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[肺上沟瘤的治疗与预后]

[Treatment and prognosis of superior sulcus tumours].

作者信息

Vos C G Niels, Dickhoff Chris, Paul Marinus A, Dahele Max, Smit Egbert F, Hartemink Koen J

机构信息

VU medisch centrum, Amsterdam, the Netherlands.

出版信息

Ned Tijdschr Geneeskd. 2012;156(49):A5419.

Abstract

Superior sulcus tumours (or Pancoast tumours) are non-small-cell lung carcinomas presenting with specific symptoms and requiring a specific approach to treatment due to their location in the pulmonary apex. Early recognition is rare as a result of the low incidence and the relatively late occurrence of symptoms .Shoulder pain, with or without radiation to the ipsilateral arm or hand, and Horner's syndrome are often presenting symptoms. The current standard of care for patients with resectable tumours is pre-operative chemoradiotherapy, followed by resection of the tumour and affected surrounding structures. This is associated with 5-year survival rates of more than 50%. Invasion of local structures, the presence of mediastinal lymph node metastases and, in a select group of patients, distant metastasis, are not necessarily contra-indications for surgical resection. Patients who have undergone complete resection, or demonstrate a pathologically complete response after induction therapy, have significantly higher survival rates. Treatment of superior sulcus tumours requires a multidisciplinary approach; considering the complexity of the treatment, patients should be referred to a specialised centre.

摘要

肺上沟瘤(或潘科斯特瘤)是非小细胞肺癌,因其位于肺尖,会出现特定症状,且需要特定的治疗方法。由于发病率低且症状出现相对较晚,早期识别很少见。肩痛,无论是否放射至同侧手臂或手部,以及霍纳综合征都是常见症状。对于可切除肿瘤患者,目前的标准治疗方案是术前放化疗,随后切除肿瘤及受影响的周围结构。这与超过50%的5年生存率相关。局部结构侵犯、纵隔淋巴结转移的存在,以及在部分患者中出现远处转移,不一定是手术切除的禁忌证。接受了完整切除或在诱导治疗后显示病理完全缓解的患者,生存率显著更高。肺上沟瘤的治疗需要多学科方法;考虑到治疗的复杂性,患者应转诊至专业中心。

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