Ozdemir Cengiz, Sökücü Sinem N, Berk Ayşegül, Dalar Levent
Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Medicine, Istanbul, Turkey.
Süreyyapaşa Chest Disease and Thoracic Surgery Training and Research Hospital, Department of Pulmonary Medicine, Istanbul, Turkey.
Indian J Cancer. 2019 Jul-Sep;56(3):236-240. doi: 10.4103/ijc.IJC_45_18.
Small cell lung cancer (SCLC) constitutes 15%-25% of all lung cancers. Their treatment approach is different from nonsmall cell lung cancer. Central airway obstruction develops at the time of diagnosis or eventually at some time as the disease progress. Quick relief of symptoms with chemotherapy will cause to postpone interventional bronchoscopy which divest patient from benefits of this procedure. There is a few data about the use of interventional bronchoscopy in SCLC.
Between January 2005 and December 2012, rigid bronchoscopy under general anaesthesia was done in a total of 944 cases. Among them, 52 consecutive SCLC cases were evaluated retrospectively.
Survival was calculated from the date of application of therapeutic bronchoscopy using statistical software.
From the 52 cases (41 males) mean age of the patients were 56,87 ± 10,16 (range 34-78). Most common obstruction areas were distal trachea and carina invasion involving both main bronchus (n: 12; 23%). Most common method used was mechanical desobstruction after coagulation with diode diode laser or APC. A total of 16 stents was applied to 15 of the cases from 52 cases (28.8%). Most common used stent was silicon Y stent (n: 11). Most common complication during the procedure was bleeding that was mild in 11 cases and massive in 1. One patient died during the procedure (1.9%).
Multimodal interventional bronchoscopic methods seem to be a last option but may be useful in the management of advanced airway obstruction in the setting of SCLC. The choice of modality may be chosen depending upon individual patient characteristics as appropriate.
小细胞肺癌（SCLC）占所有肺癌的15%-25%。其治疗方法与非小细胞肺癌不同。在诊断时或随着疾病进展最终在某个时间会出现中央气道阻塞。化疗快速缓解症状会导致推迟介入性支气管镜检查，从而使患者无法从该手术中获益。关于介入性支气管镜检查在小细胞肺癌中的应用数据较少。
2005年1月至2012年12月期间，共944例患者在全身麻醉下接受了硬质支气管镜检查。其中，对52例连续的小细胞肺癌病例进行了回顾性评估。
使用统计软件从治疗性支气管镜检查应用日期计算生存率。
52例患者（41例男性）的平均年龄为56.87±10.16岁（范围34-78岁）。最常见的阻塞部位是气管远端和隆突侵犯累及双侧主支气管（n=12；23%）。最常用的方法是用二极管激光或氩等离子体凝固后进行机械性解除阻塞。52例中的15例共置入16枚支架（28.8%）。最常用的支架是硅Y形支架（n=11）。手术期间最常见的并发症是出血，11例为轻度出血，1例为大出血。1例患者在手术期间死亡（1.9%）。
多模式介入性支气管镜检查方法似乎是最后的选择，但可能有助于治疗小细胞肺癌患者的晚期气道阻塞。可根据个体患者特征适当选择治疗方式。
