Impact of neo-adjuvant radiochemotherapy on bronchial tissue viability.
Impact of neo-adjuvant radiochemotherapy on bronchial tissue viability.
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新辅助放化疗对支气管组织活力的影响。
DOI：
10.1016/j.ejcts.2009.08.021
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发表时间：
2009
期刊：
影响因子：
--
通讯作者：
G. Friedel
中科院分区：
文献类型：
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作者：
M. Hampel;I. Dally;T. Walles;V. Steger;S. Veit;T. Kyriss;G. Friedel
目的：在晚期肺癌的治疗中，越来越多的方法被引入，在新的辅助环境下应用放疗和/或化疗。到目前为止，诱导治疗，尤其是放射治疗对支气管组织活性的影响还没有被研究。方法：2008年，我们连续测定了45例患者在手术中获得的支气管段的组织活性，包括新辅助放化疗(RCTX)后的患者。通过组织学、细胞死亡试验和组织特异性培养上清液中的细胞增殖来分析支气管组织的活性。生物医学结果与患者的临床病程进行比较。结果：44例患者的组织标本纳入本研究。14例患者(32%)接受了新辅助RCTX治疗。支气管段的组织学和死亡数测定没有显著差异。而患者的年龄、性别、肿瘤实体和切除部位对细胞的体外增殖无影响，而既往RCTX导致支气管组织活力下降46%(P=0.01)。结论：新佐剂RCTX显著降低了支气管组织的存活率。然而，这种损害并不一定转化为术后支气管功能不全的增加。标准的组织学检查不够敏感，不足以描述RCTX后支气管组织活性的变化。
Objective:In the treatment of advanced stages of lung cancer, increasingly more multimodality approaches applying radiotherapy and/or chemotherapy in a neo-adjuvant setting are being introduced. The impact of induction therapy, especially radiotherapy, on bronchial tissue viability has not been investigated so far.Methods:In 2008, we determined the tissue viability of bronchial segments obtained during surgery in 45 consecutive patients, including patients after neo-adjuvant radiochemotherapy (RCTX). Bronchial tissue viability was analysed by histology, life–dead assay and cell proliferation in tissue-specific culture media. Biomedical findings were compared with the clinical course of the patients.Results:Tissue samples of 44 patients were included into this study. Fourteen patients (32%) had undergone neo-adjuvant RCTX. Histology and life–dead assay of the bronchial segments did not show significant differences. While patient age, sex, tumour entity and site of resection had no influence on cell proliferationin vitro, previous RCTX resulted in a 46% decrease of bronchial tissue viability (P= 0.01). However, this effect was not reflected by the clinical course of the operated patients.Conclusions:Neo-adjuvant RCTX reduces bronchial tissue viability substantially. However, this impairment does not necessarily translate into an increased rate of postoperative bronchial insufficiencies. Standard histological work-up is not sensitive enough to characterise changes in bronchial tissue viability following RCTX.