Deygas N, Froudarakis M, Ozenne G, Vergnon J M
Service de pneumologie et d'oncologie thoracique, Hôpital Nord, Saint-Etienne, France.
Chest. 2001 Jul;120(1):26-31. doi: 10.1378/chest.120.1.26.
Treatment of early superficial bronchogenic carcinoma (ESBC) is under debate, and no consensus has been achieved. Different therapeutic methods have been proposed, including surgical resection and endoscopic methods.
To assess the efficacy of cryotherapy in patients with ESBC.
Patients included in the study had histologically proven ESBC after fiberoptic bronchoscopy. Cryotherapy was performed through a rigid bronchoscope. Efficacy was assessed by endoscopy with multiple biopsies 1 month after treatment and during the follow-up period. Parameters studied were response to treatment, adverse effects, and survival.
We included 35 patients (34 men and 1 woman). The mean age was 61 +/- 9 years. Multiple locations of ESBC were observed in seven patients (20%). Complete response rate at both 1 month and 1 year was 91% (32 patients). No severe adverse effects were noted. Local recurrence was observed within 4 years in 10 patients (28%). A follow-up period of at least 4 years was available in 22 patients; of them, 11 patients (50%) were long-term survivors.
Our results suggest that cryotherapy is an effective method of treatment in patients with ESBC. Due to its relative tolerance compared to surgery, cryotherapy could be proposed as a first-line therapy in this population with high carcinogenic risk.
早期浅表性支气管癌(ESBC)的治疗存在争议,尚未达成共识。已提出了不同的治疗方法,包括手术切除和内镜治疗方法。
评估冷冻疗法对ESBC患者的疗效。
纳入研究的患者经纤维支气管镜检查后组织学确诊为ESBC。通过硬支气管镜进行冷冻治疗。在治疗后1个月及随访期间通过内镜检查及多次活检评估疗效。研究的参数包括治疗反应、不良反应和生存率。
我们纳入了35例患者(34例男性和1例女性)。平均年龄为61±9岁。7例患者(20%)观察到ESBC有多个病灶。1个月和1年时的完全缓解率均为91%(32例患者)。未观察到严重不良反应。10例患者(28%)在4年内出现局部复发。22例患者有至少4年的随访期;其中11例患者(50%)为长期存活者。
我们的结果表明,冷冻疗法是ESBC患者的一种有效治疗方法。由于与手术相比其耐受性相对较好,冷冻疗法可作为该高致癌风险人群的一线治疗方法。