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Pulmonary rehabilitation: pre-and postoperative treatment. 肺康复:术前和术后治疗。
Rays Pub Date : 2004-10-01
Anna Bozzone, Angela Romanelli, Giovanni Magrone, Marco Pascoli, Mariella Milazzo, Silvia Sterzi
{"title":"Pulmonary rehabilitation: pre-and postoperative treatment.","authors":"Anna Bozzone,&nbsp;Angela Romanelli,&nbsp;Giovanni Magrone,&nbsp;Marco Pascoli,&nbsp;Mariella Milazzo,&nbsp;Silvia Sterzi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Lung cancer is the leading cause of cancer-related death in women and men in the United States. Since 1987, mortality due to lung cancer surpassed death caused by breast cancer in women. Equally discouraging is the fact that survival at five years for all lung cancer patients is only 15%. Despite improved survival in many patients with early disease, the vast majority suffer from significant morbidity and early death. Therefore, proper management of these patients is extremely challenging and requires the utmost collaboration between many different specialties. In lung cancer patients, pulmonary rehabilitation lowers the risk of postoperative complications and reduces the length of hospital stay. At the same time, exercise tolerance is improved, anxiety and depression are controlled, thus improving the quality of life. Even though quality of life is commonly overlooked when treating lung cancer patients, studies have demonstrated that better quality of life is a priority for these patients.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"431-3"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25077404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Intraoperative aspects and complications for the anesthesiologist in the management of patients undergoing thoracic surgery for lung cancer. 麻醉医师处理胸外科肺癌患者的术中问题及并发症。
Rays Pub Date : 2004-10-01
Alessandro Bacuzzi, Giovanni Cantone, Andrea Cecchin, Salvatore Cuffari
{"title":"Intraoperative aspects and complications for the anesthesiologist in the management of patients undergoing thoracic surgery for lung cancer.","authors":"Alessandro Bacuzzi,&nbsp;Giovanni Cantone,&nbsp;Andrea Cecchin,&nbsp;Salvatore Cuffari","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Surgery, when feasible, rappresents the treatment of choice for lung cancer. Several problems can come to the attention of the anesthesiologist in relation to the respiratory function with implications in airway control (double-lumen tube for lung collapse required for better surgical exposure of the pulmonary tissue), mechanical and gas-exchange aspects (increase in airway pressure of the dependent lung, increased blood shunt). The effect of these disorders, with no compensatory mechanism (pulmonary hypoxic vasoconstriction) and in the absence of an anesthesiologist (higher FiO2, low tidal volumes, allowing \"permissive hypercapnia\", CPAP to the non-dependent lung), normal arterial oxygenation (hypoxemia) is impaired. Right heart failure is the major risk particularly in preexisting pulmonary hypertension Supraventricular arrytmias can often occur in case of history of cardiovascular disease, metabolic and mechanical intraoperative alterations (type and duration of surgery, pericardial and autonomic nervous system manipulations). Unusual complications are cardiac herniation and pulmonary re-expansion-edema.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"461-3"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25077412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Histological classification of lung cancer. 肺癌的组织学分类。
Rays Pub Date : 2004-10-01
Claudia Maggiore, Antonino Mulè, Guido Fadda, Esther Diana Rossi, Libero Lauriola, Fabio Maria Vecchio, Arnaldo Capelli
{"title":"Histological classification of lung cancer.","authors":"Claudia Maggiore,&nbsp;Antonino Mulè,&nbsp;Guido Fadda,&nbsp;Esther Diana Rossi,&nbsp;Libero Lauriola,&nbsp;Fabio Maria Vecchio,&nbsp;Arnaldo Capelli","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A histological classification should provide guidelines for tumor diagnosis in order to evaluate patient prognosis and therapy. Pre-invasive lesions identified as precursors of invasive lung carcinoma are: squamous dysplasia/carcinoma in situ, atypical adenomatous hyperplasia and idiopatic pulmonary neuroendocrine cell hyperplasia. Squamous carcinoma and adenocarcinoma are the commonest types of lung carcinoma with the latter increasing in many countries mainly for changed smoking habits. Bronchioloalveolar carcinomas include exclusively noninvasive mucinous or non-mucinous tumors. Neuroendocrine tumors range from well differentiated neuroendocrine carcinoma (typical carcinoid) to intermediate grade (atypical carcinoma) to very aggressive poorly differentiated lesions (large cell neuroendocrine carcinoma and small cell carcinoma).</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"353-5"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25076910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cytologic diagnosis of pulmonary lesions. 肺病变的细胞学诊断。
