Abstract
For treatment of metastatic lung lesions there was used the method isolated chemoperfusion of the lung in combination with metastasectomy. The study includes 74 patients with metastases in the lungs who underwent 101 normothermal isolated chemoperfusion of the lung: of these 38 (37,6%) with melphalan and 63 (62,4%) with cisplatin without lethality. In the early postoperative period 1 (1,4%) patient died due to postperfusion lung edema. The period of observation of patients ranged from 2 to 99 months (median 29.3 months). Of 74 patients 53 (71,6%) patients are alive, 2 (2,7%) patients died from causes unrelated to the underlying disease. 43 (58,1%) patients showed progression of disease, what in 18 (41,9%) of them was the cause of death. Repeated appearance of metastases in perfused lung was detected in 30 (40,5%) patients. A 5-year disease-free (in the lungs) and observed survival of patients after isolated chemoperfusion of the lung with metastasectomy was 45% (median 46 months) and 59% (median not reached) respectively. There were established predictors of effectiveness of isolated chemoperfusion of the lung with metastasectomy: DFI> 13 months, ≤5 metastatic nodes in the lungs, the size of the largest metastasis in the lungs ≤20 mm, intralobular location of metastases in the lungs as well as the time of doubling the volume of metastases >64 days for chest computed tomography.References
Гафтон Г.И., Семилетова Ю.В., Сенчик К.Ю. и др. Перфузионные технологии в лечении больных меланомой кожи и саркомами мягких тканей конечностей // Вопр. онкол. - 2015. -Т. 3 (61). - С. 507-509.
Малаев С.Г., Полоцкий Б.Е. Метастатические опухоли лёгких // Энциклопедия клинической онкологии. -2004. - С. 193-195.
Трахтенберг А.Х., Паршин В.Д., Пикин О.В. Хирургическое лечение метастазов колоректального рака в лёгких // Росс. онкол. журнал. - 2005. - № 4. - С. 18-21.
Чиссов В.И., Трахтенберг А.Х., Пикин О.В. Метастатические опухоли лёгких. - М.: ГЭОТАР-Медиа. - 2009. - 160 с.
Blackmon S.H., Stephens E.H., Correa A.M. et al. Predictors of recurrent pulmonary metastases and survival after pulmonary metastasectomy for colorectal cancer // Ann. Thorac. Surg. - 2012. - Vol. 6 (94). - P. 1802-1809.
Casali C., Stefani A., Storelli E. et al. Prognostic factors and survival after resection of lung metastases from epithelial tumours // Interact Cardiovasc Thorac Surg. -2006. - Vol. 5 (3). - P. 317-321.
Grootenboers M.J., Heeren J., van Putte B.P. et al. Isolated lung perfusion for pulmonary metastases, a review and work in progress // Perfusion. - 2006. - Vol. 21. - P. 267-276.
Grootenboers M.J., Schramel F.M., van Boven W.J. et al. Re-evaluation of toxicity and long-term follow-up of isolated lung perfusion with melphalan in patients with resectable pulmonary metastases: phase I and extentional trial // Ann. Thorac. Surg. - 2007. - Vol. 83. - P. 1235-1236.
Hendriks J.M.H., Grootenboers M.J., Schramel F.M. et al. Isolated lung perfusion with melphalan for resectable lung metastases: a phase I clinical trial // Ann. Thorac. Surg. - 2004. - Vol. 78. - P. 1919-1926.
Hendriks J.M., Romijn S., Van Putte B. et al. Long-term results of surgical resection of lung metastases // Acta Chir Belg. - 2001. - Vol. 101. - P. 267-272.
Hendriks J. M., Van Putte B. P., Grootenboers M. et al. Isolated lung perfusion for pulmonary metastases // Thorac Surg Clin. - 2006. - Vol. 16. - P. 185-98.
Hengst W.A, Hendriks J.M., Balduyck B. et al. Phase II Multicenter Clinical Trial of Pulmonary Metastasectomy and Isolated Lung Perfusion with Melphalan in Patients with Resectable Lung Metastases // Journal of Thoracic Oncology. - 2014. - Vol. 9. - P. 1547 - 1553.
Pastorino U., Buyse M., Friedel G. et al. Long-term results of lung metastasectomy: prognostic analyses based on 5206 cases // The International Registry of Lung Metastases. J. Thorac Cardiovasc Surg. - 1997. - Vol. 113. - P. 37-49.
Pfannschmidt J., Hoffmann H., Muley T. et al. Prognostic factors for survival after pulmonary resection of metastatic renal cell carcinoma // Ann Thorac Surg. - 2002. - Vol. 74 (5). - P. 1653-1657.
Ratto G.B., Toma S., Civalleri D. et al. Isolated lung perfusion with platinum in the treatment of pulmonary metastases from soft tissue sarcomas // J. Thorac. Cardiovasc. Surg. - 1996. - Vol. 112. - P. 614-622.
Takakura Y., Miyata Y., Okajima M. et al. Short disease-free interval is a significant risk factor for intrapulmonary recurrence after resection of pulmonary metastases in colorectal cancer // Colorectal Dis. - 2010. - Vol. 12. - P. 68-57.
Van Schil P.E. Surgical treatment for pulmonary metastases // Acta Clin Belg. - 2002. -Vol. 57. - P. 333-339.
Van Schil P.E., Hendriks J.M., Van Putte B.P. et al. Isolated lung perfusion and related techniques for the treatment of pulmonary metastases // J. Cardiothorac. Surg. - 2008. - Vol. 33. - P. 487-496.
All the Copyright statements for authors are present in the standart Publishing Agreement (Public Offer) to Publish an Article in an Academic Periodical 'Problems in oncology' ...