Immunotherapy is becoming another possible alternative in the treatment of lung cancer. It is a completely different method of treating cancer which is not directed to the tumor itself, but to the immune system. Surface antigens present on tumor cells may be an effective and specific therapeutic targets and strategies based on antibodies inhibiting immune check-points significantly improves the antitumor immune response. Monoclonal antibody blocking CTLA 4 (cytotoxic T-lymphocyte antigen) and PD 1 receptor (protein programmed cell death) and its ligand PD L1 showed clinical efficacy and nivolumab (antiPD 1) was approved in 2nd line treatment squamous nonsmall cell lung cancer.
- MeSH
- antigen CTLA-4 antagonisté a inhibitory MeSH
- antigeny CD279 antagonisté a inhibitory MeSH
- bronchogenní karcinom farmakoterapie imunologie MeSH
- lidé MeSH
- monoklonální protilátky terapeutické užití MeSH
- nádory plic farmakoterapie imunologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Názvy látek
- antigen CTLA-4 MeSH
- antigeny CD279 MeSH
- monoklonální protilátky MeSH
Lung cancer is the worldwide most widespread tumor disease with very poor prognosis. It is the most frequent cause of death on a malignancy. Surgery remains the treatment of choice, however, it can be applied to a small number of patients who are at the time of diagnosis in the operable stage. Chemoradiotherapy can be used either as an exclusive or as a neoadjuvant treatment. This paper reviews chemoradiotherapy regiments in those two clinical situations. With exclusive chemoradiotherapy, the concomitant scheme seems to be the most favourable.
- MeSH
- bronchogenní karcinom farmakoterapie radioterapie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- nádory plic farmakoterapie radioterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
BACKGROUND: The basic task of induction (neo-adjuvant) therapy is elimination of occult micrometastatic dissemination found in some cases already in localized stages of non-small cell pulmonary cancer (stage I-IIIA NSCLC). An equally important effect is also cytoreduction in primary tumours which have before the local intervention an intact vascular supply. A difficult problem remains the correct selection of patients who from the long-term aspect may profit from such a procedure. MATERIAL AND METHODS: The authors evaluated perspectively aspects of oncological treatment and circumstances of surgical intervention after induction chemotherapy in 81 and 87 patients resp. in stage IIIA NSCLC evaluated before initiated neo-adjuvant chemotherapy. RESULTS: Complete remission was recorded in 4.9%, partial remission in 50.6%, stabilized disease in 23.5% and progression in 21% patients. Down-staging was recorded in 26%, 70.3% patients were indicated for surgery. In the group of 87 patients operated after induction therapy pneumonectomies predominated--41 (46%), only one operated patient died within 30 days after surgery (1.1%), complications were neither frequent nor serious. The median of survival after radical resection is 26 months. CONCLUSIONS: Neo-adjuvant chemotherapy by modern cytostatics is usually well tolerated and creates satisfactory conditions for successful complete resection. The operation proper may be more difficult but need not be associated with serious complications. By this treatment it is probably possible to influence long-term results not only in stage IIIA but to reduce also the risk of a later more remote metastatic dissemination in some patients operated in lower stages of lung cancer. Our present aim is to test parameters which will be able to predict possible failure of induction therapy, and seek factors predicting risk behaviour of the tumour also in lower stages (stage I and II TNM classification).
- MeSH
- bronchogenní karcinom farmakoterapie patologie chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory plic farmakoterapie patologie chirurgie MeSH
- neoadjuvantní terapie MeSH
- pneumektomie * MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
Bronchogenic carcinoma is in the Czech Republic the most frequent malignant tumour in males. For practice the classification into non-small cell bronchogenic carcinoma (NSCLC) and small cell bronchogenic carcinoma (SCLC) is most useful. Views on chemotherapy of NSCLC were before 1980 rather pessimistic. In untreated patients with advanced NSCLC the median survival is 6 months and one-year survival in 10 %. In the nineties, due to the introduction of cytostatics of the IIIrd generation into treatment of NSCLC, the median survival was prolonged to 10 - 12 months and one-year survival is reported in 40 - 50 % patients. The importance of chemotherapy in SCLC was never doubted. By concurrent chemotherapy and radiotherapy the total period of treatment of patients with SCLC was reduced and the percentage of objective responses increased. Introduction of cytostatics of the third generation is important in particular in treatment of line II SCLC. Basic prognostic factors of successful chemotherapy in patients with bronchogenic carcinoma are the stage of the disease, body weight loss, presence of paraneoplastic symptoms, immune state and clinical and sociodemographic characteristics.
