Novosti
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Year 2014 Vol. 22 No 5
ONCOLOGY
A.M. KURCHANKOU, V.P. KURCHIN
THE MULTIMODALITY TREATMENT OF PATIENTS WITH NON-SMALL CELL LUNG CANCER AND UNILATERAL DISSEMINATION COVERING THE PARIETAL PLEURA
SE “Republican Scientific and Practical Center of Oncology and Medical Radiology named after N.N. Alexandrov”, Minsk,
The Republic of Belarus
Objectives. To increase the treatment efficiency of non-small cell lung cancer patients with pleural dissemination.
Methods. Twenty one non-small cell lung cancer patients (morphologically confirmed diagnosis) with pleural dissemination on the tumor side have been included in the study. All patients were divided into two groups: a control group – 10 patients subjected to chemotherapy; a study group – 11 patients treated by multimodality therapy application: pleuropneumonectomy, intrapleural perfusion thermochemotherapy (IPT) and adjuvant chemotherapy.
Results. 4 patients were performed thermochemotherapy prior surgery; the operation was performed 2-4 weeks after it since the pleural dissemination was confirmed thoracoscopically. To the rest of patients, thermochemotherapy was performed simultaneously with the surgery since the pleural dissemination appeared to be an intraoperative finding and confirmed thoracoscopically. Lymph node affection was detected in 8 (72,7%) patients, wherein in 7 (63,6%) – mediastinal lymph nodes N2 have been also impressed. Tumor process was located on the right side in 4 (36,4%) patients, and in 7 (63,6%) – on the left side. Among them, adenocarcinomas are the dominating tumor type – in 9 (81,8%) patients. One patient (9,1%) had histologically squamous cell lung cancer, and one (9,1%) – sarcomatoid lung cancer. The postoperative complications were registered in 4 (36,4%) patients from 11 received the multimodality treatment with IPT. Mortality rate made up 18,2%. All patients of the control group died within 24 months (0%), while the overall 3-year survival rate for patients receiving the multimodality treatment was 61,4 ± 15,3% (p <0,05).
Conclusion. The carrying out of the multimodality treatment, including radical surgery, intrapleural perfusion thermochemotherapy and adjuvant chemotherapy, as well as the patients with non-small cell lung cancer, allows increasing the overall level of 3-years survival for non-small cell lung cancer patients with pleural dissemination from 0,0% up to 61,4±15,3% (p<0,05) in comparison with chemotherapeutic method.
- Rusch VW, Giroux DJ, Kraut MJ, Crowley J, Hazuka M, Johnson D, Goldberg M, Detterbeck F, Shepherd F, Burkes R, Winton T, Deschamps C, Livingston R, Gandara D.Induction chemoradiation and surgical resection for non-small cell lung carcinomas of the superior sulcus: Initial results of Southwest Oncology Group Trial 9416 (Intergroup Trial 0160). 2001 Mar;121(3):472–83.
- Mordant P, Arame A, Foucault C, Dujon A, Le Pimpec Barthes F, Riquet M.Surgery for metastatic pleural extension of non-small-cell lung cancer. Eur J Cardiothorac Surg. 2011 Dec;40(6):1444–49.
- Hanagiri T, Takenaka M, Oka S, Shigematsu Y, Nagata Y, Shimokawa H, Uramoto H, Tanaka F.Results of a surgical resection for patients with stage IV non-small-cell lung cancer. Clin Lung Cancer. 2012 May;13(3):220–24.
- Ohta Y, Oda M, Shimizu J, Watanabe G. Multimodality treatment including parietal pleurectomy as a possible therapeutic procedure for malignant pleural effusion. Surg Technol Int. 2007;16:184–89.
- Friedberg JS, Mick R, Stevenson JP, Zhu T, Busch TM, Shin D, Smith D, Culligan M, Dimofte A, Glatstein E, Hahn SM.Phase II trial of pleural photodynamic therapy and surgery for patients with non-small-cell lung cancer with pleural spread. J Clin Oncol. 2004 Jun 1;22(11):2192–201.
- Kimura M, Tojo T, Naito H, Nagata Y, Kawai N, Taniguchi S.Effects of a simple intraoperative intrathoracic hyperthermotherapy for lung cancer with malignant pleural effusion or dissemination. Interact Cardiovasc Thorac Surg. 2010 Apr;10(4):568–71.
- Combined surgery of intrapleural perfusion hyperthermic chemotherapy and panpleuropneumonectomy for lung cancer with advanced pleural spread: a pilot study. Shigemura N, Akashi A, Ohta M, Matsuda H. Interact CardioVasc Thorac Surg. 2003;2(4):671–75.
223040, Respublika Belarus,
Minskiy rayon, pos. Lesnoy,
GU «Respublikanskiy nauchno-prakticheskiy tsentr
onkologii i meditsinskoy radiologii im. N.N. Aleksandrova»,
otdel torakalnoy onkopatologii s gruppoy anesteziologii,
tel.mob.: 375 29 336-96-83,
e-mail: AKurchenkov@mail.ru
Kurchankou A.N. A researcher of the department of thoracic oncopathology with anesthesia group of SE “Republican Scientific and Practical Center of Oncology and Medical Radiology named after N.N. Alexandrov”.
Kurchin V.P. MD, a head of the department of thoracic oncopathology with anesthesia group of SE “Republican Scientific and Practical Center of Oncology and Medical Radiology named after N.N. Alexandrov”.
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