Name: endobronchial ultrasound-guided intratumoral injection of cisplatin for the treatment of isolated mediastinal recurrence of lung cancer
Uploaded: 2017-02-12T14:00:00
Description: Watch this Scientific Journal Video about Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer at JoVE.com

The authors have no acknowledgements.

EBUS rehberliğinde sisplatin ile tedavi edilen tüm hastalarda ilgili veriler incelendi. Florida Üniversitesi&#39;nde kurumsal inceleme kurulu bu çalışmayı (# IRB201400823) onayladı. Tüm veriler prospektif olarak toplanmış ve geriye dönük olarak analiz edildi. Aşağıdaki kayıt ölçütleri kullanın. 1. Hasta Seçimi <ol><li> biyopsi ile doğrulanmış küçük hücreli olmayan akciğer kanseri (KHDAK) ya da küçük hücreli akciğer kanseri (KHAK) ve patolojik teyit nüks ...

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<html> Bizim el yazması fazla radyasyon bir seçenek değildir hastalar için akciğer kanserinin izole mediastinal ve hiler nüks yönetimine odaklanmaktadır. IMHR insidansı yaklaşık% 9 11&#39;dir. Farklı tedavi seçenekleri palyatif kemoterapi, daha fazla harici ışın radyasyon tedavisi veya destekleyici bakım ve gözetim dahil olmak üzere, bu hastalarda denenmiştir. Kurumumuzda, biz bronkoskopi ile yönlendirilen intratümöral sisplatin ile bu hastaların tedavisinde. <p class="...

Akciğer kanseri tüm kanser bağlı ölümlerin 5 içinde 1 için hem erkek hem de kadın ve hesaplarına dünya çapında en yaygın kanser türüdür. Bu 0.87 1, 2 vaka ölüm oranı vardır. İlk tedaviden sonra nüks akciğer kanseri olan hastalarda en ölümlerin oluşturmaktadır. Tekrarlayan akciğer kanseri için tedavi seçenekleri sınırlıdır. Tekrarlayan akciğer kanseri daha da müdahaleler 3 kabul ve hoşgörü olasılığını azaltmak bütün bunlar, yaşam kalitesinin ve önemli bakıcı tükenmişlik önemli bozulma yol açar ve ek destekleyici bakım gerektirir. KHDAK hastalarının yaklaşık% 30&#39;u radyasyon 4 sonra lokal nüks var. Bu hastalar için tedavi seçenekleri sınırlıdır ve sadece% 10 5, 6 objektif yanıt oranı sistemik kemoterapi içerir.Tekrar göğüs radyasyon mümkün olmasına rağmen, bu palyatif amaçlarla ve belirtilerin giderilmesi için ağırlıklı olarak çalışılmış ve hastalık remisyon 3 için kullanılan olmamıştır. Kurumumuzda, bronkoskopi üzerinden erişilebilir izole mediastinal ve hiler nüks (IMHR) tüm hastalar sisplatin transbronşial tümör içi enjeksiyon (ITC) -Güdümlü endobronşiyal ultrason (EBUS) ile tedavi edildi. sistemik kemoterapi ve / veya eksternal radyoterapi (EBRT) ile eş zamanlı tedavi tedavi onkolog &#39;takdirine göre izin verildi. Bu el yazması güvenliği, etkinliği, fizibilite ve bizim kurumda kullanılan protokol ayrıntılı yöntemler vurgulamaktadır.

<table border="0" cellpadding="0" cellspacing="0" width="261">
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			<td colspan="2" height="20" style="height:20px;width:261px;">Bronchoscope</td>
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			<td colspan="2" height="20" style="height:20px;">22 Guage olympus EBUS needle</td>
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			<td colspan="2" height="20" style="height:20px;">40 g of cisplatin in 40 mls of normal saline</td>
		</tr>
	</tbody>
</table>

endobronchial ultrasound-guided intratumoral injection of cisplatin for the treatment of isolated mediastinal recurrence of lung cancer

