Abstract

Edwards, F. R. and Whitwell, F. (1974).Thorax, 29, 654-658. Use of BCG as an immunostimulant in the surgical treatment of carcinoma of the lung. Cell-mediated immunity to cancer cells would appear to exert some control over the extension of tumour growth, and stimulation of this factor might result in increased survival after surgical treatment of the tumour. Of the various agents used as stimulators in experimental work, BCG would seem to be the most convenient to use in man. A single dose of BCG-Glaxo (500,000 organisms) was given subdermally 10 days after excision of lung carcinoma. The length of survival was used as the index of the effect of the BCG.

Two trials were initiated, the first to study the safety of BCG and a survival study of 120 consecutive cases (60 used as controls). This is an interim report at two years of this trial. The main features at this stage show that the overall survival rate has increased from 38% in the controls to 52% in the BCG group. In the squamous-cell group survival has risen from 50% to 62% and, in those with positive nodes, from 33% to 53%. In the oat-cell group, two-year survival has risen from 11% in the controls to 50% in the BCG groups, though the numbers are small. Although encouraging, the results are not statistically significant.

The second trial is a randomized trial in which five surgeons have taken part, and 500 consecutive cases of lung resection for carcinoma are documented (250 control and 250 BCG). It is too early for results to be assessed in this group.

It is hoped that at three, four, and five years more favourable survival figures will be obtained.