Treatment of bronchogenic carcinoma.

Progress in the treatment of bronchogenic carcinoma, the leading cause of cancer death in men and women in the United States, has been slow throughout the past few years, and no major breakthroughs have occurred in the past 12 months. Significant developments in monoclonal antibody techniques and tissue cellular markers offer hope for improved diagnosis and are useful in staging and following disease response to treatment. Advances in patient selection and staging have been primarily responsible for improved surgical outcomes, but some new surgical alternatives like video-assisted thoracoscopy and other tissue-sparing procedures may offer reasonable outcomes with a lower morbidity. New drugs and new drug combinations are being evaluated with hematopoietic growth factors in the management of small cell lung cancer. Neoadjuvant chemotherapy and radiotherapy are finding a definite role in the management of non-small cell lung cancer. The optimal parameters for radiotherapy in the management of small cell lung cancer are being defined. The use of immunotoxins, adjuvant immunotherapy, and monoclonal antibodies offers major theoretical promise, but are as yet in the early stages of development. Ancillary techniques for palliation of local airway obstruction, including both laser and endobronchial stents, are proving beneficial in selected patients.