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Radiation Enhancement by The Combined Use of CPT-11 and Etoposide in Human Lung Cancer Cells.

Jae Sung KIM ; Jun Sang KIM ; Moon June CHO

Journal of Lung Cancer.2002;1(1):60-65.

PURPOSE: To evaluate the radiation enhancement by a combination of CPT-11 and etoposide, with in vitro ionizing radiation. MATERIALS AND METHODS: H460 human lung carcinoma cells were plated, and treated with 4.5 microM CPT-11 for 4 hr, then irradiated with various doses of radiation, and treated with 1microM etoposide for 1.5 hr. The survival and sublethal damage recovery (SLDR) were determined by a clonogenic assay. The analysis of apoptosis, due to the combined treatment with drugs and radiation, was performed using 7-AAD staining and flow cytometry. RESULTS: The survival experiments resulted in radiation dose enhancement ratios (DER) of 1.30, 1.39, and 1.65 for CPT-11, etoposide, and CPT-11 plus etoposide, respectively. The analysis of apoptosis, using 7-AAD staining and flow cytometry, indicated an synergistic effect. Inhibition of the SLDR was not observed with the CPT-11 plus etoposide. CONCLUSION: These data show that the combination of CPT-11 and etoposide is a more effective radiation enhancer in human lung cancer cells than either agent used individually in human lung cancer cells. This radiation enhancement is not caused by the inhibition of the SLDR, but other mechanisms may be involved in the combined treatment of CPT-11 and etoposide combined treatment.
Apoptosis ; Etoposide* ; Flow Cytometry ; Humans* ; Lung Neoplasms* ; Lung* ; Radiation, Ionizing

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K-ras Gene Mutation in Non-Small Cell Lung Cancer.

Hyo Joong YOON ; Jin Young JU ; Gye Jung CHO ; Eun Joung KIM ; Kyung Hwa PARK ; Kyu Sik KIM ; Young Choon KO ; Sung Chul LIM ; Young Chul KIM ; Kyung Ok PARK ; Jong Tae PARK

Journal of Lung Cancer.2002;1(1):55-59.

PURPOSE: Point mutation of the K-ras gene causes irreversible binding of GTP to the P21-ras protein, which induces nuclear transcription factors and enhances cellular proliferation. Point mutation of the K-ras gene is known to be a poor prognostic marker of an adenocarcinoma of the lung. As about 30% of adenocarcinomas harbor the K-ras mutation, studies are being undertaken trying to use the K-ras mutation as a marker for the early detection of lung cancer. In Korea, squamous cell carcinomas are more prevalent than adenocarcinomas, but the incidence of the K-ras mutation has not been properly investigated. MATERIALS AND METHODS: Using 25 surgically resected lung cancer specimens (10 squamous cell lung carcinomas, 10 adenocarcinomas and 5 non-small cell lung cancers), 25 pairs of DNA were extracted from cancerous and normal lung tissues. After PCR, with two sets of primers flanking codons 12~13 and 61 of the K-ras gene, the mutation was screened using single strand conformational polymorphism (SSCP). To verify the SSCP findings, automatic sequencing was also performed for all DNA's from the tumor and normal lung tissues. RESULTS: No samples with a band shift in SSCP were observed. In the sequencing of the 25 pairs of DNA, there were no mutations in codons 12, 13 or 61 of the K-ras gene. CONCLUSION: As there were no mutations in the K-ras codons 12, 13 and 61 in this study, the incidence of the K-ras mutation, in Korean lung cancer, may well be very low. However, further investigations on a larger population will be required, as we only studied 25 non-small cell lung cancer specimens, with only 10 adenocarcinomas.
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cell Proliferation ; Codon ; DNA ; Genes, ras* ; Guanosine Triphosphate ; Incidence ; Korea ; Lung ; Lung Neoplasms ; Point Mutation ; Polymerase Chain Reaction ; Polymorphism, Single-Stranded Conformational ; Transcription Factors

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Fractionated Stereotactic Radiotherapy for Metastatic Brain Tumor in Non-Small Cell Lung Cancer.

Moon June CHO ; Ki Hwan KIM ; Jun Sang KIM ; Seon Hwan KIM ; Shi Hun SONG ; Chang Joon SONG ; Seung Pyung LIM ; Sun Young KIM ; Jae Sung KIM

Journal of Lung Cancer.2002;1(1):48-54.

