Intratumoral chemotherapy for lung cancer: re-challenge current targeted therapies.

Strategies to enhance the already established doublet chemotherapy regimen for lung cancer have been investigated for more than 20 years. Initially, the concept was to administer chemotherapy drugs locally to the tumor site for efficient diffusion through passive transport within the tumor. Recent advances have enhanced the diffusion of pharmaceuticals through active transport by using pharmaceuticals designed to target the genome of tumors.

Intratumoural chemotherapy of lung cancer for diagnosis and treatment of draining lymph node metastasis.

Objectives: Reviewed here is the potential effectiveness of cytotoxic drugs delivered by intratumoural injection into endobronchial tumours through a bronchoscope for the treatment of non-small cell lung cancer and the diagnosis of occult or obvious cancer cell metastasis to mediastinal lymph nodes.

Key Findings: Intratumoural lymphatic treatment may be achieved by injection of cisplatin or other cytotoxic drugs into the malignant tissue located in the lumen of the airways or in the peribronchial structures using a needle catheter through a flexible bronchoscope. This procedure is termed endobronchial intratumoural chemotherapy and its use before systemic chemotherapy and/or radiotherapy or surgery may provide a prophylactic or therapeutic treatment for eradication of micrometastases or occult metastases that migrate to the regional lymph nodes draining the tumour area.

[Endobronchial chemotherapy by direct injection of cytotoxic drugs into the tumor in lung cancer].

Intratumoral injection of one or several conventional cytotoxic drugs directly into the tumoral tissue through a flexible bronchoscope by means of an ordinary needle-catheter which is called "endobronchial intratumoral chemotherapy (EITC)" is a therapeutic paradigm of bronchoscopic interventional procedure. The achievement of intratumoral chemotherapy should never be considered merely an ablation technique of endobronchial tumor bulk alike the other endoscopic ablative procedures; but, it exerts most importantly an additional chemotherapeutic specific effect on malignant cells through the action of cytotoxic drug. Owing to its specific effect it has a similarity to brachytherapy and photodynamic therapy.

Bronchoscopic intratumoral chemotherapy of lung cancer.

Described in this review is a therapeutic procedure for localized chemotherapy of lung cancer by bronchoscopic intervention. This procedure involves the intratumoral injection of one or several conventional cytotoxic drugs directly into tumor tissue through a flexible bronchoscope by means of an ordinary needle-catheter, and is termed "endobronchial intratumoral chemotherapy" (EITC). Intratumoral (IT) chemotherapy should not be considered merely an ablation technique for treatment of endobronchial tumor bulk such as other ablative endoscopic procedures.

Endobronchial intratumoral chemotherapy (EITC) followed by surgery in early non-small cell lung cancer with polypoid growth causing erroneous impression of advanced disease.

Background: Seventeen patients with (M0) non-small cell lung cancer (NSCLC) without distant metastasis were treated by preoperative endobronchial intratumoral chemotherapy (EITC) followed by surgery. Preoperative intratumoral chemotherapy was performed for the purpose of either reducing the extent of resection or increasing operability. Clinically, in the preliminary diagnostic bronchoscopic examination, the tumor was located in the main stem bronchus closer than 2 cm to the carina [T3] in 12 patients, or at the level of carina or bulging towards the trachea [T4] in 5 patients.

Intratumoral administration of cisplatin through a bronchoscope followed by irradiation for treatment of inoperable non-small cell obstructive lung cancer.

Purpose: Patients presenting with inoperable non-small cell carcinoma of the lung associated with severe bronchial obstruction are at a high risk for developing post-obstructive pneumonia or respiratory failure. This often leads to death in weeks to months. Several studies suggest that initial use of debulking of obstructed airways by Nd-YAG laser photo resection or by cryotherapy lessens morbidity by reducing infections and respiratory insufficiencies.

Intratumoural chemotherapy with 5-fluorouracil for palliation of bronchial cancer in patients with severe airway obstruction.

Patients with tracheal or major airway obstruction owing to inoperable carcinomas are at risk of developing respiratory failure or postobstructive pneumonia. In such cases, there is an urgency to restore the airway. Bronchoscopic interventional procedures for palliation of malignant airway obstruction are becoming more common in clinical practice.

Lipid peroxidation and osmotic fragility of red blood cells in sleep-apnea patients.

Background: Obstructive sleep apnea (OSA) refers to the occurrence of episodes of complete or partial pharyngeal obstruction with oxyhemoglobin desaturation during sleep. These hypoxia/reoxygenation episodes may cause generation of reactive oxygen species. Reactive oxygen species are toxic to biomembranes and may lead to the peroxidation of lipids.

The association of the severity of obstructive sleep apnea with plasma leptin levels.

Objective: To examine whether circulating leptin levels correlate with the severity of disease in patients with obstructive sleep apnea.

Design: Prospective nonrandomized study.

Setting: Referral sleep laboratory for patients with sleep-disordered breathing and biochemistry laboratory.