non-small cell lung cancer is the surgical resection of the involved lung and mediastinal lymphnodes. A 5-year-survival in patients who underwent operations in the period between 1981 and 1986 was 56.4%. This result is superior to that in the previous decade. However, the effect of adjuvant chemotherapy following operation was not observed in a randomized control study. At present, the trial of pre-operative radiochemotherapy is ongoing. Although we have not reached the final result, the survival of patients who received the treatment appears to be higher than that of the historical control.
N-CWS was used as an adjuvant immunotherapy in randomized control study. N-CWS was administered for 3 years on the average. We did not find the effect of N-CWS on the survival of the patients. In addition, the incidence of second malignancy was not different between CWS and control groups.