Akciğer kanserli hastalarda izole hiler ve eksternal radyoterapi (EBRT) aşağıdaki mediastinal nüks (IMHR) yaygındır. Bu hastalar birçok tedavi seçeneği yoktur ve genellikle palyatif kemoterapi ya da en iyi destekleyici bakım sunulmaktadır. Endobronşiyal ultrason (EBUS) sisplatin tümör içi enjeksiyon -Güdümlü (ITC) bu hastalar için yeni bir yaklaşımdır. prosedür bilinçli sedasyon altında yapılır. lezyon EBUS kullanarak bronkoskopi ile bulunur ve bir 22-gauge EBUS iğne kapsamında çalışma kanalından gelişmiş ve pozisyonda kilitlenir. ultrasonografi eşliğinde, trakeobronşiyal ağacın duvar delinir ve iğne hedef lezyonun taşınır. İğne stile daha sonra çıkarılır ve sisplatin (40 mg / 40 mi) bir lezyon içine enjekte edilir. Bir iki site seans başına tedavi edilir. prosedürün ayrıntıları kağıt protokolü bölümünde açıklanmıştır. Merkezimizde, 50 siteler 36 hastada tedavi edildi(19 erkek, 17 kadın). Bizim kohort yaş ortalaması 61.9 ± 8.5 yıl idi. Biz 35 hasta ve 41 sitelerinde son analizler gerçekleştirilmiştir. 11/35 (% 31) stabil veya progresif hastalığı (non-yanıt) sahipken 24/35 (% 69), tam ya da kısmi yanıt (yanıt) vardı. Genel olarak, bizim grupta sağkalım vermedi olanlardan çok daha iyi sağkalım sahip yanıtladı hastalarda 8 ay (6-11 ay% 95 CI), oldu.

yanıtı 8-12 hafta tedaviden sonra takip görüntülemesi ile ölçüldü. Yanıtı tam remisyon (CR), kısmi remisyon (PR), stabil hastalık (SD), progresif hastalığı (PH), ya da RECIST 1.1 kriter 8 dayalı yanıtı değerlendirmek mümkün olarak sınıflandırıldı. CR ve PR ile hastalar yanıt olarak kabul edildi, diğerleri olmayan yanıt olarak sınıflandırıldı. İkincil sonuçlar tümör histolojisi, nüks boyutu ve eşzamanlı sistemik tedavi daya...

Watch this Scientific Journal Video about Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer at JoVE.com

Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer

The management of isolated recurrent lung cancer in a previously-irradiated field is challenging. Here, we describe an endobronchial ultrasound (EBUS)-guided cisplatin injection for the management of patients with localized lung cancer recurrence in a previously-radiated field.

Endobronşiyal Akciğer Kanseri İzole Mediastinal Nüks Tedavisinde Sisplatin intratümöral Enjeksiyon Ultrason eşliğinde

Isolated hilar and mediastinal recurrence (IMHR) following external beam radiation therapy (EBRT) in patients with lung cancer is common. These patients ...

The overall goal of this procedure is to describe an endobronchial ultrasound or EBUS-guided cisplatin injection for the management of patients with localized lung cancer recurrence in a previously radiated field. This method can help answer key questions in the field of lung cancer treatment about the safety and efficacy of EBUS-guided trans-bronchial intratumoral injection of cisplatin for recurrence of lung cancers in the post-radiated field. The main advantage of this technique is that it provides an alternative treatment option to systemic chemotherapy for patients with isolated, hilar, and mediastinal recurrence of lung cancer.For real-time visualization of hilar, mediastinal, and peribronchial structures for intratumoral cisplatin injection, first intravenously administer dexamethasone and ondansetron to a patient who has abstained from oral food and fluids for at least six hours. Next, induce conscious sedation with intravenous Midazolam and Fentanyl treatment, coupled with the topical application of five milliliters of Lidocaine. Use standard monitoring, including a continuous 3-lead electrocardiogram for heart rate monitoring, continuous pulse oximetry, and respiratory rate measurements.Now locate the target lesion using a convex probe EBUS with a built-in ultrasound probe on a flexible bronchoscope to advance the scope through the vocal cords. When the scope reaches the airways, turn on the EBUS processor and use one to two milliliters of normal saline to inflate the balloon at the tip of the scope. Flex the scope across the airway wall to locate the lesion.Then deploy the 22-gauge EBUS needle through the working channel of the scope and lock the needle into position. Under real-time ultrasound guidance, puncture the tracheobronchial wall and insert the needle into the target lesion. Remove the stylet within the needle and inject 10 milliliters of cisplatin into the lesion.Then retract the needle back into the sheath and inject the needle into a separate area of the lesion for the injection of another 10 milliliters of cisplatin. Remove the needle from the working channel of the scope and suction any additional drug from the distal airways. Then remove the bronchoscope.In this representative study, 8 to 12 weeks after therapy, 69%of the patients were classified as responders and 31%as non-responders, with a median survival of 8 months, 10 months for the responders, and six months for the non-responders, with a significantly higher progression-free survival rate observed in the responders group. While attempting this procedure, it is important to select appropriate patients, and to perform all of the steps in the protocol in a systematic manner. After its development, this technique paved the way for us and other researchers in the field of lung cancer to explore intratumoral chemo and other immunotherapies in animal models and in humans.After watching this video, you should have a good understanding of how to treat mediastinal and hilar recurrence of lung cancer with EBUS-guided intratumoral cisplatin injection.

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