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Metastasis to the lung is the most common place connected with kidney cancer progression. Wherein metastasectomy is accompanied by satisfactory 5- and 10-year survival achieving 49% and 21% respectively. Pleural lesion due to this tumor develops as a part of systemic metastasis and, as a rule, is a consequence of neoplastic spread from lung parenchyma, which indicates a poor prognosis and is an indication for palliative care.

The literature and our own experience were analyzed in multimodal approach to the treatment of patients with malignant pleural mesothelioma (MPM). Survival and quality of life of patients with MPM who underwent multimodal treatment, according to modern standards, are often limited by the occurrence of local recurrences. The value of a number of local therapy methods is still being explored in order to determine the possible side effects as well as the duration of disease-free survival. Photodynamic therapy and intraoperative hyperthermic chemoperfusion of the pleural cavity are the methods of the local treatment of this disease, applied after surgery. These approaches have been investigated separately in several studies, but their efficacy and tolerability is still not clear. The authors wanted to find the best indications for the use of these methods and to assess the immediate and long-term results.

The paper describes the general experience of modern lung cancer treatment methods application. Neoadjuvant therapy was shown to improve the long-term results of stage III patients increasing the 5-year overall survival by 7,8% (p=0,012). The special diagnostic algorithm for treatment results evaluation including autofluorescence spectrometry with 97,1% sensitivity and 88,3% specificity was developed. The adjuvant external-beam radiotherapy in patients with mediastinal lymph nodes metastases was shown to increase the 5-year overall survival (14,7% versus 19,7%) (p=0,01). The combination of endotracheobronchial surgery with chemoradiotherapy allowed to increase the median survival time of patients with inoperable lung cancer to 17 months. Isolated lung chemoperfusion was shown to increase the overall (p=0,019) and relapse-free (p=0,005) survival in patients with lung metastases.

The paper deals with complex treatment for pleural malignancies with concomitant effusions. Cytoreduction and abatement of effusion, protein loss, inflammation, intoxication and pain syndrome were reported after argon-plasma electrocoagulation of the pleura followed by photodynamic therapy and hyperthermal intrapleural chemoperfusion. Stable effusion abatement effect was confirmed in all eight cases by X-ray examination and changes in homeostatic indices and breathing function as well as lowered severity of intoxication and pain. No emergency repeat intervention or pleural puncture was reported.

The paper deals with data on 191 endotracheobronchial surgeries (ETBS) in 153 patients with advanced non-small lung cancer involving breath obstruction (stage IIb--13.7%, III--71.9%, IV--14.4%). Difficulty in breathing either subsided or decreased significantly immediately after surgery. When followed by radiochemotherapy, ETBS was followed by survival median (over 14 months), both until tumor progression and during relapse-free survival. Complications were infrequent (8.5%); there was no lethality. End results were improved due to use of photodynamic therapy at the closing stage of treatment which pushed survival median to 17 months. In 11 cases (7.2%), combination of ETBS and radiotherapy rendered tumor operable; after radical surgery, survival median rose to 23 months, relapse-free survival--20 months. Postoperative radiotherapy was followed by 23.5 and 22 months of survival respectively. Hence, ETBS alone or carried out in conjunction with radiochemotherapy significantly improved (by 30-50%) quality of life in patients with advanced non-small lung cancer.

The article is devoted to a combined method of treatment of malignant tumorous lesions of the pleura accompanied by exudative pleurisy. The main result of using the method is cytoreduction, discontinuation of exudation and loss of protein, reduction of inflammation, intoxication and pain syndrome. It results from argonoplasmic electocoagulation of the pleura followed by photodynamic therapy. The treatment was used in 10 patients with a palliative aim. In all cases persistent discontinuation of the accumulation of pleural exudates was obtained that was confirmed by better state of the patient, normalization of homeostasis indices, X-ray examination data, reestablished functions of external respiration, reduced intoxication and pain syndrome. No reoperations or pleural punctures were needed.

Thirty-eight patients with disseminated skin melanoma received chemotherapy in conjunction with laser coagulation or interstitial hyperthermia of intra- or subcutaneous metastases. Use of combination therapy was followed by a rise to 37% in total response and 16%--complete regression, respectively. Most effectiveness was attained when the dacarbazine + cisplatin + BCNU + tamoxifen regime was employed. In this group of 16 patients (46%), total response was 56% and, what is most significant, 31% in complete regression. In all cases of apparent response, polychemotherapy was administered both before and after laser coagulation or interstitial hyperthermia.

The feasibilities of infrared spectroscopy of bronchoalveolar lavages were studied in patients with tuberculosis and cancer of the lung, which was based on recording the spectroscopic characteristics of phosphorus-containing products of cellular metabolism. The high integral infrared spectroscopic coefficient (over 0.8) is typical of proliferative processes, including tumoral ones.

A 45-year experience of diagnosis and treatment of lung cancer is presented. In groups at high risk of cancer, photoroentgenographic screening has proved effective. The use of out-patient complex pulmonologic examination serves to improve identification of central cancer. Early cancers of the lung can be reliably detected in 92.2% of patients with central cancer and in 92.6%-peripheral localizations of tumor. After radical surgery, 5-year survival in cases of stage I tumor was 63.5: stage II-43.5 and stage III-22.9%, mean 5-year survival (irrespective of stage) being 37%. Postoperative radiation was shown to be followed survival over 5 years in cases of non-small cell carcinoma (N2). Early diagnosis and combined therapy are key in raising efficacy of lung cancer treatment.

Endoscopic laser photodestruction is regarded not only as an independent procedure of treatment but primarily as an important and effective component of combined therapy of lung cancer. Direct-contact destruction of carcinoma of the bronchus and distal segment of the trachea has been performed using YAG:Ne lasers in 32 cases. The procedure has proved highly effective, especially, in combination with radiation therapy. Lysis of tumor in areas remote from the exposed one has been observed. It is suggested that endoscopic laser treatment of tumors offers considerable advantage.

The data concerning the changes in the circulating blood volume, globular and plasma volumes, red blood cells indices and also some indices of the external respiration function in lung cancer cases are set forth. Radiopneumography has permitted to find out some significant disorders in the regional ventilation and in the pulmonary blood flow in early postoperative period, which in case of hypoventilation is likely to cause a severe respiratory insufficiency and, therefore, requires an energetic therapeutic control.