Chest
Cilnical InvestigationsSerial Fiberoptic Bronchoscopy during Chemotherapy for Small Cell Carcinoma of the Lung: Early Detection of Patients at High Risk of Relapse
Section snippets
Materials and Methods
Serial fiberoptic bronchoscopic examinations were performed before or during therapy (or at both times) in 77 previously untreated patients with small cell carcinoma. Most were referred to our unit for intensive treatment after diagnosis elsewhere. Treatment consisted of alternating regimens of chemotherapy with a combination of drugs;10 radiotherapy was initially given only for lesions of the central nervous system. Bronchoscopic examination was done before treatment, after 6 and 24 weeks of
Results
No deaths and no hemorrhagic or major respiratory complications were observed after these elective bronchoscopic procedures, which included examinations with endobronchial biopsy before treatment in seven patients with the superior vena cava syndrome.
Discussion
Evaluation of the response to therapy in patients with cancer of the lung was not mentioned in a recent review of the indications for fiberoptic bronchoscopic examination;9 however, at least two groups of authors have demonstrated superior survival in patients with lung cancer who are found to be without residual carcinoma at bronchoscopic examination performed after therapy with irradiation.12, 13 Oka et al14 have utilized bronchoscopic examination to assess the effects of therapy with
ACKNOWLEDGMENT
We thank Adi F. Gazdar, M.B., B.S., for reviewing some of the pathologic material and for supplying the illustrations.
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Management of small cell lung cancer
2002, Clinics in Chest MedicineSurvival in small cell lung carcinoma is independent of bcl-2 expression
1999, Human PathologyTumour response evaluation during lung cancer chemotherapy
1995, La Revue de medecine interneSmall cell carcinoma of the lung: clinical and biologic aspects
1991, Critical Reviews in Oncology and Hematology
Manuscript received February 27; revision accepted May 4.