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
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-
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.
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,
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.
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.
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
Am. J. Clin. Path.
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-
operable bronchial cancer: methotrexate,