Lee R B
The Cardiovascular Surgical Clinic, Jackson, Mississippi 39202-1655, USA.
Semin Surg Oncol. 2000 Mar;18(2):173-82. doi: 10.1002/(sici)1098-2388(200003)18:2<173::aid-ssu11>3.0.co;2-i.
Bronchogenic carcinoma remains a relentless plague of modern society causing far more deaths than the well-popularized "AIDS epidemic" and secondary only to cardiovascular disease as a cause of death in America. Despite medical advances and treatment breakthroughs, only 40% of newly identified lung cancer patients are "potentially curable". Therefore, a large portion of this patient population will require palliative care and treatment. Surgical palliation is somewhat a misnomer in that most endobrachial lesions causing significant obstruction that result in dyspnea are not amenable to surgical intervention, i.e., operative resectional therapy. The palliative management options of airway obstruction resulting from advanced stage lung cancer will be reviewed, including the historical aspects, development and current use of laser resection, airway stenting, and endobrachial brachytherapy for management of unresectable airway tumors. These modalities frequently are used simultaneously in the same patient and may be used in conjunction with current chemotherapeutic and conventional external-beam radiation protocols.
支气管源性癌仍然是现代社会的一大顽疾，其导致的死亡人数远多于广为人知的“艾滋病流行”，在美国，它是仅次于心血管疾病的第二大致死原因。尽管医学取得了进步，治疗也有了突破，但新确诊的肺癌患者中只有40%“有可能治愈”。因此，这一患者群体中的很大一部分将需要姑息治疗。手术姑息治疗在某种程度上是一个误称，因为大多数导致严重阻塞并引起呼吸困难的支气管内病变不适合手术干预，即手术切除治疗。本文将综述晚期肺癌导致气道阻塞的姑息治疗选择，包括激光切除、气道支架置入和支气管内近距离放射治疗在不可切除气道肿瘤治疗中的历史、发展及当前应用。这些治疗方式常常在同一患者中同时使用，也可与当前的化疗和传统外照射放疗方案联合使用。
