Is salvage surgery for patients with lung cancer after carbon ion radiotherapy easy or difficult?
Is salvage surgery for patients with lung cancer after carbon ion radiotherapy easy or difficult?
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DOI：
10.1093/icvts/ivy350
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发表时间：
2019-06-01
影响因子：
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通讯作者：
Shirabe, Ken
中科院分区：
文献类型：
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作者：
Ohtaki, Yoichi;Shimizu, Kimihiro;Shirabe, Ken
与常规放疗相比，碳离子放疗（CIRT）显示出更高的局部控制率和对正常肺实质的最小损伤;然而，一些患者会出现局部复发。非小细胞肺癌CIRT后补救手术的有效性和安全性尚不清楚。我们回顾了2010年至2015年期间在CIRT后接受挽救手术的6例患者的临床、手术、病理和预后数据。所有患者均为有吸烟史的男性，中位年龄为67岁。从CIRT到手术的时间为18个月（范围12-24）。所有患者均至少接受了肺叶切除术和纵隔淋巴结清扫术。所有病例均经病理证实存在活的肿瘤细胞。5例患者由于粘连较强和肿瘤可能扩展而需要联合切除或额外手术;然而，没有患者的肿瘤侵犯邻近器官。无严重并发症、围手术期死亡和局部复发，3例患者存活28-84个月，无复发。补救手术似乎是安全和有效的。即使肿瘤没有侵犯邻近器官，由于严重粘连，需要联合切除。
Carbon ion radiotherapy (CIRT) shows higher local control rates and minimal damage to normal lung parenchyma compared with conventional radiotherapy; however, some patients experience local recurrence. The efficacy and safety of salvage surgery after CIRT for non-small-cell lung cancer are unclear. We reviewed clinical, surgical, pathological and prognostic data of 6 patients who underwent salvage surgery after CIRT between 2010 and 2015. All patients were men with a smoking history, and their median age was 67 years. The time from CIRT to surgery was 18 (range 12-24) months. All patients underwent at least lobectomy with mediastinal node dissection. Viable tumour cells were confirmed pathologically in all cases. Five patients required combined resection or extra procedure because of strong adhesions and the possibility of tumour extension; however, none of the patients had a tumour invasion to the adjacent organ. None of the patients had severe complications, perioperative death and local recurrence, and 3 patients are alive without recurrence (range 28-84 months). Salvage surgery appears to be safe and effective. Even though the tumours did not invade the adjacent organs, combined resection was required because of severe adhesion.