Neodymium yttrium-aluminium-garnet laser resection significantly improves quality of life in patients with malignant central airway obstruction due to lung cancer

Zarić, Bojan; Kovačević, Tomi; Stojšić, Vladimir; Šarčev, Tatjana; Kocić, M.; Urošević, Ivana; Kalem, Dijana; Perin, Branislav

doi:10.1111/ecc.12256

Cited by 12 publications

(6 citation statements)

References 20 publications

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“…It is particular effective for intraluminal and mixed type airway obstruction and less suitable for extraluminal compression (40). In additional to constant and immediate effect in tumor shrinkage, the quality of life and overall health are also improved significantly in patients with malignant central airway obstruction due to lung cancer (41). Although laser monotherapy is quite effective in alleviating symptoms from malignant central airway obstruction, survival benefit will be improved when it combined with multimodal adjuvant therapy (including brachytherapy, chemotherapy, radiotherapy, stenting, chemoradiotherapy) (42).…”

Section: Lasermentioning

confidence: 99%

Central airway tumors: interventional bronchoscopy in diagnosis and management

Lin

Chung

2016

J. Thorac. Dis.

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The diagnosis of central airway tumors is usually challenging because of the vague presentations.Advances in visualization technology in bronchoscopy aid early detection of bronchial lesion. Cryotechnology has great impact on endobronchial lesion sampling and provides better diagnostic yield. Airway tumor involvements result in significant alteration in life quality and lead to poor life expectancy. Timely and efficiently use ablation techniques by heat or cold energy provide symptoms relief for central airway obstruction. Prostheses implantation is effective in maintaining airway patency after ablative procedure or external compression. Combined interventional bronchoscopy modalities and other adjunctive therapies have improvement in quality of life and further benefit in survival. This review aims to provide a diagnostic approach to central airway tumors and an overview of currently available techniques of interventional bronchoscopy in managing symptomatic central airway obstruction. Here, we provide a clinical review of interventional bronchoscopy in diagnoses and management of central airway tumors. Keywords Diagnostic modalities Computed tomographyOnly less than 30% patients with tracheal tumors have been diagnosed via chest radiography (14). Traditional CT scan is more sensitive and can provide information on the extent of airway lesions. Newly developed multidetector CT (MDCT) can accurately detect airway tumor locations, natures, quantities (1). The extra luminal anatomy is also clearly depicted. Thus, MDCT is a rapid and non-invasive method to provide comprehensive information about the extent of disease process before surgery or interventional bronchoscopy (1). Visualization of bronchoscopyBronchoscopy is the mainstay to approaching endobronchial lesion under direct vision. In addition to conventionally white light bronchoscopy, autofluorescence (AFB) and narrow band imaging (NBI) are new visualization techniques of bronchoscopy which can aid detection of bronchial mucosa lesions (15). Although the specificity of AFB is low and similar to white light bronchoscopy, there is no doubt in usefulness of detecting early bronchial mucosal lesion and evaluate the margin of mucosal involvement (16,17). NBI is designed to detect angiogenesis and neovascular lesion. The diagnostic accuracy is increased under NBI bronchoscopy (15). Both of them have superior sensitivity comparing with white light bronchoscopy [3][4][5]. Endobronchial ultrasonography (EBUS) is also helpful in evaluating the extent of airway lesion involvement (14,18). Tissue sampling: forceps versus cryotechnologyForceps biopsy under direct bronchoscopic vision is the most common method to obtain tissue sample from endobronchial lesion. However, the size of tissue sample is limited by the forceps size. Small samples with crush artifacts are probably insufficient for accurate diagnosis. The diagnostic yield is only 85% of conventional forceps biopsy and patients usually have to repeat bronchoscopy (2,3).Cryotechnology has been used as a t...

