Oki Masahide, Saka Hideo
Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan.
Clin Respir J. 2018 Jul;12(7):2257-2263. doi: 10.1111/crj.12901. Epub 2018 May 7.
Airway stenting has been reported to be useful for patients with malignant airway stenosis as a bridge to tumour-specific therapy, such as chemotherapy and radiation therapy, as well as palliative therapy. However, its role in patients with small-cell lung cancer (SCLC), the most aggressive lung cancer subtype, is unclear. We investigated the efficacy of airway stenting for patients with airway stenosis resulting from SCLC.
All stenting procedures were performed using both rigid and flexible bronchoscopes under general anaesthesia. Among 512 patients who underwent rigid bronchoscopy during a 9-year period at a single centre, those who underwent airway stenting for airway stenosis because of SCLC were retrospectively reviewed.
Twenty-one SCLC patients with airway stenosis who underwent stenting were eligible for analysis. Twelve patients (57%) were chemoradiotherapy-naïve. Supplemental oxygen was reduced after the procedure in 11 out of 12 patients (92%) who had previously required it. Fourteen patients (67%) received tumour-specific therapy after the procedure. The median post-procedural survival was 47 days (range, 5-617 days). Longer survival was associated with the performance of post-procedural tumour-specific therapy, low serum lactate dehydrogenase levels and either tracheal or bronchial stenosis.
SCLC patients with airway stenting experienced longer survival when post-procedural tumour-specific therapy was performed, when they showed low serum lactate dehydrogenase levels, and when they had either tracheal or bronchial stenosis.
气道支架置入术已被报道对恶性气道狭窄患者有用,可作为肿瘤特异性治疗(如化疗和放疗)以及姑息治疗的桥梁。然而,其在最具侵袭性的肺癌亚型小细胞肺癌(SCLC)患者中的作用尚不清楚。我们研究了气道支架置入术对SCLC所致气道狭窄患者的疗效。
所有支架置入手术均在全身麻醉下使用硬质和柔性支气管镜进行。在一个中心9年期间接受硬质支气管镜检查的512例患者中,对因SCLC气道狭窄而接受气道支架置入术的患者进行回顾性分析。
21例接受支架置入术的SCLC气道狭窄患者符合分析条件。12例患者(57%)未接受过放化疗。12例之前需要补充氧气的患者中,11例(92%)术后补充氧气减少。14例患者(67%)术后接受了肿瘤特异性治疗。术后中位生存期为47天(范围5 - 617天)。生存期较长与术后肿瘤特异性治疗、低血清乳酸脱氢酶水平以及气管或支气管狭窄有关。
接受气道支架置入术的SCLC患者,若术后进行肿瘤特异性治疗、血清乳酸脱氢酶水平低以及存在气管或支气管狭窄,则生存期较长。