PURPOSE: To evaluate the results of treatment with fractionated stereotactic radiotherapy for metastatic brain tumors in non-small cell lung cancer. MATERIALS AND METHODS: Between August 1997 and August 2001, 17 patients, with metastatic brain tumors in non-small cell lung cancer (26 lesions), completed frameless fractionated stereotactic radiotherapy. All patients received a 30~36 Gy/10~20 fx external beam irradiation to the whole brain. Twelve received fractionated stereotactic radiotherapy for a single lesion, 3 for 2 lesions and 1 each for 3 and 5 lesions. The median tumor volume was 1.7 cc (0.3~55.2 cc). The fractionation schedule for the fractionated stereotactic radiotherapy was 21 Gy/3 fx in 8 lesions, 25 Gy/5 fx in 7, 18 Gy/1 fx in 6, 30 Gy/5 fx in 4 and 15 Gy/5 fx in 1. Multiple-arc, and 3D conformal, fractionated stereotactic radiotherapy, were delivered to 24 and 2 lesions, respectively. Follow-up was possible in all patients. RESULTS: Nine out of 13 patients with follow-up radiological evaluations achieved a complete response (CR). The overall median survival, and 1 and 2 year survival rates were 20 months, and 64 and 28%, respectively. The median survival, and the 1 and 2 year survival rate of CR group were 20 months, and 73 and 22%, respectively. No patient has experienced any acute side reactions or late complications from the fractionated stereotactic radiotherapy. CONCLUSION: Although the number of patients treated with fractionated stereotactic radiotherapy was small, and follow-up period short, this study suggests that external beam irradiation to the whole brain, with 30 Gy/10 fx followed by fractionated stereotactic radiotherapy, could be a good treatment option for patients with metastatic brain tumors in non-small cell lung cancer.
Appointments and Schedules ; Brain Neoplasms* ; Brain* ; Carcinoma, Non-Small-Cell Lung* ; Follow-Up Studies ; Humans ; Radiotherapy* ; Survival Rate ; Tumor Burden

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Preliminary Results of Stereotactic Body Frame Based Fractionated Radiosurgery on Consecutive Days for Primary Lung Cancer or Metastatic Lung Tumors.

Sang Wook LEE ; Eun Kyung CHOI ; Heon Joo PARK ; Seung Do AHN ; Jong Hoon KIM ; Kyung Ju KIM ; Sang Min YOON ; Young Seok KIM ; Byong Yong YI

Journal of Lung Cancer.2002;1(1):41-47.

To evaluate the feasibility and treatment outcomes of stereotactic radiosurgery (SRS) using a stereotactic body frame (Precision TherapyTM), we prospectively reviewed 34 tumors of the 28 patients with primary or metastatic intrathoracic lung tumors. Eligible patients included were 9 with primary lung cancer and 19 with metastatic tumors from the lung, liver and many other organs. A single dose of 10 Gy to the clinical target volume (CTV) was delivered to a total dose of 30~40 Gy with 3~4 fractions. Four to 8 coplanar or non-coplanar static fields were generated to adequately cover the planning target volume (PTV) as well as to exclude the critical structures as much as possible. More than 90% of the PTV was delivered the prescribed dose in the majority of cases (average; 96%, range; 74%~100%). The mean PTV was 41.4 cc ranging from 4.4 to 230 cc. Set-up error was within 5 mm in all directions (X, Y, Z axis). The response was evaluated by using a chest CT and or 18FDG-PET scans after SRS treatment, 11 patients (39%) showed complete response, 12 (43%) partial response (decrease of more than 50% of the tumor volume), and 4 patients showed minimally decreased tumor volume or stable disease, but 1 patient showed progressive disease. With a median follow-up period of 18 months, a median local disease progression free interval was 18 months ranging from 7 to 35 months. Although all patients developed grade 1 radiation pneumonitis within 3 months, none had symptomatic or serious late complications after completing SRS treatment. Given these observations, it is concluded that the stereotactic body frame based SRS is a safe and effective treatment modality for the local management of primary or metastatic lung tumors. However, the optimum total dose and fractionation schedule used should be determined after the longer follow-up of these results.
Appointments and Schedules ; Disease Progression ; Follow-Up Studies ; Humans ; Liver ; Lung Neoplasms* ; Lung* ; Prospective Studies ; Radiation Pneumonitis ; Radiosurgery* ; Tomography, X-Ray Computed ; Tumor Burden

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Postoperative Adjuvant Chemotherapy and Radiotherapy for Stage II and III Non-Small Cell Lung Cancer (NSCLC).

Jin Hong PARK ; Sang Wook LEE ; Eun Kyung CHOI ; Weon Kuu CHUNG ; Kyung Hwan SHIN ; Seung Do AHN ; Jong Hoon KIM ; Sang We KIM ; Cheolwon SUH ; Jung Shin LEE ; Woo Sung KIM ; Dong Soon KIM ; Dong Kwan KIM ; Seung Il PARK ; Kwang Hyun SOHN

Journal of Lung Cancer.2002;1(1):34-40.

