Saji Hisashi, Furukawa Kinya, Tsutsui Hidemitsu, Tsuboi Masahiro, Ichinose Shuji, Usuda Jitsuo, Ohira Tatsuo, Ikeda Norihiko
Department of Thoracic Surgery and Oncology, Tokyo Medical University, 6-7-1, Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
Interact Cardiovasc Thorac Surg. 2010 Oct;11(4):425-8. doi: 10.1510/icvts.2010.238196. Epub 2010 Jul 23.
Approximately 30% of lung cancer patients will develop central airway obstruction (CAO). Interventional therapeutic bronchoscopy including airway stenting (AS) providing immediate and effective palliation is therefore essential to improve quality of life (QoL). However, no report has demonstrated the survival benefit of AS. We retrospectively reviewed 65 patients with CAO due to lung cancer who underwent AS from June 1994 to May 2008. Seventy-nine stents were required. Silicon, metallic, or both stents were placed in 42 (60%), 19 (29%), or eight (11%) patients, respectively. Single stent was required in 53 (83%) patients, double in 10 (14%), and triple in two (3%). AS could provide acute relief of central airway and significant improvement was seen in 98% of patients. Fifty-nine patients with detailed observations were assessed further. Morbidity and mortality rates were 22% and 8%, respectively. AS resulted in 25.2% of one-year survival rate and 6.2 months of median survival time (MST). AS followed by adjuvant therapy provided a four-month increase in MST, although overall survival was not significantly changed. This study represents a single-institution experience. Although an aggressive strategy of AS is justified in order to improve symptoms and QoL, AS itself did not contribute to survival benefit.
约30%的肺癌患者会发生中央气道阻塞（CAO）。因此，包括气道支架置入术（AS）在内的介入治疗性支气管镜检查能提供即时有效的姑息治疗，对提高生活质量（QoL）至关重要。然而，尚无报告证明AS能带来生存获益。我们回顾性分析了1994年6月至2008年5月期间因肺癌接受AS治疗的65例CAO患者。共需要79个支架。分别有42例（60%）、19例（29%）或8例（11%）患者置入了硅酮支架、金属支架或两者皆用。53例（83%）患者需要单个支架，10例（14%）需要两个，2例（3%）需要三个。AS能迅速缓解中央气道阻塞，98%的患者病情有显著改善。对59例有详细观察资料的患者进行了进一步评估。发病率和死亡率分别为22%和8%。AS的一年生存率为25.2%，中位生存时间（MST）为6.2个月。AS联合辅助治疗使MST增加了4个月，尽管总体生存率没有显著变化。本研究是单中心经验。尽管为改善症状和生活质量采取积极的AS策略是合理的，但AS本身并未带来生存获益。
