Khan Maliha, Wasim Anum, Mirrakhimov Aibek E, McMahon Blaithin A, Judge Daniel P, Chu Linda C, Banavali Ashtami, Zeidan Amer M
Department of Internal Medicine, Presence Saint Joseph Hospital, Chicago, IL 60657, USA.
Dow University of Health Sciences, Karachi, Sindh 74200, Pakistan.
Case Rep Oncol Med. 2015;2015:163727. doi: 10.1155/2015/163727. Epub 2015 Mar 22.
The optimal management of cancer in patients with severe heart failure is not defined. This issue is particularly challenging when a diagnosis of limited-stage small cell lung cancer (SCLC) is made incidentally in the context of evaluating patient for candidacy for cardiac transplantation. Limited-stage SCLC is typically managed on a curative therapeutic paradigm with combined modality approach involving chemotherapy and radiation. Even with excellent performance status and good organ function, the presence of severe cardiomyopathy poses significant challenges to the delivery of even single modality approach with chemotherapy or radiotherapy, let alone the typical curative combined modality approach. With mechanical left ventricular devices to provide cardiac support, treatment options for cancer in the setting of advanced heart failure may be improved. Here we discuss the therapeutic dilemma involving a patient with severe cardiomyopathy and left ventricular assistant device (LVAD) who was found to have limited-stage SCLC during the evaluation process for cardiac transplantation.
严重心力衰竭患者癌症的最佳管理方法尚未明确。当在评估患者心脏移植候选资格时偶然诊断出局限期小细胞肺癌（SCLC）时，这个问题尤其具有挑战性。局限期SCLC通常采用包括化疗和放疗的综合治疗模式进行根治性治疗。即使患者的身体状况良好且器官功能正常，严重心肌病的存在对单纯采用化疗或放疗的单一治疗模式的实施都构成了重大挑战，更不用说典型的根治性综合治疗模式了。借助机械左心室装置提供心脏支持，晚期心力衰竭患者癌症的治疗选择可能会得到改善。在此，我们讨论了一名患有严重心肌病且植入左心室辅助装置（LVAD）的患者在心脏移植评估过程中被发现患有局限期SCLC所涉及的治疗困境。