PURPOSE: The role of postoperative adjuvant chemo-radiotherapy in the treatment of patients with non-small cell lung cancer (NSCLC) remains unclear. This study was undertaken to evaluate the survival outcomes, relapse patterns, prognostic factors and complications of postoperative adjuvant MVP chemotherapy and radiotherapy. MATERIALS AND METHODS: The study involved some 96 patients who had undergone curative resection of stage II and III NSCLC between 1991 and 1996. Among these, 94 patients who completed their adjuvant treatment were analyzed. Surgery consisted of pneumonectomy (33%), single lobectomy (54%) or bilobectomy (13%). Within 4 weeks of curative resection, two cycles of MVP chemotherapy (mitomycin C 8 mg/m2, vinblastine 8 mg/m2, cisplatin 60 mg/m2) were started at 4 weeks intervals. Conventionally fractionated radiotherapy was given 3 weeks after chemotherapy to a total dose of 50 Gy in completely resected patients and 55~60 Gy in patients with positive resection margins. RESULTS: The TNM classification of the AJCC, as revised in 1997, was used for pathologic staging. The number of patients at AJCC stages IIa, IIb, IIIa, and IIIb were 4, 40, 45, and 5, respectively. A pathologically positive bronchial resection margin was found in nine patients. At the time of analysis, death was recorded in 29 patients (31%), though five had died without evidence of lung cancer. Overall 2-year, 3-year, and 5-year survival rates for all patients were 74.2%, 70.2%, and 65%, respectively, locoregional diseasefree survival (LRDFS) rates were 88.6%, 83.7%, 74.3%, at 2-years, 3-years, and 5-years, and distant metastasis disease-free survival (DMDFS) rates were 67.7%, 65.0%, and 63.6%, respectively. In the multivariate model, a primary tumor size of more than 5 cm and the level of pathologically positive nodes were found to be associated with poor overall survival, LRDFS and DMDFS. Although positive bronchial resection margin affected overall survival, LRDFS and DMDFS were unaffected. With respect to the first site of relapse, distant metastasis occurred more frequently (N=33, 35%) than locoregional recurrence (N=15, 16%). Grade 3 esophagitis in two patients and weight loss of more than 10% in five patients were observed during adjuvant treatment. Grade 4 pulmonary toxicity was observed in one patient after radiotherapy and this patient ultimately died 5 months after treatment. CONCLUSION: The postoperative adjuvant MVP chemotherapy and radiotherapy regimen showed relatively low locoregional recurrence and distant metastasis rates and good survival rate with acceptable toxicity. A prospective randomized trial, which compares this regimen to surgery alone or postoperative adjuvant radiotherapy is needed.
Carcinoma, Non-Small-Cell Lung* ; Chemotherapy, Adjuvant* ; Cisplatin ; Classification ; Disease-Free Survival ; Drug Therapy ; Esophagitis ; Humans ; Lung Neoplasms ; Neoplasm Metastasis ; Pneumonectomy ; Prospective Studies ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence ; Survival Rate ; Vinblastine ; Weight Loss

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A Case of Lung Squamous Cell Carcinoma Mimicking Benign Solitary Cyst.

Ji Young PARK ; Taehoon LEE ; Hong Yeul LEE ; Hyo Jeong LIM ; Jong Sun PARK ; Young Jae CHO ; Ho Il YOON ; Jae Ho LEE ; Kyung Won LEE ; Bo Seong KIM ; Jin Haeng CHUNG ; Kwhanmien KIM ; Choon Taek LEE

Journal of Lung Cancer.2012;11(2):108-110. doi:10.6058/jlc.2012.11.2.108

Lung cancer with cyst formation is a rare entity. We report a 63-year-old man who underwent surgical treatment of primary lung cancer, which mimics benign solitary cyst. We incidentally found his pulmonary cyst by a low dose chest tomography and followed up for 2 years. Rapid growth of cyst and focal wall thickening evoke us to have a suspicion of its malignancy. Left lower lobectomy via video-assisted thoracoscopic surgery was performed without any preoperative pathologic confirmation. The postoperative pathological finding revealed squamous cell carcinoma with carcinoma in situ on the cyst wall. We emphasize the need for physicians to be aware of the potential of lung cancer in patients with growing pulmonary cyst.
Bone Cysts ; Carcinoma in Situ ; Carcinoma, Squamous Cell ; Humans ; Lung ; Lung Neoplasms ; Thoracic Surgery, Video-Assisted ; Thorax

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Extra-Adrenal Paravertebral Thoracic Myelolipoma.