Rays Pub Date : 2004-10-01
Esther Diana Rossi, Antonino Mulè, Claudia Maggiore, Antonella Miraglia, Libero Lauriola, Fabio Maria Vecchio, Guido Fadda
{"title":"Cytologic diagnosis of pulmonary lesions.","authors":"Esther Diana Rossi,&nbsp;Antonino Mulè,&nbsp;Claudia Maggiore,&nbsp;Antonella Miraglia,&nbsp;Libero Lauriola,&nbsp;Fabio Maria Vecchio,&nbsp;Guido Fadda","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The major types of cytologic preparations used in most laboratories to detect the lesions of the lower respiratory tract (LRT) are examined. These methods include sputum, bronchial washing, bronchial brushing, bronchoalveolar lavage (BAL) and fine-needle aspiration biopsy (FNAB). Sputum represents the simplest and most cost-effective sampling method even though fiberoptic bronchoscopy and radiologic guided FNAB are superseding it as the first diagnostic choice in most cases. There are advantages and disadvantages associated with each technique:bronchial brushing and FNABs tend to preserve both the cellular details and their architectural arrangement whereas sputum and bronchial washing often cause a variable degree of cellular degeneration and fragmentation. As a result, most pulmonary lesions may be detected and correctly diagnosed if multiple techniques are used to acquire diagnostic material. CT-guided FNAB represents the most effective method to achieve a correct diagnosis in pulmonary tumors.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"357-61"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25076911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Tnm independent prognostic factors in lung cancer. 肺癌的独立预后因素。
Rays Pub Date : 2004-10-01
Kenji Kawamukai, Alfredo Cesario, Stefano Margaritora, Elisa Meacci, Alessio Piraino, Maria Letizia Vita, Adele Tessitore, Giacomo Cusumano, Pierluigi Granone
{"title":"Tnm independent prognostic factors in lung cancer.","authors":"Kenji Kawamukai,&nbsp;Alfredo Cesario,&nbsp;Stefano Margaritora,&nbsp;Elisa Meacci,&nbsp;Alessio Piraino,&nbsp;Maria Letizia Vita,&nbsp;Adele Tessitore,&nbsp;Giacomo Cusumano,&nbsp;Pierluigi Granone","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Large studies have demonstrated that TNM staging system is the most consistent prognostic factor in patients with non small cell lung carcinoma. However, because patients within the same stage may have very different survival, better prognostic information is needed. The recent progress in molecular biology has allowed the analysis of proteins and genes involved in cancer development. To date, more than 150 different prognostic factors affecting survival in patients with lung cancer have been discovered and extensively studied. Despite the encouraging prognostic results in angiogenesis markers, there is not yet a molecular marker validated in large prospective trials that has major independent predictive prognostic value.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"373-6"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25076913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neoadjuvant concurrent chemotherapy and radiotherapy in non-small cell lung cancer. 非小细胞肺癌的新辅助同步化疗和放疗。
Rays Pub Date : 2004-10-01
Sara Ramella, Marzia Ciresa, Mariangela Massaccesi, Gianluca Franceschini, Rolando M D'Angelillo, Lucio Trodella
{"title":"Neoadjuvant concurrent chemotherapy and radiotherapy in non-small cell lung cancer.","authors":"Sara Ramella,&nbsp;Marzia Ciresa,&nbsp;Mariangela Massaccesi,&nbsp;Gianluca Franceschini,&nbsp;Rolando M D'Angelillo,&nbsp;Lucio Trodella","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Abstract. Radiotherapy was the standard treatment for patients with locally advanced non-small cell lung cancer until the mid 1990s. Chemotherapy was added in order to improve outcome, and during the last decade sequential, concurrent or mixed modalities have been extensively explored and discussed. Goals of neoadjuvant chemoradiation are resecability and downstaging. Recent published experiences evidenced that neoadjuvant chemoradiotherapy is feasible if delivered with low total dose and limited volume; pathological downstaging to stage 0-I could be a reasonable surrogate end-point for overall and disease free survival and for distant metastasis.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"439-43"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25077407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lung cancer: multidisciplinary refresher course for residents. Rome, Italy, October 1-2, 2004. 肺癌:住院医师多学科进修课程。罗马，意大利，2004年10月1-2日。
Rays Pub Date : 2004-10-01
{"title":"Lung cancer: multidisciplinary refresher course for residents. Rome, Italy, October 1-2, 2004.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"351-475"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25127003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Chest wall reconstruction after resection in lung cancer: personal experience. 肺癌切除术后胸壁重建:个人经验。
