Lung cancer : journal of the International Association for the Study of Lung Cancer
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In the last years, the main topoisomerase I inhibitors (TP1-I) (i.e. topotecan and irinotecan) have been used in combination chemotherapy in non-small cell lung cancer. Several drugs (also alternative to cisplatin) have been used in combination with TP1-I, but to date the higher remission rate obtained with combinations is not translated into a more prolonged survival in comparison with TP1-I given alone. ⋯ Furthermore, the best schedule for TP1-I has not been completely elucidated. Randomised studies are few (only two phase III trials) and only controlled studies will be able to clarify the best TP1-I combination regimen.
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Among all cancer, lung cancer has the highest rate of mortality in the western world. The persisting grim lung cancer mortality figures argue powerfully for new approaches for controlling this disease such as chemoprevention that has been defined as the use of agents that inhibit or reverse lung carcinogenesis. Carcinogens from cigarette smoke are implicated in about 90% of male and 75-80% of female lung cancer deaths. ⋯ The fact that 85% of heavy smokers will not develop lung cancer points to a variation in individual susceptibility. It also suggests that modulation of susceptibility might be used as a preventive strategy. This review summarizes the outcomes of recent clinical chemoprevention trials and reveals that the chemoprevention approach in lung cancer is still experimental.
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Endobronchial ultrasound (EBUS) is a new diagnostic tool, which has expanded the view of the bronchoscopist beyond the confinements of the airways. It has great potential for diagnosis of mediastinal processes and staging of lung cancer. These will be discussed and illustrated. EBUS will become a superior tool for staging of lung cancer, and several comparative studies on EBUS as compared with standard techniques in order to assess its role in the staging procedure are just on their way or already completed.
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Clinical Trial
High dose rate endobronchial brachytherapy in combination with external beam radiotherapy for stage III non-small cell lung cancer.
A phase-II study was planned to test the effect of external beam radiotherapy in combination with endobronchial brachytherapy on the local control and survival of stage-III non-small cell lung cancer patients. ⋯ It is concluded that endobronchial brachytherapy in combination with external irradiation provides a good rate of response, however does not eradicate locoregional disease and does not prolong survival except for some subgroups such as younger patients.