Case report of two patients having successful surgery for lung cancer after treatment for Grade 2 radiation pneumonitis.
Case report of two patients having successful surgery for lung cancer after treatment for Grade 2 radiation pneumonitis.
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DOI：
10.1016/j.amsu.2015.11.003
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发表时间：
2016-02
期刊：
影响因子：
--
通讯作者：
Uramoto H
中科院分区：
文献类型：
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作者：
Nakajima Y;Akiyama H;Kinoshita H;Atari M;Fukuhara M;Saito Y;Sakai H;Uramoto H
局部晚期肺癌的手术在放化疗后进行。然而，没有报告阐明在放射性肺炎病例中进行手术对后续预后的影响。在本文中，我们报告了2例非小细胞肺癌诱导放化疗后发生2级放射性肺炎的病例，在治疗肺炎后，我们能够安全地进行根治性手术。病例1是一名68岁男性，诊断为鳞状细胞肺癌cT2aN2M0，IIIA期。放疗结束后60天，诊断为2级放射性肺炎。给予强的松后，检查放射性肺炎已改善，进行根治性手术。病例2为63岁男性。他被诊断为鳞状细胞肺癌cT2bN1M0，IIB期。放疗结束后120天，他被诊断为2级放射性肺炎。给予强的松后，症状消失，并进行根治性手术。在这两例病例中，术后病程良好，无并发症，患者出院。对于2级放射性肺炎的肺癌患者，应推迟手术治疗，直到患者完成类固醇治疗，临床肺炎治愈。此外，人们认为重要的是要去除已解决的放射性肺炎，而不留下任何残留区域，并且尽可能不切割任何活动性放射性肺炎区域。本文报告两例肺癌合并放射性肺炎2级患者的安全手术。在出现放射性肺炎症状时应推迟手术。手术中不应切入放射性肺炎区域。
Surgery for locally advanced lung cancer is carried out following chemoradiotherapy. However, there are no reports clarifying what the effects on the subsequent prognosis are when surgery is carried out in cases with radiation pneumonitis. In this paper, we report on 2 cases of non-small cell lung cancer with Grade 2 radiation pneumonitis after induction chemoradiotherapy, in which we were able to safely perform radical surgery subsequent to the treatment for pneumonia. Case 1 was a 68-year-old male with a diagnosis of squamous cell lung cancer cT2aN2M0, Stage IIIA. Sixty days after completion of the radiotherapy, Grade 2 radiation pneumonitis was diagnosed. After administration of predonine, and upon checking that the radiation pneumonitis had improved, radical surgery was performed. Case 2 was a 63-year-old male. He was diagnosed with squamous cell lung cancer cT2bN1M0, Stage IIB. One hundred and twenty days after completion of the radiotherapy, he was diagnosed with Grade 2 radiation pneumonitis. After administration of predonine, the symptoms disappeared, and radical surgery was performed. In both cases, the postoperative course was favorable, without complications, and the patients were discharged. Surgery for lung cancer on patients with Grade 2 radiation pneumonitis should be deferred until the patients complete steroid therapy, and the clinical pneumonitis is cured. Moreover, it is believed that it is important to remove the resolved radiation pneumonitis without leaving any residual areas and not to cut into any areas of active radiation pneumonitis as much as possible. We report on two safely operation of the lung cancer with Grade 2 radiation pneumonitis. Surgery should defer during having symptoms with radiation pneumonitis. It should not cut into areas of radiation pneumonitis in operation.