Rays Pub Date : 2004-10-01
Dario Familiari, Rosaria Pavia, Francesco Monaco, Baldassare Mondello, Maurizio Monaco
{"title":"Chest wall reconstruction after resection in lung cancer: personal experience.","authors":"Dario Familiari,&nbsp;Rosaria Pavia,&nbsp;Francesco Monaco,&nbsp;Baldassare Mondello,&nbsp;Maurizio Monaco","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Chest wall reconstruction after resection, for locally advanced lung cancer but also for some selected secondary tumors, is a demanding challenge to surgeons, anesthetists and experts in respiratory function rehabilitation who must guarantee a regular natural ventilation, adequate protection of intrathoracic organs and acceptable cosmetic outcome. To this aim, many procedures using autologous, heterologous, or prosthetic materials, are available. A study conducted on 13 lung cancer patients who after resection underwent reconstruction with heterologous prosthetic material is presented. No intraoperative mortality or septic complications were observed. There was prompt wall stabilization in 10 patients; it occurred 3 weeks later in another patient (polytetrafluoridethylene patch). Only in one patient (prolene mesh) a seroma developed, treated with US-guided drainage. In the authors' experience, even for fairly small defects reconstruction with prosthetic material is suitable, to prevent, in case of the presence of risk factors, pulmonary hernia-induced major respiratory symptoms. Prosthetic materials are also preferred for benign lesions characterized by a long-term survival.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"419-21"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25076359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Adjuvant chemotherapy in resected non-small cell lung cancer. 非小细胞肺癌切除后的辅助化疗。
Rays Pub Date : 2004-10-01
Rodolfo Cangiano
{"title":"Adjuvant chemotherapy in resected non-small cell lung cancer.","authors":"Rodolfo Cangiano","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There is still a high mortality ratio in completely resected non-small cell lung cancer patients either due to local or, more often, to metastatic recurrence. The NSCLC Collaborative Group Meta-analysis demonstrated a not statistically significant advantage in patients treated with cisplatin-based regimens. Many subsequent trials were unable to demonstrate the real effectiveness of cisplatin-based adjuvant chemotherapy with a significant rate of toxicity. The IALT trial demonstrated little advantage in overall and disease-free survival with acceptable toxicity. A recent meta-analysis of trials including 5716 patients demonstrated the role of cisplatin-based chemotherapy as adjuvant treatment of resected non-small cell lung cancer even if results shoud be carefully examined. At present, adjuvant chemotherapy in non-small cell cancer should not be reserved to experimental trials.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"435-7"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25077405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Induction therapy before surgery for non-small cell lung cancer. 非小细胞肺癌术前诱导治疗。
Rays Pub Date : 2004-10-01
Roberta Ferraldeschi, Giuliana D'Auria, Adolfo De Pasquale Ceratti, Pasquale Assalone, Lucia Mentuccia, Marika Ciprotti, Maria Laura Evangelista, Marta Mazzoli, Concetta Di Fonzo, Enrico Cortesi
{"title":"Induction therapy before surgery for non-small cell lung cancer.","authors":"Roberta Ferraldeschi,&nbsp;Giuliana D'Auria,&nbsp;Adolfo De Pasquale Ceratti,&nbsp;Pasquale Assalone,&nbsp;Lucia Mentuccia,&nbsp;Marika Ciprotti,&nbsp;Maria Laura Evangelista,&nbsp;Marta Mazzoli,&nbsp;Concetta Di Fonzo,&nbsp;Enrico Cortesi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Surgery alone is currently still accepted as the principal therapy for cure for patients with localized non-small cell lung cancer. The optimal therapy in locally advanced and unresectable stage III disease remains unclear. The limited performance of each single therapeutic strategy (surgery, radiotherapy, or chemotherapy) in the treatment of locally advanced non-small cell lung cancer accounted for the rationale of the many attempts at improvement by integrating the different approaches. In recent years, to improve clinical outcome, chemotherapy or chemoradiation followed by surgery, and definitive chemoradiation have commonly been used. Despite numerous phase-II trials, little evidence from randomized phase-III trials has been generated. The ongoing randomized trials will probably provide more reliable indications to define the management of the large number of patients with locally advanced disease.</p>","PeriodicalId":77342,"journal":{"name":"Rays","volume":"29 4","pages":"445-52"},"PeriodicalIF":0.0,"publicationDate":"2004-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25077406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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