支气管内超声引导下顺铂瘤内注射对肺癌纵隔孤立复发的治疗
Summary
The management of isolated recurrent lung cancer in a previously-irradiated field is challenging. Here, we describe an endobronchial ultrasound (EBUS)-guided cisplatin injection for the management of patients with localized lung cancer recurrence in a previously-radiated field.
Abstract
患者孤立肺门以下体外放射治疗（EBRT）纵隔复发（IMHR）肺癌是常见的。这些患者没有太多的治疗方案，并且通常提供姑息性化疗或最佳支持治疗。支气管内超声（EBUS）引导下顺铂瘤内注射（ITC）是这些患者的新方法。该过程下清醒镇静进行。病变位于使用EBUS支气管镜，和22号针头EBUS通过范围的工作通道先进，锁定到位。在超声引导下，气管支气管树的壁被刺穿并且针移入目标病变。然后将针管心针被移除，顺铂（40毫克/ 40毫升）注射到病灶。一到两个站点每个会话处理。该过程的细节将在纸的协议部分中描述。在我们中心，50个站点中36例患者接受治疗（男性19例，女性17例）。我们的队列的平均年龄为61.9±8.5年。我们对35例患者和41位点进行最终的分析。 24/35（69％）有完全或部分响应（应答），而11/35（31％）具有稳定或进行性疾病（无应答）。总体而言，生存在我们组为8个月（6-11个月95％CI），与谁回答具有比谁没有的那些显著更好地生存的病人。
Introduction
肺癌是所有癌症相关死亡的5男女双方，占全球1最常见的癌症。它有0.87 1，2病死率。初次治疗后复发占患者死亡人数最多肺癌。复发性肺癌的治疗选择是有限的。复发性肺癌也导致显著损害生活质量和护理人员显著倦怠并且需要额外的支持治疗，从而会降低接受和容忍的可能性进一步干预3。
NSCLC患者近30％有辐射4后局部复发。对这些患者的治疗选择是有限的，包括全身化疗，其具有仅10％的5，6的客观响应率。虽然重复胸部放疗是可行的，它已被主要研究姑息目的，缓解症状，并没有被用于疾病缓解3。
在我们的机构，孤立纵隔及肺门复发（IMHR）通过支气管镜访问的所有患者均与支气管内超声（EBUS）引导下治疗顺铂支气管内注射（ITC）。全身化疗和/或体外放射治疗（EBRT）并行处理被允许按照所述处理肿瘤学家“酌情。这份手稿突出了安全性，有效性，可行性，并在我们的机构所使用的协议的详细方法。
Protocol
Representative Results
Discussion
我们的手稿集中在肺癌纵隔孤立和肺门复发的管理病人谁更辐射是不是一种选择。 IMHR的发病率约为9％11。不同的治疗方案已经尝试在这些患者中，包括姑息性化疗，更多的外照射放疗，或支持治疗和监测。在我们的机构，我们将这些患者经纤支镜引导下肿瘤内顺铂。
出现了在肿瘤内化疗和免疫过去几年越来越感兴趣。之一的注入化疗剂进入肿瘤块的潜…
Declarações
The authors have nothing to disclose.
Acknowledgements
The authors have no acknowledgements.
Materials
| Bronchoscope | |
| 22 Guage olympus EBUS needle | |
| 40 g of cisplatin in 40 mls of normal saline |
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