- MeSH
- bronchogenní karcinom diagnóza farmakoterapie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- malobuněčný karcinom farmakoterapie MeSH
- nádory plic diagnóza farmakoterapie MeSH
- nemalobuněčný karcinom plic farmakoterapie MeSH
- prognóza MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- MeSH
- bronchogenní karcinom farmakoterapie chirurgie MeSH
- kombinovaná terapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory plic farmakoterapie chirurgie MeSH
- protinádorové látky terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- protinádorové látky MeSH
From 1987 to 1989 22 men and one woman with morphologically certified tumors of the lungs were symptomatically treated with cryocoagulation. The cryoequipment KNF 4/5 with 30 W freezing capacity was used. After treatment in 20 out of 22 patients an objective improvement could be observed. A significant increase of spirographically measured vital capacity was found. Control observations of the results after treatment using a densitographic investigation of the regional distribution of the ventilation included the advantage that valuable informations concerning the effect of the treatment were received without further burden for the patient.
- MeSH
- adenokarcinom farmakoterapie radioterapie chirurgie MeSH
- bronchogenní karcinom farmakoterapie radioterapie chirurgie MeSH
- bronchoskopy * MeSH
- karcinom farmakoterapie radioterapie chirurgie MeSH
- kombinovaná terapie MeSH
- kryochirurgie přístrojové vybavení MeSH
- lidé MeSH
- malobuněčný karcinom farmakoterapie radioterapie chirurgie MeSH
- nádory plic farmakoterapie radioterapie chirurgie MeSH
- nádory průdušek farmakoterapie radioterapie chirurgie MeSH
- obstrukce dýchacích cest farmakoterapie radioterapie chirurgie MeSH
- spinocelulární karcinom farmakoterapie radioterapie chirurgie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- MeSH
- bronchogenní karcinom farmakoterapie MeSH
- cisplatina terapeutické užití MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- malobuněčný karcinom farmakoterapie MeSH
- rentgendiagnostika hrudníku MeSH
- senioři MeSH
- spinocelulární karcinom farmakoterapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- cisplatina MeSH
- MeSH
- bronchogenní karcinom diagnóza diagnostické zobrazování farmakoterapie MeSH
- bronchoskopie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory plic diagnóza diagnostické zobrazování farmakoterapie MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- radiografie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- bronchogenní karcinom farmakoterapie MeSH
- kombinovaná terapie MeSH
- lidé MeSH
- nádory plic farmakoterapie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The limiting factors in the treatment of bronchogenic cancer consist, from the bronchological point of view, in the possibility to estimate the advanced macromorphological stage of the disease with the determination of the degree of the affection of regional intrathoracic nodes. By the perbronchial route it is possible to obtain also a sufficient amount of material from unaffected nodes for purposes of testing their function. The testing of the spontaneous E-rosette formation is shortened, with the use of this method, by three quarters of an hour, but the possibility of obtaining a sufficient quantity of lymphocytes by the perbronchial puncture with the use of a fine needle is on average smaller than 50% in all types of bronchogenic cancer. It will be probably possible to introduce gradually also other immunological and biochemical methods of testing the function of the regional lymphatic tissue, as confirmed by the authors' experiences with immunological and biochemical investigations of bronchial washings with the use of 4 ml of the saline washing liquid. Experiences are thus far only preliminary and not unequivocal. Different alkaline under study, with better treatment results in patients treated with Cis-Platine, indicate phosphatase levels in patients with Penberol and Cis-Platine monotherapy in the series under study, with better treatment results in patients treated with Cis-Platine, indicate the possibility of using a further limiting aspect of cytostatic therapy.
- MeSH
- akryláty terapeutické užití MeSH
- alkalická fosfatasa metabolismus MeSH
- bronchogenní karcinom farmakoterapie enzymologie imunologie MeSH
- cisplatina terapeutické užití MeSH
- lidé MeSH
- lymfocyty imunologie MeSH
- nádory plic farmakoterapie enzymologie imunologie MeSH
- protinádorové látky terapeutické užití MeSH
- tvorba rozet MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- akryláty MeSH
- alkalická fosfatasa MeSH
- cisplatina MeSH
- Penberol MeSH Prohlížeč
- protinádorové látky MeSH
