Endobronchial electrocautery

Endobronchial electrocautery

83 free survival in these two groups was 27% and 12%, respectively. This review shows that complete resection and moderate doses of postoperative ext...

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free survival in these two groups was 27% and 12%, respectively. This review shows that complete resection and moderate doses of postoperative external irradiation achieves a satisfactory local control and improves survival. When all gross disease cannot be removed, then brachytherapy and postoperative external irradiation may achieve similar local control. Distant metastases still remain a major problem in these patients.

Sequential Hemibody and Local Irradiation with Combination Chemotherapy for Small Cell Lung Carcinoma: A Preliminary Analysis. Powell, B.L., Jackson, D.V. Jr., Scarantino, C.W., et al. Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27103, U.S.A. Int. J. Radiat. Oncol. Biol. Phys. ii: 457-462, 1985. Sequential hemibody irradiation (SHB) was integrated with combination chemotherapy and local irradiation (LRT) in the induction and consolidation phases of a therapeutic protocol for small cell lung carcinoma (SCLC). Forty-one previously untreated patients were entered into this program. Among 38 evaluable patients (20 with limited disease (LD) and 18 with extensive disease (ED)), the overall response rate was 63% (90% in LD and 33% in ED patients). The estimated overall survival is 8.1 months. The major toxicity has been myelosuppression - especially thrombocytopenia. The frequency of previously described "acute radiation syndromes" and radiation pneumonitis associated with hemibody irradiation have been substantially decreased at the current dosage with premedication and shielding techniques. The integration of SHB as a systemic therapy with combination chemotherapy and LRT is a feasible program for sequential administration of non-cross-resistant agents in SCLC and may be beneficial in patients with limited disease.

Esophageal Complications from Combined Chemoradiotherapy (Cyclophosphamide + Adriamycin + Cisplatin + XRT) in the Treatment of Non-Small Cell Lung Cancer. Umsawasdi, T., Valdivieso, M., Barkley, H.T. Jr., et al. Department of Medical Oncology, Radiotherapy, University of Texas System Cancer Center, M.D. Anderson Hospital, Houston, TX 77030, U.S.A. Int. J. Radiat. Oncol. Biol. Phys. ii: 511-519, 1985. Esophageal complications from combined chemoradiotherapy (CCRT) were analyzed in 55 patients with limited non-small cell lung cancer. CCRT consisted of chemotherapy (cyclophosphamide, doxorubicin (adriamycin), add cisplatin: CAP) and chest irradiation

(5000 rad in 25 fractions/5 weeks). Forty-five patients received two courses of CAP, followed by five weekly courses of low dose CAP and irradiation followed by maintenance courses of CAP (Group i). Ten patients received concomitant CCRT from the onset of treatment (Group 2). Esophagitis occurred in 80% of all patients. Severe esophagitis occurred in 27% of patients of Group 1 and 40% of patients of Group 2. Esophageal stricture or fistula developed in 1 of 45 (2%) patients in Group i, and 3 of i0 (30%) patients in Group 2 (p < 0.025). Weekly lowdose chemotherapy administered concomitantly with chest irradiation (R) at the onset of treatment significantly increases esophageal complications. A review of the literature suggests that CCRT may be used safely with split courses of R. The duration between onset of chemotherapy either before or after R should be greater than one week.

10, OTHER TREATMENT MODALITIES Endobronchial Electrocautery. Hooper, R.G., Jackson, F.N. The Heart Lung Center, St. Luke's Medical Center, Phoenix, AZ 85006, U.S.A. Chest 87: 712-714, 1985. Endobronchial electrocautery was successfully used to treat three patients with major airway obstruction resulting from bronchogenic carcinoma and to establish a diagnosis in a fourth. Electrocautery was applied through fiberoptic bronchoscopes. In two cases, a wire snare was used to remove polypoid lesions and in two others, probes were used to ablate tumor tissue. As a result of high inspired oxygen concentration in one patient, a tracheal fire occurred without injury to the patient. Electrocautery is an available economical tool which has potential value in the diagnosis and therapy of endobronchial obstructing airway lesions.

Early Hilar-Type Squamous Cell Carcinoma of the Lung Resected by Bronchofiberscopy Surviving 5 Years. Nishiyama, H., Kitaya, T., Nishiwaki, Y., et al. Department of Surgery and Internal Medicine, National Matsudo Chest Hospital, Matsudo City, Chiba 271, Japan. Am. J. Surg. Pathol. 9: 135139, 1985. We record a case of early squamous cell carcinoma located in the hilar region of the lung, which was completely resected by multiple tumor biopsies through the bronchofiberscope. In this case, there was concomitant contralateral pulmonary tuberculosis which was treated by right upper lobe lobectomy. The patient had a long history of smoking and had worked for 27 years in a factory that used chromate. Bronchoscopically, there were no abnormal findings in the visible branches of the right bronchial tree, but an early stage squamous cell carcinoma lesion was found at the bifurcation of left Bsup 8 and Bsup 9sup +sup isup 0 bronchi. After bronchofiberscopic excision of the tumor, the