Kvale Paul A, Selecky Paul A, Prakash Udaya B S
Division of Pulmonary, Critical Care, Allergy, Immunology, and Sleep Disorders Medicine, Henry Ford Health System, 2799 W Grand Blvd, Detroit, MI 48202, USA.
Chest. 2007 Sep;132(3 Suppl):368S-403S. doi: 10.1378/chest.07-1391.
GOALS/OBJECTIVES: To review the scientific evidence on symptoms and specific complications that are associated with lung cancer, and the methods available to palliate those symptoms and complications.
MEDLINE literature review (through March 2006) for all studies published in the English language, including case series and case reports, since 1966 using the following medical subject heading terms: bone metastases; brain metastases; cough; dyspnea; electrocautery; hemoptysis; interventional bronchoscopy; laser; pain management; pleural effusions; spinal cord metastases; superior vena cava syndrome; and tracheoesophageal fistula.
Pulmonary symptoms that may require palliation in patients who have lung cancer include those caused by the primary cancer itself (dyspnea, wheezing, cough, hemoptysis, chest pain), or locoregional metastases within the thorax (superior vena cava syndrome, tracheoesophageal fistula, pleural effusions, ribs, and pleura). Respiratory symptoms can also result from complications of lung cancer treatment or from comorbid conditions. Constitutional symptoms are common and require attention and care. Symptoms referable to distant extrathoracic metastases to bone, brain, spinal cord, and liver pose additional problems that require a specific response for optimal symptom control. There are excellent scientific data regarding the management of many of these issues, with lesser evidence from case series or expert opinion on other aspects of providing palliative care for lung cancer patients.
Palliation of symptoms and complications in lung cancer patients is possible, and physicians who provide such care must be knowledgeable about these issues.
目标：回顾与肺癌相关的症状及特定并发症的科学证据，以及缓解这些症状和并发症的可用方法。
对1966年以来以英文发表的所有研究进行MEDLINE文献综述（截至2006年3月），包括病例系列和病例报告，使用以下医学主题词：骨转移；脑转移；咳嗽；呼吸困难；电灼术；咯血；介入性支气管镜检查；激光；疼痛管理；胸腔积液；脊髓转移；上腔静脉综合征；气管食管瘘。
肺癌患者可能需要缓解的肺部症状包括由原发癌本身引起的症状（呼吸困难、喘息、咳嗽、咯血、胸痛），或胸部局部区域转移引起的症状（上腔静脉综合征、气管食管瘘、胸腔积液、肋骨和胸膜）。呼吸系统症状也可能由肺癌治疗的并发症或合并症引起。全身症状很常见，需要关注和护理。远处胸外转移至骨、脑、脊髓和肝脏引起的症状带来了额外问题，需要采取特定措施以实现最佳症状控制。关于这些问题中许多问题的管理有出色的科学数据，而关于为肺癌患者提供姑息治疗其他方面的病例系列或专家意见的证据较少。
肺癌患者的症状和并发症是可以缓解的，提供此类护理的医生必须了解这些问题。
