High-dose concurrent chemo-proton therapy for Stage III NSCLC: preliminary results of a Phase II study.

The aim of this report is to present the preliminary results of a Phase II study of high-dose (74 Gy RBE) proton beam therapy (PBT) with concurrent chemotherapy for unresectable locally advanced non-small-cell lung cancer (NSCLC). Patients were treated with PBT and chemotherapy with monthly cisplatin (on Day 1) and vinorelbine (on Days 1 and 8). The treatment doses were 74 Gy RBE for the primary site and 66 Gy RBE for the lymph nodes without elective lymph nodes.

Early-stage thymic carcinoma: is adjuvant therapy required?

Although the prognosis of advanced thymic carconoma remains poor, previous reports have shown survival rates of 70% to 100% in patients with Masaoka stage I or stage II of the disease who were treated with surgery followed by adjuvant therapy. However, the role of adjuvant therapy in these stages is controversial. We retrospectively evaluated the outcome of 4 patients with Masaoka stage II thymic carcinoma who were treated with surgery alone between 1992 and 2008.

Significant correlation between endothelial nitric oxide synthase (eNOS) expression and alveolar repair in elastase-induced rat pulmonary emphysema.

Background And Purpose: Angiogenic factors, such as endothelial nitric oxide synthase (eNOS), are thought to play an important role in the repair of pulmonary emphysema (PE); yet, the correlation of the factors involved has not been investigated. We conducted this study to clarify the positive correlation between eNOS expression and alveolar repair in PE recovery.

Methods: We used elastase to induce PE in rats, which were divided into Groups A (Control), B (G-CSF), C (PE) and D (PE + G-CSF).

Expression of a splicing variant of the CADM1 specific to small cell lung cancer.

CADM1, a member of the immunoglobulin superfamily cell adhesion molecule, acts as a tumor suppressor in a variety of human cancers. CADM1 is also ectopically expressed in adult T-cell leukemia (ATL), conferring an invasive phenotype characteristic to ATL. Therefore, CADM1 plays dual roles in human oncogenesis.

Preoperative lymphocyte count is an independent prognostic factor in node-negative non-small cell lung cancer.

A number of prognostic factors have been reported in non-small cell lung cancer (NSCLC). Although lymph node metastasis is the most poorly predictive value in completely resected NSCLC, a significant number of patients have a fatal recurrence even in node-negative curative NSCLC. Recently inflammatory response has been shown as a predictive value in NSCLC.

Postoperative follow-up for patients with non-small cell lung cancer.

Background: It is unclear whether postoperative follow-up by thoracic surgeons or chest physicians for non-small cell lung cancer (NSCLC) alters survival.

Patients And Methods: The charts of 1,398 NSCLC patients, diagnosed between 1980 and 2008, were reviewed. Prognostic factors contained therein were evaluated using univariate and multivariate analyses.

Limited thymectomy for stage I or II thymomas.

Background: Once an anterior mediastinal tumor has been diagnosed as a thymoma, complete excision including the thymic gland and perithymic fat is currently the procedure of choice. However, little is known about the clinical outcome of grossly encapsulated thymomas excised only with the surrounding tissue while leaving a part of the thymic gland.

Methods: A retrospective historical comparative study was conducted on 79 patients who had received surgery for stage I (n=25) or stage II (n=54) thymomas.

Blood flow velocity is reduced in a tumor micro-dissemination in the visceral pleura in anesthetized open-chest rat lung.

Background: Recently we developed a method to observe pulmonary micrometastasis by labeling cancer cells with green fluorescent protein (GFP). We applied the method for observation of micro-dissemination on the visceral pleura.

Materials And Methods: RCN9 rat colon cancer cells labeled with GFP were injected into the pleural cavity of Fischer F344 rats.

Pathologic radioresponse of preoperatively irradiated invasive thymomas.

Background: We have been applying preoperative radiotherapy (RT) to Masaoka stage III thymomas intending to make surgical resection more complete by reducing mass volume, to prevent possible dissemination caused by surgical manipulation and to get better survival as a result. However, the radioresponses vary from tumor to tumor. We hypothesized that thymoma is a variable radioresponsive tumor depending on pretreatment histology.

Prone positioning improves distribution of pulmonary perfusion: noninvasive magnetic resonance imaging study in healthy humans.

The purpose of this study was to evaluate the effects of prone positioning on pulmonary perfusion using flow-sensitive alternating inversion recovery (FAIR), a noninvasive magnetic resonance imaging technique that requires no contrast medium. Seven healthy volunteers were studied in the supine and prone positions under three respiratory conditions: normal breathing of room air, unassisted breathing of 45% O2, and controlled mechanical ventilation (CMV) with positive end-expiratory pressure. Signal intensities (SIs) were obtained from ventral, middle, and dorsal regions on sagittal lung images and dependent/nondependent SI ratios were calculated to evaluate pulmonary perfusion distribution.

Preoperative CYFRA 21-1 levels as a prognostic factor in c-stage I non-small cell lung cancer.

Objective: The clinical importance of preoperative CYFRA 21-1 measurement in early-stage non-small cell lung cancer (NSCLC) is still unclear. The aim of this study is to clarify the prognostic value of preoperative CYFRA 21-1 levels in clinical stage (c-stage) I NSCLC.

Methods: The records of 101 c-stage I NSCLC patients who had undergone complete resection were analyzed to correlate preoperative CYFRA 21-1 levels to both the pathologic factors of resected specimens and postoperative outcomes.

