Wu Ranpu, Li Chuling, Wang Zimu, Fan Hang, Song Yong, Liu Hongbing
Department of Respiratory and Critical Care Medicine, Jinling Hospital, Southeast University of Medicine, Nanjing, China.
Department of Respiratory and Critical Care Medicine, Affiliated Jinling Hospital, Medical School of Nanjing Medical University, Nanjing, China.
Transl Lung Cancer Res. 2020 Dec;9(6):2469-2478. doi: 10.21037/tlcr-20-1147.
Small cell lung cancer (SCLC) is one of the malignant cancers of lung tumors, and hyponatremia, defined as serum sodium concentration (Na) lower than 135 mmol/L, is the most common complication of solid tumors, with an incidence of up to 18.9% and a negative impact on quality of life in SCLC. As a prognostic index of SCLC, timely monitoring and correcting of hyponatremia is of great clinical significance for prolonging the survival period of patients. In the explore of new drugs for small cell lung cancer, it is necessary to include hyponatremia as an evaluation index in clinical studies. As the occurrence of hyponatremia is sometimes unavoidable owing to SCLC specific neurological characteristics, early monitoring to detect the presence of hyponatremia and timely correction are helpful to improve the prognosis of patients. There are many predisposing factors for hyponatremia, including heterotopia of antidiuretic hormone (ADH), use of platinum-based chemotherapy drugs, and intracranial metastasis, among others. Patients with small cell lung cancer are usually asymptomatic in the early stage, while it is of great significance to find a suitable clinical index to judge whether it is a malignant inducement or not. In the clinical setting, due to different electrolyte levels and therapeutic scheduling for the primary disease, an individualized plan is often made, mainly comprising water restriction, infusion, and medications. This review includes related clinical studies and describes the common symptoms and predisposing factors of hyponatremia in patients with SCLC, and their impact on quality of life and prognosis.
小细胞肺癌(SCLC)是肺部肿瘤的恶性癌症之一,低钠血症定义为血清钠浓度(Na)低于135 mmol/L,是实体瘤最常见的并发症,在小细胞肺癌中的发生率高达18.9%,并对患者生活质量产生负面影响。作为小细胞肺癌的一项预后指标,及时监测和纠正低钠血症对于延长患者生存期具有重要临床意义。在探索小细胞肺癌新药时,有必要在临床研究中将低钠血症作为一项评估指标。由于小细胞肺癌具有特定的神经学特征,低钠血症的发生有时不可避免,早期监测以发现低钠血症的存在并及时纠正有助于改善患者预后。低钠血症有许多诱发因素,包括抗利尿激素(ADH)异位分泌、使用铂类化疗药物以及颅内转移等。小细胞肺癌患者早期通常无症状,而找到一个合适的临床指标来判断是否为恶性诱因具有重要意义。在临床实践中,由于原发性疾病的电解质水平和治疗方案不同,通常会制定个体化方案,主要包括限水、输液及药物治疗。本综述纳入了相关临床研究,并描述了小细胞肺癌患者低钠血症的常见症状、诱发因素及其对生活质量和预后的影响。