[Surgery and adjuvant therapy of non-small cell lung cancer]

Bronchial arterial infusion of chemotherapeutic agents (BAI), radiation therapy, chemotherapy and immunotherapy were used as surgical adjuvant therapy for non-small cell lung cancer, and the clinical effects of these treatment modalities on survival rates were evaluated. BAI brought about a decrease of tumor size, but no significant effect on survival rats was noted. Postoperative radiation therapy on P-N2 cases exerted no significant effect on the survival rate, but when immunotherapy was combined with radiation therapy, there was a significant prolongation of the survival rate. As for post-operative chemotherapy, three types of combination chemotherapy have been performed over the past twelve years: short-term chemotherapy (S-C), long-term intermittent chemotherapy (L-I-C), and long-term continuous chemotherapy (L-C-C). Retrospective comparison of survival rates between these three methods was carried out. The survival rate of the group which was treated by L-I-C showed better results than those obtained by S-C. The group treated by L-C-C showed a much better survival rate than that treated by L-C-C: Stage I + II cases that underwent curative resection and were treated by L-I-C showed a significantly better survival rate than those treated by S-C. Furthermore, the survival rate of stage III cases with curative resection was improved by L-C-C (CQ+CPA+ADM+5-FU) with statistical significance. To evaluate the clinical efficacy of OK-432, a streptococcal preparation, as an immunotherapeutic agent for lung cancer, patients admitted between 1975 and 1982 were randomized into two groups: (1) an immunochemotherapy group and (2) a chemotherapy group (control group). For both groups, the same L-I-C was administered in accordance with the cancer histological cell type. There were 119 resected cases in the immunochemotherapy group and 115 cases in the control group, that were eligible for evaluation of long-term survival after surgery. Overall, the cases in the immunochemotherapy group showed a better survival rate than the control group, and this difference was statistically significant. In addition, statistically significant improvements of survival rate by the immunotherapy were observed for the following items; resected stage I + II cases, resected stage III + IV cases, cases with curative resection, cases with non-curative resection and resected epidermoid carcinoma. On the other hand, there were no statistically significant differences between the two groups in cases of adenocarcinoma.(ABSTRACT TRUNCATED AT 400 WORDS)