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Titolo:
Multimodality treatment of advanced pulmonary malignancies
Autore:
Bolliger, CT;
Indirizzi:
Univ Basel Hosp, Dept Internal Med, Div Resp, CH-4031 Basel, Switzerland Univ Basel Hosp Basel Switzerland CH-4031 sp, CH-4031 Basel, Switzerland
Titolo Testata:
INTERVENTIONAL BRONCHOSCOPY
, volume: 30, anno: 2000,
pagine: 187 - 196
SICI:
1422-2140(2000)30:<187:MTOAPM>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
CELL LUNG-CANCER; THORACIC RADIOTHERAPY; LASER PHOTORESECTION; SURGICAL RESECTION; ADVANCED-CARCINOMA; ONCOLOGY-GROUP; IRRADIATION; THERAPY; MANAGEMENT; TUMORS;
Tipo documento:
Article
Natura:
Collana
Settore Disciplinare:
Clinical Medicine
Citazioni:
32
Recensione:
Indirizzi per estratti:
Indirizzo: Bolliger, CT Univ Stellenbosch, Fac Med, Dept Internal Med, 19063, ZA-7505Tygerberg, South Africa Univ Stellenbosch 19063 Tygerberg South Africa ZA-7505 frica
Citazione:
C.T. Bolliger, "Multimodality treatment of advanced pulmonary malignancies", PROG R RES, 30, 2000, pp. 187-196

Abstract

At the time of diagnosis, only 20-25% of lung cancers can be cured, primarily by surgery. Thus, for the large majority of patients presenting with inoperable, locally advanced or metastatic disease, treatment remains palliative. Classically, this treatment consists of external beam irradiation, chemotherapy or a combination of both. About 30% of all lung cancers present with neoplastic bronchial obstruction, and about 35% of all lung cancer patients will die from local intrathoracic complications, such as hemoptysis, respiratory infections and asphyxia. Local tumor control should therefore not only lead to palliation of the symptoms, but also to improved survival. With the rapidly developing field of interventional bronchoscopy with both the rigid as well as the flexible bronchoscope, a large variety of differentendoscopic treatment modalities are now available which have shown their utility in controlling local tumor progression. The modern approach to inoperable pulmonary malignancies should therefore always include an endoscopic assessment of the central airways, and the term multimodality treatment should include endoscopic modalities. In patients exhibiting locally advanced tumors with central airway obstruction leading to moderate to severe symptoms and/or to an obstruction of > 50% of the normal airway diameter, the initial combination of endoscopic with nonendoscopic therapy is recommended. Using endoscopic measures first leads to rapid relief of endobronchial obstruction, and subsequent radio- or chemotherapy helps to consolidate the initial therapeutic result. An exception to this rule can be made in untreated small cell carcinoma and lymphoma which can show dramatic response to chemotherapy. An algorithm for the management of locally advanced pulmonary malignancies is presented. Currently there are no data showing unequivocally what endoscopic treatment to use and what multimodality approach might be best in a certain situation. Therefore, prospective outcome studies are clearly needed.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 16:50:51