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Section: Lasermentioning

confidence: 99%

Central airway tumors: interventional bronchoscopy in diagnosis and management

Lin

Chung

2016

J. Thorac. Dis.

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“…Among traditional laser therapies, the neodymium yttrium–aluminum–garnet laser is one of the most used techniques for tumor debulking and urgent de-obstruction, and shows an improvement in OS and quality of life. 28 , 29 In contrast, it is proposed that radiotherapy improves the risk of pulmonary function injury and pneumonia, and both local recurrence and toxicity occur late after radiotherapy in patients with central tumors. 30 – 32 As the result of our study, it is suggested that radiotherapy is more appropriate for nonsurgical patients, but not helpful to surgical patients.…”

Section: Discussionmentioning

confidence: 99%

Prognosis of patients with primary malignant main stem bronchial tumors: 7,418 cases based on the SEER database

Ma¹,

Sun²,

Yang³

et al. 2017

OTT

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BackgroundThe aim of this study was to identify risk factors for patients with malignant main stem bronchial tumors (MBTs) and to develop a nomogram for predicting prognosis in those patients using data from the Surveillance, Epidemiology, and End Results (SEER) database.MethodA process was used for case screening from the SEER database. The effect of prognostic factors on survival was evaluated using the Kaplan–Meier method and log-rank test, a competing risk model, and the Cox proportional hazards regression model. A nomogram was established for predicting 1-, 3-, and 5-year overall survival (OS) in patients with MBTs.ResultsA total of 7,418 cases were included in this study. Age, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were identified as independent risk factors by univariate and multivariate analyses. A nomogram was established based on the results of the Cox model, which was validated by a C-index of 0.672 (95% CI, 0.664–0.680), and a group of calibration plots.ConclusionAge, gender, pathologic grade, histologic type, tumor size, involvement of lymph nodes, tumor extension, chemotherapy, and surgery were independent risk factors for OS of patients with MBTs. A nomogram was formulated to predict 1-, 3-, and 5-year OS in patients with MBTs based on individual clinical characteristics.

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“…Several types of endobronchial therapies are performed in the management of lung cancer [8] , [9] , [10] , [11] , [12] such as photodynamic therapy [13] , [14] , [15] , high-dose-rate brachytherapy [15] , [16] , [17] , [18] , [19] , [20] , [21] , electrocautery [22] , APC [4] , [23] , neodymium yttrium-aluminium-garnet (Nd-YAG) laser therapy [24] , [25] , and cryotherapy [26] . These methods have been used for both the palliation of obstructing inoperable lung cancers in combination with [18] , [21] or after EBRT [16] , and primary treatment of early-stage radiographically occult non-small cell lung cancer [17] .…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of limited-stage small-cell lung cancer in the right mainstem bronchus by a combination of chemotherapy and argon plasma coagulation

Takeda¹,

Itano²,

Takeuchi³

et al. 2017

Respiratory Medicine Case Reports

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The current standard-of-care treatment for patients with limited-stage small-cell lung cancer (SCLC) is concurrent chemoradiotherapy for local and systemic control. However, standard-of-care treatment strategies have not been established for those with limited-stage SCLC who have a history of thoracic radiotherapy due to concerns with complications associated with radiation overdose. A 37-year-old male developed an aspergilloma in the postoperative left thoracic space after he was treated with concurrent chemoradiotherapy for mediastinal type lung adenocarcionoma and subsequent left upper lobectomy for heterochronous dual adenocarcinoma. Fiberoptic bronchoscopy was performed to examine the status of the suspected bronchopleural fistula when a polypoid mass was observed in the right mainstem bronchus. A histological examination showed that the mass was SCLC at a clinical stage of cTisN0M0, stageIA, without local invasion. Since thoracic radiotherapy was not an option due to a previous history of thoracic irradiation, a combination treatment of carboplatin and etoposide was administered for 4 cycles and resulted in good partial response. In addition, argon plasma coagulation (APC) was performed as an alternative to curative radiotherapy on day 22 of the 4th cycle. The 5th cycle was administered 7 days after APC at which the anticancer therapy was completed. The patient remains disease-free 60 months after the completion of treatment, which suggests that this combination therapy may resolve very early-stage SCLC.

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Neodymium yttrium-aluminium-garnet laser resection significantly improves quality of life in patients with malignant central airway obstruction due to lung cancer

Cited by 12 publications

References 20 publications

Central airway tumors: interventional bronchoscopy in diagnosis and management

Central airway tumors: interventional bronchoscopy in diagnosis and management

Prognosis of patients with primary malignant main stem bronchial tumors: 7,418 cases based on the SEER database

Successful treatment of limited-stage small-cell lung cancer in the right mainstem bronchus by a combination of chemotherapy and argon plasma coagulation

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