Photodynamic therapy for multiple central type lung cancer - a case report.

In case of central type lung cancer, it happens that tumors tend to grow at many foci of bronchial tree, sometimes simultaneously and sometimes not. And these patients with such abnormalities often suffer from pulmonary emphysema or chronic bronchitis because of heavy smoking habits. So it is important to choose the treatment which preserve the pulmonary function in these cases. Today among several kinds of treatments, photodynamic therapy (PDT) is the definite method to maintain lung function. We report here a case of multiple central type lung cancer treated successfully by PDT.

[Trial of fluoroscopy-guided transbronchial lung biopsy for the diagnosis of lung tumors].

As computed tomography( CT) technology has improved, chest CT has been adopted as a means to survey masses. We now see many cases of pulmonary small nodules or ground-glass opacities( GGO). Herein, we report our investigation of a new procedure, fluoroscopy-guided transbronchial lung biopsy (TBLB), for the diagnosis of such lesions. From 2009 through 2010, we examined 25 patients with pulmonary small nodules or GGO. Of these, 76% were successfully examined by conventional methods versus 62% by TBLB.

[Palliative radiation treatment for superior mediastinal lymph nodes of a patient with recurrent laryngeal nerve palsy-a case report of advanced lung cancer].

The recurrent laryngeal nerve is a branch of the vagus nerve. On the right side, it branches anteriorly to the subclavian artery in the neck. In cases of malignant diseases, lymph node metastasis can lead to recurrent laryngeal nerve palsy. Patients with this condition often suffer from aspiration pneumonia, which requires tube feeding. In this case of an advanced lung cancer, we treated the involved lymph node in the neck with palliative radiotherapy, which restored normal nerve function.

[Evaluation of bronchial arterial infusion (BAI) for lung cancer with carcinomatous pleuritis].

MATERIALS AND METHODS: Six high-risk patients of lung cancer with carcinomatous pleuritis to which BAI was done were examined. BAI was performed using CDDP (40-50 mg/m2) + CPT-11 (40-50 mg/m2). The therapeutic effects, side effects, a reduction of the symptoms and prognosis were examined. RESULTS: All cases were revealed as stable disease according to the rule of the RECIST. The side effect of appetite loss for over grade 2 was found in one case. The reduction of respiratory symptoms (cough, dyspnea at the movement in 3, chest pain in 1 and loss of the movement in 1) was recognized by four out of five cases. Five patients died in three to seven months after the treatment of BAI. The causes of death were the recurrence of carcinomatous pleuritis and the primary lesion or the metastasis lesion of the lung in 4 cases and the recurrence of the primary lesion in 1 case. The recurrence of the malignant pleural effusion was recognized in 1 case without intra-thoracic infusion. COMMENT: BAI was effective as a reduction of the respiratory symptoms in the high-risk patients of lung cancer with carcinomatous pleuritis. It appeared that a long-term survival was probable with the combination of BAI, intra-thoracic infusion and systemic chemotherapy.

[Carboplatin and CPT-11 chemotherapy in a hemodialysis patient with small-cell lung cancer].

We administered a dose-down chemotherapy, which was a combination of carboplatin 100 mg/body (AUC 3.0, day 1) and CPT-11 30 mg/m2 (day 1, day 15) to the patient with a poor performance status of extensive small-cell lung cancer with renal failure. Hemodialysis was performed two hours after the chemotherapy. We measured plasma levels of total-platinum and CPT-11 and metabolic products (SN-38) after the hemodialysis. The results of pharmacokinetic study showed a high level collection of total-platinum caused by carboplatin and SN-38, and that was caused by CPT-11 in the blood. Although the grade 3 of granulocytopenia was found, the decrease in tumor marker and an improvement of the ADL were confirmed. It thought that this chemotherapeutic regimen was effective for small-cell lung cancer with renal failure undergoing hemodialysis. Further study is needed for a selection of suitable chemotherapeutic regimens, an optimal dosage of each drug and timing of hemodialysis.

[Evaluation of bronchial arterial infusion (BAI) for lung cancer with brain metastasis].

MATERIALS AND METHODS: Seven high risk patients of lung cancer with brain metastasis to which BAI was done were examined. The standard systemic chemotherapy was not indicated in these cases due to the patients' systemic condition. BAI was performed using CDDP (40-80 mg/m2)+CPT-11 (40-60 mg/m2). The therapeutic effects, side effects, quality of life (QOL) and prognosis were examined. RESULTS: All cases revealed a stable disease according to the rule of the RECIST. Side effects over grade 2 were not recognized. QOL was improved because clinical effects were recognized in all seven cases with respiratory symptoms (cough in 6, dyspnea at movement in 5 and hemosputum in 1). Six patients died three-thirty months after the treatment of brain metastasis, and the median survival was twelve months. The causes of death were recurrence of brain tumor in 3, increase of primary lesion in 1, recurrence of brain tumor and increase of primary lesion in 2. The prognosis of the patient who had progressing T and N factors was bad. COMMENT: BAI was effective in keeping the quality of life for a lung cancer patient with brain metastasis. It was thought that BAI should be performed positively in the high risk patient who did not have progressing T and N factors.

[Evaluation of bronchial arterial infusion (BAI) for metastatic lung tumor from colorectal cancer].

Three cases of metastatic lung tumor from colorectal cancer with an ineffectual systemic chemotherapy were examined based on the therapeutic effectiveness and safety of bronchial infusion (BAI) as a symptomatic therapy. Two out of three cases were rectal cancer and the third case being ascending colon cancer. After the operations, each of the three cases showed a multiple lung metastases recurrence at the primary and metastatic lesions of the lung. The lung metastases became large in size and thoracic symptoms (severe cough, chest pain) appeared in spite of the systemic chemotherapy of CPT-11, 5-FU and CDDP. A low dosage of BAI was administered by using CPT-11 (40 mg/m2) + CDDP (40 mg/m2) as one shot, and was repeated (three and six times respectively) for the two cases. When the low dosage of BAI was administered, there were light side effects and no complications were observed. The average hospital stay was 7.8 days. All three patients were stable and showed improvement in the condition of the disease. The prognoses from the first BAI were 3, 6, and 9 months in all three cases, respectively. BAI using low dosage of anti-cancer agents was effective, as means of improving the chest condition and quality of life in patients with metastatic lung tumor from colorectal cancer, with an ineffectual systemic chemotherapy.