原发性肺癌术后继发或第二原发气管内肿瘤:系列病例报道及文献综述

Secondary or Second Primary Endotracheal Cancer after Surgery for Primary Lung Cancer:Case Series and Review of the Literature

背景与目的原发性肺癌根治术后出现继发或第二原发气管内肿瘤患者的临床特征、治疗手段及疗效、预后尚不清楚。本文将通过归纳总结相关病例,对以上问题进行详细阐述。方法搜索广东省人民医院病历,筛选出5例肺癌术后出现气管肿物的患者,同时搜索PubMed从其他文献中筛选出9例病例。结果本单位的5例患者中4例的气管内肿瘤被认为是继发于肺癌。在治疗方面,对这5例患者的气管内肿瘤分别进行了根治性切除术(n=2)、同步放化疗(concurrent chemoradiotherapy,CCRT)(n=1)、化疗(n=1)和姑息治疗(n=l)。接受CCRT治疗的患者获得最长的无进展生存期,为29.5个月。对于从其他文献中筛选到的9例患者,其中8例患者的气管内肿瘤被定义为转移。这9例患者的10个气管肿瘤分别进行了单独放疗(n=4)、CCRT(n=2)、单独化疗(n=2)和手术(n=2)。其中,1例单独接受放疗及1例接受CCRT的患者气管病灶均获得了完全缓解。结论肺癌术后的患者出现气管内肿物应需引起足够重视。CCRT是原发性肺癌术后气管内新发肿瘤的有效治疗手段。

Background and objective The clinical feature,treatment and outcomes of the patients with endotracheal cancer after radical surgery for primary lung cancer are unclear.This article will provide a detailed explanation of the above issues by summarizing the relevant cases.Methods We retrospectively reviewed five patients in Guangdong Provincial People’s Hospital and retrieved 9 cases from other literatures by searching PubMed.Results For five patients in out institute,4 endotracheal cancers were considered as secondary to lung cancers.Radical stump resection(n=2),concurrent chemoradiotherapy(CCRT)(n=1),chemotherapy(n=1)and palliative care(n=1)were performed separately in 5 patients.The patient underwent CCRT achieved the longest progression-free survival of 29.5 months.For 9 patients retrieved from other studies,8 endotracheal cancers were defined as metastases.Radiotherapy alone(n=4),CCRT(n=2),chemotherapy alone(n=2)or surgery(n=2)were performed separately in 10 lesions of 9 patients.1 patient with radiotherapy alone and 1 patient with CCRT achieved complete response.Conclusion More attention should be paid to the abnormality of the trachea after surgery of lung cancer.CCRT may be a good choice for endotracheal cancers after primary lung cancer.