上腔静脉综合征与肺癌:生存和预后因素

N. Fahem, A. Migaou, A. Ben Saad, S. Jobeur, Saoussen cheikh Mhammed, N. Rouatbi
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引用次数: 1

摘要

简介:上腔静脉综合征(SVCS)是由于上腔静脉压迫、侵犯或血栓形成引起的上腔静脉电流阻塞的一组体征。其病因多种多样,但以支气管肺源性肿瘤为主。工作目的:本研究的目的是评估肺癌患者上腔静脉综合征的生存率和确定预后因素。我们还建议制定SVCS恶性起源的临床概况和治疗管理。材料与方法:法图马-布尔吉巴大学附属医院肺内科25年间收治的SVCS合并原发性支气管癌患者108例。结果:男性优势明显(98.1%),平均年龄60.2岁。吸烟占68.5%,上腔静脉综合征显示肿瘤占55%,异时性占30.5%。中位生存期为7个月。在单因素研究中,一般健康状况受损(PS评分≥2)、SVCS严重程度、呼吸功能改变、慢性呼吸衰竭、非小细胞肺癌组织学类型和支气管肺癌单独对症治疗的患者的生存率降低。多因素分析显示,性别、吸烟、PS评分和严重程度是独立的预后因素。结论:SVCS的治疗是多学科交叉的。它需要药物治疗,但其有效性仍不确定,而放射治疗被认为是治疗SVCS的金标准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Superior vena cava syndrome and lung cancer: survival and prognostic factors
Introduction: The superior vena cava syndrome (SVCS) is a set of signs related to the obstruction of the upper cava current caused by a compression, an invasion or a thrombosis of the superior vena cava. Its etiologies are numerous but dominated by neoplastic causes mainly of bronchopulmonary origin. Aim of the work: The aim of this study is to evaluate survival and to identify the prognostic factors of superior vena cava syndrome in patients with lung cancer. We also propose to draw up the clinical profile as well as the therapeutic management in SVCS of malignant origin. Materials and methods: A total of 108 patients with SVCS complicating primary bronchial cancer were hospitalized in the Pneumology Department at Fattouma Bourguiba University Hospital during a period of 25 years. Results: The results showed the existence of a clear male predominance (98.1%) and an average age of 60.2 years. Smoking was found in 68.5% of cases .The superior vena cava syndrome revealed a neoplasm in 55% of cases and it was metachronous in 30.5% of cases. Median survival was 7months. In univariate study, survival was reduced in patients having general health impairment with Performans Status (PS) score≥2, signs of severity of SVCS, altered respiratory function, chronic respiratory failure, histological type of non small cell lung carcinoma and exclusive symptomatic treatment for bronchopulmonary cancer. Multivariate analysis revealed that gender, smoking, PS score and signs of severity were independent prognostic factors. Conclusion: The management of the SVCS is multidisciplinary. It requires medical treatment whose effectiveness is still uncertain and radiotherapy which is considered the gold standard of treatment for SVCS.
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