J.Jpn. Surg. Soc.. 88(9): 1213-1216, 1987

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Report on the annual meeting

PRE- AND POST-OPERATIVE ADJUVANT THERAPY FOR PATIENT WITH ADVANCED LUNG CANCER THROUGH INDUCTION OF TUMORICIDAL ACTIVITY

Between 1973 and 1986, 223 cases of stage III lung cancer were operated on. The five-year-survival rates of those which underwent curative resection were 28.8％, whereas that of T1NO lesion in stage I was 84.8％.To improve the surgical outcome of the advanced lung cancer, pre- and post-operative adjuvant therapy were applied by systemic and local administration.
Statistically significant improvement of the survival rates by systemic immunotherapy using Streptococcal preparation, OK-432 were noticed on the following categories : Resected stage III cases, curatively resected cases, incompletely resected cases, and cases with epidermoid carcinoma.
In vitro study, cytotoxic activity of lymphocytes taken from the regional Iymphnode (RLNL) in the lung cancer patient were markedly enhanced by incubation for five days with rlL-2 or OK-432 through induction of lymphokine activated killer cell (LAK cell). In addition, ability of IL-2 production in RLNL (stimulated by PHA or OK-432) was 10 to 100 times higher than that of the peripheral lymphocytes in healthy adults or lung cancer patients. Based on these experimental study, in vivo induction of LAK was attempted on fifteen cases in stage III lung cancer by preoperative infusion of OK-432 through the bronchial artery. This local treatment was specially effective in the cases with squamous cell carcinoma and complete disappearance of the viable tumors cells was observed in two cases.
From the results of our present investigation, it was concluded that pre- and postoperative adjuvant therapy by enhancement of the Iocal and systemic immunological tumoricidal activity could bring improvement of the survival rates of the surgical result of the advanced lung cancer.

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