Hong Kong

Hong Kong

196 Toronto, Canada, 1985. 12. ii. Sculier, J.P., Klastersky, J., Stryckmans, P. et Sculier, J.P., Klastersky, J., Stryckmans, al. Late intensif...

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Toronto, Canada, 1985.



Sculier, J.P., Klastersky, J., Stryckmans, P. et

Sculier, J.P., Klastersky, J., Stryckmans,

al. Late intensification in small-cell lung cancer:

P. et al. Chimioth4rapie intensive tar-

a phase I study of high doses of cyclophosphamide

dive avec autogreffe de moelle. Etude

and etoposide with autologous bone marrow trans-

pilote dans les cancers bronchiques ana-


plasiques ~ petites cellules.

J. Clin. Oncol. 3: 184-191, 1985.

La Presse M~dicale 12: 677-680, 1983.

HONG KONG In Hong Kong, 98 per cent of the 5.5

carcinoma and smoking habits, and 61% of adeno-

million population are Chinese, and ma-

carcinoma cases were life-long non-smokers (3).

lignant neoplasms are the leading cause

Even more intriguing is the observation that a lar-

of death, followed by cardiovascular dis-

ge proportion of our female adenocarcinoma cases

eases and cerebrovascular diseases. Lung

showed clinical, roentgenographic and bronchoscopic

cancer is the commonest lethal malignant

features of a centrally situated tumour

disease in both sexes, and accounted for

This may suggest that an inhaled carcinogen other

(3, 5).

30% of the male and 24% of the female

than that from active cigarette smoking is opera-

cancer deaths in 1983 (I). The mortality

tive in the genesis of lung cancer in our female

rate of lung cancer in men in Hong Kong

patients. Passive smoking was not found to play

is 'medium' in world ranking (2), but

a role in 1 study (6), but in another (7), passi-

that in women is the highest in the world

ve smoking from a smoking husband was shown to be

(95/100,000 population of age > 45 years),

associated with adenocarcinoma of the peripheral

followed by Cuba (73/100,000) and Scot-


land (67/100,000)

other environmental factors, including the use


Several groups of workers in Hong Kong

(p = 0.02). Investigations into the role of

of kerosene stove for cooking (7, 8), burning of

have been engaging in clinical research

incense in the home

in lung cancer, including the University

residence (8), have so far been negative or incon-

(7), occupation and place of

of Hong Kong, the Government Chest Ser-

clusive. Likewise, despite the relatively high

vice and Institute of Radiology and Onco-

incidence of tuberculosis in Hong l
logy, and more recently the new medical

tion rate 144/100,000 population in 1982) and

school in the Chinese University of Hong

the suggestion that adenocarcinoma may arise from

Kong which had her first intake of stu-

tuberculous scars, scar cancer has not been found

dents in 1981. Several reports on patho-

to contribute to the high incidence of adenocar-

logy and epidemiology have recently been

cinoma in our patients (9). Further studies in

published. Two studies (3, 4) confirmed

this direction include a large, multicentre study

the low male to female sex ratio of our

on passive smoking and lung cancer, and a study of

patients (1.9-2.1: i), and highlighted

genetically determined susceptibility factors,

the preponderance of adenocarcinoma in

such as HLA. The latter study has just been com-

our female patients (55%). Interestingly,

pleted and submitted for publication. The results

there is no association between adeno-

have again been negative.


Although chemotherapy in lung cancer has been given to our patients since

between research workers in Hong Kong and Canton and other centres in China.

early 1970ies, formal protocol studies did not start until 1978 in the Depart-


ment of Medicine, University of Hong


Kong. For small cell carcinoma, MACC regi-

Hong Kong Government: Annual Report, Hong Kong


Chest Service of the Medical and Health Department,



became the standard treat-


ment after it was shown to produce 74%


response rate and 50 weeks overall median

Benjamin B. Trends & differentials in lung cancer



(i0). Prophylactic cranial irra-

diation is given in patients with complete

World Health Stat. Rep.: 30: 118-145, 1977.



and about 8% of patients have

survived over two years. A study of eto-

Lam, W.K., So, S.Y., Yu, D.Y.C. Clinical features

poside/cisplatin as second line treatment

of bronchogenic carcinoma in Hong Kong - a review

is being completed, and a comparison of

of 480 patients.

two equidosage CAV schedules

Cancer 52: 369-376, 1983.


(cyclophosversus cy-



Kung, I.T.M., So, K.F., Lam, T.H. Lung Cancer in

is being initiated. For non-small cell

Hong Kong Chinese: mortality and histological types,

carcinoma, effective

the MACC regimen has proved in(i0). A study of etoposide/cis-

platin regimen has just been completed,

1973-1982. Br. J. Cancer 50: 381-388, 1984. 5.

and it appears to confer no overall survi-

Lam, W.K., So, S.Y., Yu, D.Y.C. Bronchogenic carci-

val benefit. We are especially interested

noma in Chinese women in Hong Kong.

in adenocarcinoma,

Proc. III World Conference on Lung Cancer, Tokyo,

which is, as noted be-

fore, the predominant cell type. A compa-

pp. 28, 1982.

rison of two FAM schedules



cil/adriamycin/mitomycin-C) has shown similar but disappointing results



Koo, L.C., Ho, J.H.C., Saw, D. Is passive smoking an added risk factor for lung cancer in Chinese

Similarly, a study comparing FAM and


high-dose FAM in adenocarcinoma,

J. Exp. Clin. Cancer Res. 3: 277-283, 1984.

just com-

pleted, has shown no increased efficacy with the more toxic, high-dose schedule.


Phase II studies in progress, or planned,

Lam, W.K., Kung, T.M., So, S.Y., Bacon-Shone, J.H.

for non-small cell carcinoma include ifos~

Active & passive smoking, kerosene stove usage &

famide, vindesine, and hexamethylmelamine.

home incense burning among female lung cancer pa-


a Lung Cancer Chemotherapy

tients: a case-control study.


Study Group is being formed, combining the

Proc. XV World Congress on Diseases of the Chest,

efforts of four major hospitals. Contacts

Sydney, pp. 33, 1985.

and exchanges with the Guangdong Research


Centre for Lung Cancer in Canton, China,

Chan, W.C., Colbourne, M.J., Fung, S.C., Ho, H.C.

are being initiated, and there will be

Bronchial cancer in Hong Kong, 1976-77.

great potentials for collaborative studies

Br. J. Cancer 39: 182-192, 1979.


adriamycin, cyclophosphamide and lomustine.

9. Kung, I.T.M., Lui, I.O.L., Loke, S.L.,

Proc. 13th International Congress of Chemotherapy,

Khin, M.A., Mok, C.K., Lam, W.K., So, $.

Vienna, Spitz & Karrer eds., Egermann, Part 248:

Y. Pulmonary scar cancer - a pathologic

114-117, 1983.



Am. J. Clin. Path.

(in press).

Lam, W.K., So, S.Y., Ip, Mary, Yu, D.Y.C. Cyclic


combination chemotherapy in advanced adenocarcinoma

Lam, W.K., So, S.Y., Ng, R.P., Yu, D.Y.C.

of the lung - comparison of two FAM schedules.

Four-drug combination chemotherapy in in-

Cancer Chemother.

operable bronchial cancer: methotrexate,


14: 282-283,