STUDIES ON THE TREATMENT AND CHARACTERISTICS OF THORACIC MALIGNANCIES

我们的部门已经制定了治疗和研究 胸部恶性肿瘤包括间皮瘤、转移性疾病 肺癌和食道癌。在执行第一阶段试验后 胸膜疾病的光疗法(Ann Surg Oncol1994；1：28-37)和 免疫化疗II期试验(顺铂、干扰素和 他莫昔芬：CIT治疗恶性胸膜间皮瘤(Ann Surg Onol) 1995；2：214-220)，第三阶段试验正在进行中，将最大 去髓核手术、术中光动力疗法和术后 CIT到最大限度的去髓核手术和术后CIT。这个项目有 自1993年7月以来共收治MPM患者63例。48名患者接受了治疗 (15例患者不能被除名)。此项目现已停止计提 由于预期中的负责人变动，胸科肿瘤科。中位生存期 48名患者的有效期限为14个月，而未确诊的患者为7个月 病人。在存活率或生存时间上没有显著差异 两组间的复发率。由此产生的钳工调查 来自间皮瘤的临床试验包括开发 20个新的细胞系，正在评估生长因子机制 包括胰岛素生长因子，以及CD44的存在， 透明质酸结合受体。我们还在扩大我们的 SV40等DNA病毒与MPM关系的研究 致癌，在我们最初的描述之后，我们人类MPM的60% 标本中有T抗原的DNA。这些调查包括分析 抗T抗原抗体血清中羧基的聚合酶链式反应扩增 SV40的T抗原DNA末端和增强子启动子区域 人类MPM和T-抗原-P53的关系。通过以下方式延缓肿瘤发展 利用反义技术靶向IGF-1受体的研究已有报道。 对于18名肺转移患者，隔离的I期试验 重组人肿瘤坏死因子肺灌流对小鼠肺组织的影响 论证了这种细胞因子方法的可行性和安全性 剂量不超过9毫克的送货。干扰素的新辅助试验， 顺铂、5-FU和亚叶酸钙已经完成评估 食道内超声的应用和对食道的反应率 癌症。

Our Section has developed protocols for the treatment and study of thoracic malignancies including mesothelioma, metastatic disease to the lungs, and esophageal cancer. After performing a Phase I trial of phototherapy for pleural disease (Ann Surg Oncol 1994; 1:28-37) and a Phase II trial of immunochemotherapy (cisplatin, interferon, and tamoxifen: CIT) for malignant pleural mesothelioma(MPM) (Ann Surg Oncol 1995;2:214-220), a Phase III trial has been ongoing which compares maximal debulking surgery, intraoperative photodynamic therapy, and postoperative CIT to maximal debulking surgery and postoperative CIT. This program has accumulated 63 patients with MPM since July 1993. 48 patients have treated (15 patients could not be debulked). This project is now closed to accrual due to the anticipated change in Head, Thoracic Oncology. Median survival for the 48 patients is 14 months, compared to 7 months for the undebulked patients. There are no significant differences in survival or time to recurrence between the two groups. Benchwork investigations resulting from the clinical trials in mesothelioma have included the development of 20 new cell lines, which are being evaluated for growth factor mechanisms including the insulin growth factors, and the presence of CD44, the hyaluronic acid binding receptor. We are also expanding our investigations into the relationship of DNA viruses such as SV40 and MPM carcinogenesis, after our original description that 60% of our human MPM specimens had DNA for T-antigen. These investigations include analysis of sera for antibodies to T-antigen, PCR amplification of the carboxyl terminal end of T-antigen DNA and enhancer promoter region for SV40 from human MPM, and T-antigen-p53 relationships. Delayed tumor development by targeting the IGF-1 receptor with antisense technology has been reported. For 18 patients with pulmonary metastases, a Phase I trial of isolated lung perfusion with human recombinant tumor necrosis factor has demonstrated the feasibility and safety of this method of cytokine delivery for doses up to 9 mg. A neoadjuvant trial of interferon, cisplatinum, 5-FU, and leucovorin has been completed evaluating the utility of endoesophageal ultrasound, and response rates in esophagageal carcinoma.