Jung Won MOON ; Joungho HAN ; Chin A YI ; Yong Soo CHOI

Journal of Lung Cancer.2012;11(2):105-107. doi:10.6058/jlc.2012.11.2.105

Extra-adrenal myelolipoma is a rare benign tumor which can occur in the abdomen, thorax, or even in the face. We present a case of 58-year-old woman patient with thoracic myelolipoma, which has manifested as three paravertebral masses at the level of T9 and T10. The computed tomography scan showed heterogenous enhancing masses, which contained fat component. She underwent video-assisted thoracoscopic surgery, and the pathologic examination revealed adipose tissue with many hematopoietic cells, consistent with myelolipoma.
Abdomen ; Adipose Tissue ; Female ; Humans ; Myelolipoma ; Thoracic Surgery, Video-Assisted ; Thorax

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Solitary Capillary Hemangioma of the Lung: A Report of Two Cases.

Hyun Woo LEE ; Soomin AHN ; Young Mog SHIM ; Yong Soo CHOI ; Kyung Soo LEE ; Joungho HAN

Journal of Lung Cancer.2012;11(2):102-104. doi:10.6058/jlc.2012.11.2.102

It has long been recognized that tumors of capillary vessels in the lung are extremely rare. While pulmonary capillary hemangiomatosis, which is a rare cause of pulmonary hypertension, is relatively well known, there have been only a few reports of solitary capillary hemangioma (SCH) of the lung. Herein we report two cases of SCH. Both cases were first detected as a solitary nodule of the lung in chest computed tomography images. Both lesions were recognized as early lung cancer and surgical resections were performed. At low power view, one was not encapsulated but was well delineated from the non-neoplastic lung and the other was pseudo-capsulated. Both tumors consisted of uniform capillaries with cuboidal or flattened endothelial cells. There was no cytologic atypia. Endothelial cells were highlighted by CD31 stain. Awareness of this entity is important for pathologists for differential diagnosis of a solitary pulmonary nodule.
Capillaries ; Diagnosis, Differential ; Endothelial Cells ; Hemangioma ; Hemangioma, Capillary ; Hypertension, Pulmonary ; Lung ; Lung Neoplasms ; Solitary Pulmonary Nodule ; Thorax

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Bilateral Diffuse Radiation Pneumonitis Caused by Unilateral Thoracic Irradiation: A Case Report.

Sung Heon SONG ; Yoon Jung OH ; Chang Won HA ; Soo Min CHAE

Journal of Lung Cancer.2012;11(2):97-101. doi:10.6058/jlc.2012.11.2.97

Radiation therapy is one of the most important therapeutic modalities for the treatment of lung cancer. Radiation pneumonitis is one of the important complications associated with radiotherapy for lung cancer. Radiation pneumonitis is generally limited to the irradiated lung and is manifested by the insidious onset of dry cough, dyspnea, and mild fever, resulting in damage and edematous changes of alveolar structures on histologic inspection. Clinically, diffuse bilateral radiation pneumonitis accompanied with acute symptoms after unilateral thoracic irradiation appears very rarely. Histopathologic examinations for the diagnosis of out-of-field radiation pneumonitis are rarely performed. We herein describe a case of extensive bilateral radiation pneumonitis which developed acutely after salvage radiotherapy for squamous cell carcinoma in the left upper lobe of the lung. The condition was confirmed by a diagnostic help of histopathologic findings.
Carcinoma, Squamous Cell ; Cough ; Dyspnea ; Fever ; Lung ; Lung Neoplasms ; Radiation Pneumonitis

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Mixed Squamous Cell and Glandular Papilloma Presented with Peripheral Lung Mass: A Case Report.

Si Hyong JANG ; Tae Sung KIM ; Jae Ill ZO ; Joungho HAN

Journal of Lung Cancer.2012;11(2):94-96. doi:10.6058/jlc.2012.11.2.94

Mixed squamous cell and glandular papilloma is a rare pulmonary neoplasm typically occurring in the central lung area. Herein, we report a case of peripherally located mixed papilloma in a 54-year-old man with a complaint of dyspnea. Chest computed tomography demonstrated an infiltrative peripheral lung mass in the right middle lobe, measuring 1.5 cm in diameter. The resected lung tumor had papillary configuration lined by both squamous cell epithelium and mucin-containing glandular epithelium. The papillary stroma showed a fibrovascular core with inflammatory infiltrates. p63 immunostaining was positive in basal and parabasal tumor cells in papillary fronds.
Dyspnea ; Epithelium ; Lung ; Lung Neoplasms ; Papilloma ; Thorax

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