悪性病変による中枢気道狭窄に対するNd:YAGレーザー照射およびステント留置療法

Abstract

Endpscopic Nd: YAG laser irradiation were performed in a total of 122 cases including 7 tracheal cancers, 67 lung cancers and 38 metastatic or infiltrated lung cancers. Patients were treated 1 to 12 times irradiating 120 to 68,536 Joules totally and airway obstruction was dissolved successfully in 87.5% of the patients. The survival rates of cases irradiated in carinas and in main bronchi were low as 0% at 32 months and 4.3% at 45 months after first irradiation whereas those of cases irradiated in tracheas and in lobar bronchi were 26.1% at 5 years and 34.0% at 51 months respectively. Airway stents were performed in a total of 7 cases including 2 tracheal cancers, 2 lung cancers and 3 metastatic or infiltrated lung cancers. 5 cases were treated with Nd: YAG laser irradiation of 3,689 to 52,104 Joules before airway stents. A patient with squamous cell carcinoma in her left main bronchus were treated with Dumon stent followed by linac irradiating 60 Gy and surviving more than 4 years without any recurrence. The combination of Nd: YAG irradiation and/or airway stents followed by other adjuvant therapies is considered to be a modality of effective treatment for airway obstruction due to malignant tumors.