Preoperative TNM evaluation of peripheral clinical stage I small cell lung cancer treated by initial lobectomy with adjuvant chemotherapy.

Surgery with chemotherapy has been the accepted procedure for treating pathological stage I small cell lung cancer. However, there is a question of whether all clinical stage I patients should undergo surgery or not because of discrepancies between clinical and pathological staging. We conducted a retrospective analysis of TNM evaluation and postoperative survival on 10 clinical stage IA (T1N0M0) and 6 stage IB (T2N0M0) patients who had undergone initial lobectomy followed by chemotherapy.

In vivo observation of pulmonary micrometastasis of colon cancer in normal rats.

The initial kinetics of cancer cell metastasis to organs requires investigation to establish an effective strategy against malignant disease. In vivo observation of pulmonary micrometastasis at an extremely early stage is of particular importance, and it is desirable from a clinical perspective to use an animal model with a normal immune system. RCN-9 cells labeled with green fluorescent protein were injected into the liver parenchyma of Fischer F344 male rats and the lungs were observed using real-time confocal laser scanning microscopy from 3 to 10 weeks after injection.

Carcinomatous meningitis from non-small-cell lung cancer responding to gefitinib.

The prognosis for carcinomatous meningitis remains poor, and focal neurological dysfunctions usually do not improve despite the available treatment options. We report a case of carcinomatous meningitis from non-small-cell lung cancer treated with gefitinib, which brought about a sustained clinical response. A 40-year-old Japanese man was diagnosed with adenocarcinoma in the right lower lobe of the lung, and with multiple pulmonary and brain metastases.

Excision after chemoradiotherapy of invasive thymoma extending into the right atrium: report of a case.

We report a case of invasive thymoma with intracardiac extension, resulting from the progression of intracaval growth, in a 56-year-old woman. Initially, the patient received two courses of chemotherapy, but the tumor showed only a modest response; however, subsequent radiotherapy reduced the tumor size further and the intracardiac lesion disappeared, making it possible to excise the tumor without cardiopulmonary bypass. Thus, when a thymoma does not respond well, we recommend radiotherapy as another treatment option, because its effects may allow for less invasive and more complete tumor excision.

Effectiveness of steroid treatment for hoarseness caused by idiopathic fibrosing mediastinitis: report of a case.

A 65-year-old woman was referred to our department for investigation and treatment of hoarseness. A chest computed tomography (CT) scan showed a mediastinal mass spreading into the aortopulmonary window. This finding and that of flexible laryngoscopy suggested that the hoarseness was being caused by left recurrent nerve involvement resulting in left vocal cord paralysis.

Hypermethylation of the TSLC1/IGSF4 promoter is associated with tobacco smoking and a poor prognosis in primary nonsmall cell lung carcinoma.

Background: The tumor suppressor gene TSLC1/IGSF4 on chromosomal region 11q23 is frequently inactivated by promoter methylation in various cancers, including nonsmall cell lung carcinoma (NSCLC). Several studies have demonstrated that the hypermethylation of the CpG islands of genes, including tumor suppressors, is associated with exposure to tobacco smoke. The purpose of this study was to investigate the possible association of TSLC1/IGSF4 methylation with tobacco smoking as well as with the clinical characteristics of tumors using a large number of primary NSCLC.

Prognostication of small-sized primary pulmonary adenocarcinomas by histopathological and karyometric analysis.

To reveal useful prognostic factors in cases of small-sized pulmonary adenocarcinoma, we conducted a histological and karyometric analysis of 116 small-sized pulmonary adenocarcinomas measuring less than 2 cm in maximum diameter and four specimens of atypical adenomatous hyperplasia (AAH). The small-sized pulmonary adenocarcinomas were classified by using criteria described previously [Noguchi M, Morikawa A, Kawasaki M, et al. Small adenocarcinoma of the lung.

Promoter methylation of DAL-1/4.1B predicts poor prognosis in non-small cell lung cancer.

Purpose: DAL-1/4.1B is an actin-binding protein originally identified as a molecule whose expression is down-regulated in lung adenocarcinoma. We have previously shown that a lung tumor suppressor, TSLC1, associates with DAL-1, suggesting that both proteins act in the same cascade.

A direct measurement of serum amylase levels produced by lung cancer.

The production of amylase by lung cancer has been previously diagnosed pathologically or immunohistochemically, or it has been confirmed by a decrease in serum levels after resection. It is possible to directly probe the continuous production of amylase by collecting samples from the inflow and outflow vessels of lung cancer. We herein describe an intraoperative measurement in which the amylase level in the pulmonary lobar vein was 3 times greater than that in the superior vena cava which was 6 times greater than the normal range.

Diffuse pulmonary hamartoma: a case report.

Pulmonary hamartoma usually occurs as a benign, well-circumscribed single nodule in the lung parenchyma. We report on a unique case of hamartoma that extended along the bronchial tree, formed endobronchial polypoid lesions, and expanded into the lung parenchyma. The patient, a 48-year-old man, was admitted with dyspnea and chest pain.

Primary chondrosarcoma of the lung recognized as a long-standing solitary nodule prior to resection.

As the use of computed tomography (CT) increases, incidental lung nodules have become a clinical issue that is being addressed more than before. We detected a solitary lung nodule which was smooth-margined, round-shaped, 11 mm in size. Follow-up for 18 months after initial detection by chest CT did not show any interval change.