Lung cancer 1634 INDEX

Biomarkers of Disease. No biomarkers are known that are specific for BCME-induced lung injury. Standard chemical examination of nose and throat can provide an index of local irritation, and examination of sputum for abnormal cell types can provide information on the state of the respiratory epithelium. However, these tests cannot distinguish BCME-induced effects from effects caused by smoking or exposure to other chemicals, and can only discover changes after damage to the tissue has already occurred. Continued efforts to devise more sensitive and more specific early biomarkers of disease (especially lung cancer) would be valuable. 

On questioning the patient, you discover that he suffers from the more common type of lung cancer and is undergoing irradiation treatment currently. At this point you also notice that his right index and middle fingers as well as his teeth are stained yellow. 

Borak TB and Johnson JA (1988) Estimating the risk of lung cancer from inhalation of radon daughters indoors Review and evaluation. Government Reports Announcements and Index 18 pp. 1-131. 

Warner, K.A., et al.. The c-myc x E2F-l/p21 interactive gene expression index augments cyto-morphologic diagnosis of lung cancer in fine-needle aspirate specimens, J Mol Diagn, 5, 176, 2003. 

Lurtotecan (GL147211C, 7-[(4-methylpiperazine)methyl]-10,l l-(ethylenedioxy)-CPT, 13) is another example of water-soluble, synthetic derivative of CPT bearing a dioxalane moiety between C-10 and C-11 [28-30, 278], The antitumor activity of lurtotecan in Phase II trial was moderate in breast cancer patients and minimal in nrai-small-cell lung cancer patients, and no clear responses were obtained in colorectal patients [278], Better results were observed with the use of liposomal lurtotecan formulation. Such prepared drug exhibited superior levels of activity and higher therapeutic index in prechnical models [279, 280], Its clinical activity has also been confirmed in treatment of epithelial ovarian cancer [28],... 

Table 17.1 depicts nine reports on findings of increased lung cancer incidences and mortdities in both battery and smelter workers with elevated Pb exposures and one report derived from Pb exposure monitoring analysis. These cohorts and other subjects were from Britain, Finland, Italy, Sweden, and the United States. Pb exposures were indexed by actual environmental measurements in air or measurements of Pb in blood and urine. A job-exposure matrix approach was employed in part of one study using a nested case—control approach. 

Swedish smelter workers 3,979 workers, primary Cu—Pb smelter, follow-up 1958—1987. Subcohort 1 710 workers in Pb department and elsewhere Subcohort 2 383 workers only employed in Pb department Cumulative blood Pb index PbB x work duration Subcohort 1 lung cancer cases = 10 SIR = 240 (120-450) Subcohort 2 lung cancer cases = 5 SIR = 360 (120-830) Englyst et al. (2001)... 

Similarly, it is not possible at present to predict which tumours will respond to RT. Patients with lung cancer receiving RT will have a dose of RT based on, amongst other things, the size of the tumour, the patient s general health, and the localization of the tumour. Furthermore, RT is also associated with side effects. Therefore, S-FTIR spectroscopy could also be used to assess tumour cell resistance or sensitivity to RT. In this way, clinicians could deliver doses of RT based on S-FTIR spectroscopy data which would lead to an increase in the benefits of RT and a decrease in the side effects. This is known in clinical practice as the therapeutic index or ratio (the amount of a therapeutic agent that causes a therapeutic effect in relation to the amount that causes toxic effects). 

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