TAILIEUCHUNG - Chapter 085. Neoplasms of the Lung (Part 14)

Superior Sulcus or Pancoast Tumors Non-small cell carcinomas of the superior pulmonary sulcus producing Pancoast's syndrome appear to behave differently than lung cancers at other sites and are usually treated with combined radiotherapy and surgery. Patients with these carcinomas should have the usual preoperative staging procedures, including mediastinoscopy and CT and PET scans, to determine tumor extent and a neurologic examination (and sometimes nerve conduction studies) to document involvement or impingement of nerves in the region. If mediastinoscopy is negative, curative approaches may be used in treating Pancoast's syndrome despite its apparent locally invasive nature. . | Chapter 085. Neoplasms of the Lung Part 14 Superior Sulcus or Pancoast Tumors Non-small cell carcinomas of the superior pulmonary sulcus producing Pancoast s syndrome appear to behave differently than lung cancers at other sites and are usually treated with combined radiotherapy and surgery. Patients with these carcinomas should have the usual preoperative staging procedures including mediastinoscopy and CT and PET scans to determine tumor extent and a neurologic examination and sometimes nerve conduction studies to document involvement or impingement of nerves in the region. If mediastinoscopy is negative curative approaches may be used in treating Pancoast s syndrome despite its apparent locally invasive nature. The best results reported thus employed concurrent preoperative irradiation 30 Gy in 10 treatments and cisplatin and etoposide followed by an en bloc resection of the tumor and involved chest wall 3-6 weeks later 65 of thoracotomy specimens showed either a complete response or minimal residual microscopic disease on pathologic evaluation. The 2year survival rate was 55 for all eligible patients and 70 for patients who had a complete resection. NSCLC with T3 N0 Disease Stage IIB The subset of T3 N0 disease which does not present as Pancoast tumor was initially considered stage III disease. However it has a different natural history and treatment strategy than stage III N2 disease and is now considered as stage IIB. Patients with peripheral chest wall invasion should have resection of the involved ribs and underlying lung. Chest wall defects are then repaired with chest wall musculature or Marlex mesh and methylmethacrylate. Five-year survival rates as high as 35-50 have been found and adjuvant chemotherapy is usually recommended. NSCLC Stage III Treatment of locally advanced NSCLC is one of the most controversial issues in the management of lung cancer. Treatment options include a local therapy surgery or radiation therapy combined with systemic .

• Y học thường thức
• Neoplasms of the Lung
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• bệnh học và điều trị
• bài giảng bệnh học
• tài liệu y khoa
• Harrisons Internal Medicine
• BMC Cancer
• Bone metastases
• Stereotactic radiotherapy
• Neoplasm metastasis
• Lung neoplasms
• Prostatic neoplasms
• Breast neoplasms
• Multivariate analysis
• Bone neoplasms
• Orthopedic surgery
• Lung cancer
• Atlas of pulmonary cytopathology
• Benign lung neoplasms
• Malignant lung neoplasms
• Unusual and metastatic lesions
• Metastatic lesions
• Colorectal neoplasms
• Molecular targeted therapy
• Molecular diagnostics
• Chest radiology
• Upper lung disease
• Peripheral lung disease
• Unilateral hyperlucent hemithorax
• Congenital lung disease
• BMC Pulmonary Medicine
• Diagnostic yields
• Transbronchial lung biopsy
• Radial probe endobronchial ultrasound
• Specific therapeutic interventions
• Multivariate logistic regression model
• Factors significantly