Abstract
Forty patients with diagnosed primary lung cancer were treated by a combination of radiotherapy (total dose surpassing 30 Gy) and bronchial artery infusion of chemotherapeutic agents. This study was carried out from May, 1977, to May, 1981, at Nippon Medical School Second Hospital. These cases were histologically or cytologically classifiable as follows : squamous cell carcinoma (23), adenocarcinoma (6), large-cell carcinoma (3) and small-cell carcinoma (8). More than 30 Gy/3 weeks of 4 MV X-ray were administered to primary lesions and to hilar and mediastinal lymph nodes ; bronchial artery infusion of chemotherapeutic agents (MMC, ADM, CQ) was performed once or twice before, or during, each period of radiotherapy. Standards established by General Rule for Clinical and Pathological Record of Lung Cancer (The Japan Lung Cancer Society, Tokyo, 1979) were used in analyzing tumor response to this combined therapy.
Overall response rate was 72.5% (CR : 9/PR : 20). By histological type, response rate for squamous cell carcinoma was 69.5%, adenocarcinoma (66.7%), large-cell carcinoma (66.7%) and small-cell carcinoma (87.5%). Thus, the combined therapy appeared most effective in treating small-cell carcinoma. Systemic chemotherapy did not appear to influence tumor response significantly.
The type of combined therapy undertaken in this study enabled us to decrease the radiation dose to the hilum and mediastinum, with the additional advantage that bronchial angiography before infusion of chemotherapeutic agents showed the extent of carcinoma to these regions. We expect that the use of such combined therapy will result in an increased survival rate for patients with inoperable lung cancer.
