The sensitivity and specificity of Cyfra 21-1 as marker for lung cancer was evaluated in comparison with carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC) and neuron-specific enolase (NSE). Patients with histologically verified lung cancer and different groups without lung cancer were investigated. Sensitivity of Cyfra 21-1 (cut-off level 2.9 micrograms/l) was 40% for non-small cell lung cancer (NSCLC), 60% for rare histological types and 21% for small cell lung cancer (SCLC). In NSCLC sensitivity of Cyfra 21-1 was 35% for squamous cell carcinoma and 41% for adenomous carcinoma. The highest sensitivity for CEA was 45% in NSCLC, with 57% in the subtype of adenomous cell carcinoma; for SCC 30% was achieved in squamous cell carcinoma and for NSE 66% sensitivity was reached in SCLC. In our patients Cyfra 21-1 and CEA appeared equally useful for evaluating patients with NSCLC.

From March 1988 to May 1994, 15 patients underwent the treatment protocol of superficial photodynamic therapy (PDT) in dermatological localized malignancies. Two tumours (one M. Queyrat of the penis, one basalioma) were treated primarily; the other 13 patients experienced relapses of underlying disease after treatment by surgery, radiotherapy or chemotherapy. Most of the patients (10/15) received doses of 2 mg Photosan III kg-1 body weight (BW), four received a lower dose of 1-1.5 mg kg-1 BW and one patient received 3 mg kg-1 BW. Only one remarkable side-effect (tachyarrhythmia) during Photosan III infusion occurred. All patients were treated by an argon dye laser system. The light dose was 200 J cm-2 (11 patients) and 150 J cm-2 (four patients). Complete response occurred in six lesions, including one M. Queyrat and five basaliomas. Two patients had significant partial response with distinct regression of tumour (one pretreated basalioma of the upper lip and one superficially spreading mesothelioma of the scrotum). Five patients (all basaliomas) demonstrated only local response and two patients gave no response (one basalioma, one melanoma metastasis). The results obtained from this small sample suggest the necessity of an optical dosimetric system. At present, PDT should be restricted for selected or pretreated cases.

We describe the first local use of hypericin as photosensitizer for photodynamic therapy in a patient with recurrent malignant mesothelioma. Hypericin is a polycyclic quinone, which has been shown to possess in vivo and in vitro antiretroviral and photosensitizing activity; moreover, it is used in depressive disorders. The semiquinone radical, singlet oxygen, and superoxide anion radical are reported to be the toxic agents in hypericin phototherapy. Our first experience with locally applied hypericin in a superficial tumor-plate was performed 8 weeks after the systemic administration of hematoporphyrin derivatives. For tumor light illumination we used an argon pumped dye laser tuned to 632 nm. Owing to satisfactory results, we repeated the same therapy 4 weeks later — and no therapeutic effect was noted. Following this, we proved the interstitial application of HPD and the combination of interstitial HDP and superficially applied hypericin. The subsequent light illumination 6 hours later had no efficacy in the HDP-photosensitized area but there was tumor destruction in the field with both administered photosensitizers. Our first experience suggests a potentiation of two photosensitizers: hematoporphyrin derivatives and hypericin.

Seit 1974 bis 1991 wurden an unserer Abteilung 83 Patienten, mit einem Schilddrüsenkarzinom, einer perkutanen Strahlentherapie zugeführt.