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气道支架置入在不可手术的晚期肺癌所致的气管支气管狭窄治疗中的作用。

The role of airway stent placement in the management of tracheobronchial stenosis caused by inoperable advanced lung cancer.

机构信息

Department of Thoracic Surgery, Tokyo Medical University, Kasumigaura Hospital, 3-20-1 Chuo, Ami-machi, Inashiki-gun, Ibaraki, 300-0395, Japan.

出版信息

Surg Today. 2010 Apr;40(4):315-20. doi: 10.1007/s00595-008-4058-2. Epub 2010 Mar 26.

Abstract

PURPOSE

To our knowledge there is no in-depth report on the benefits of airway stenting, which focuses specifically on patients with inoperable advanced lung cancer causing severe central airway obstruction. We evaluated the role of airway stenting as one aspect of the multidisciplinary management of advanced lung cancer.

METHODS

We performed airway stenting in 40 lung cancer patients, placing a total of 58 stents. Stenting was done as a final modality in 22 patients with terminal-stage lung cancer (group A). The other 18 patients received additional therapy after stenting (group B), 12 (66.7%) of whom were treatment-naïve on admission.

RESULTS

The performance status (PS) and Hugh-Jones classification (H-J) scores improved in both groups after stenting: from 3.56 to 2.48 (P = 0.001) and 4.29 to 3.20 (P = 0.004) in group A, and from 3.15 to 1.25 (P < 0.001) and 4.10 to 2.10 (P < 0.001) in group B, respectively. The median survival time and 1-year survival rate after stenting were 1.6 months and 5.1%, respectively, in group A, and 5.6 months and 25.0%, respectively, in group B.

CONCLUSIONS

Airway stenting followed by adjuvant therapy may improve the survival of treatment-naïve patients with severe symptomatic airway obstruction caused by advanced lung cancer.

摘要

目的

据我们所知,尚无深入报告探讨气道支架置入术的益处,该手术特别针对无法手术的晚期肺癌导致严重中央气道阻塞的患者。我们评估了气道支架置入术作为晚期肺癌多学科管理的一个方面的作用。

方法

我们对 40 例肺癌患者进行了气道支架置入术,共置入 58 个支架。22 例终末期肺癌患者(A 组)将支架置入作为最终治疗手段。其余 18 例患者在支架置入后接受了额外的治疗(B 组),其中 12 例(66.7%)入院时为初治。

结果

支架置入后两组患者的体能状态(PS)和 Hugh-Jones 分级(H-J)评分均得到改善:A 组从 3.56 分改善至 2.48 分(P = 0.001)和从 4.29 分改善至 3.20 分(P = 0.004),B 组从 3.15 分改善至 1.25 分(P < 0.001)和从 4.10 分改善至 2.10 分(P < 0.001)。支架置入后 A 组的中位生存时间和 1 年生存率分别为 1.6 个月和 5.1%,B 组分别为 5.6 个月和 25.0%。

结论

气道支架置入术联合辅助治疗可能改善初治的晚期肺癌严重症状性气道阻塞患者的生存。

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