Bertoletti Laurent, Elleuch Rami, Kaczmarek David, Jean-François Rita, Vergnon Jean Michel
Departments of Pulmonary Diseases and Thoracic Oncology, Hôpital Nord, St. Etienne University Hospital, Saint-Etienne, 42000 Saint-Etienne, France.
Chest. 2006 Nov;130(5):1405-11. doi: 10.1378/chest.130.5.1405.
Bronchial typical carcinoid tumors are rare. The "gold standard" treatment is surgery, but there is literature to support bronchoscopic therapy with curative intent. Based on the efficacy of cryotherapy for in situ lung cancer, we studied the safety and efficacy of rigid bronchoscopic treatment with cryotherapy on isolated endoluminal typical carcinoid tumors.
All the patients from the Department of Pulmonary Diseases and Thoracic Oncology of St. Etienne University Hospital (France), and of Hôpital Notre Dame, University Hospital of Montreal referred with typical carcinoid were screened. Inclusion criteria included the following: proven typical carcinoid, strictly endoluminal disease amenable to bronchoscopic therapy, and no evidence of lymph node invasion. All patients had a complete removal of the tumor, and all patients received cryotherapy to the implantation base.
Twenty-nine patients were screened, and 18 were included. Mean age was 47 years, and study population included 11 women. Median follow-up was 55 months. There was a single recurrence 7 years after the initial bronchoscopic treatment.
Cryotherapy is a safe and effective adjunct to endobronchial mechanical resection of typical carcinoids. Unlike other adjuncts that have been proposed, cryotherapy is not associated with long-term complications including bronchial stenosis.
支气管典型类癌肿瘤较为罕见。“金标准”治疗方法是手术，但也有文献支持以治愈为目的的支气管镜治疗。基于冷冻疗法对原位肺癌的疗效，我们研究了硬质支气管镜下冷冻治疗孤立性腔内典型类癌肿瘤的安全性和有效性。
对法国圣艾蒂安大学医院以及蒙特利尔大学医院圣母院医院肺病与胸肿瘤学科室转诊的所有典型类癌患者进行筛查。纳入标准如下：经证实为典型类癌、严格的腔内疾病适合支气管镜治疗且无淋巴结侵犯证据。所有患者均完整切除肿瘤，且所有患者均对植入基底进行冷冻治疗。
共筛查29例患者，18例被纳入。平均年龄47岁，研究人群包括11名女性。中位随访时间为55个月。初次支气管镜治疗7年后出现1例复发。
冷冻疗法是支气管内机械切除典型类癌的一种安全有效的辅助手段。与其他已提出的辅助手段不同，冷冻疗法不会导致包括支气管狭窄在内的长期并发症。
