Indications and contraindications to resection, radiation, and the amount of time, now I study of treatment efficacy and side effects are a lot of lung function tests. Lobectomy or pneumonectomy in lung cancer surgery mainly. Because the disease is progressive and propagation properties are often pneumonectomy. Therefore, pneumonectomy in respiratory function before surgery is appropriate, not evaluated. If ZVK1> 2 L or the value that should be> 80% in the pneumonectomy can be done. ZVK1 <2l zvk1 = "pre"> 800 or> 40% can be applied in the pneumonectomy. If the post for the 800 or 40% will be in the pneumonectomy. In such patients, lobectomy is needed.
Indication for resection in cases with a limited diffusion capacity, and increases the blood tests help to determine the value of P02.
Expiration of air flow and volume in a meaningful and easy to measure the relationship between the evaluation of lung function tests. Ration of maximal expiration flow and volume relationship (MEAV) curves may be beneficial in the study of obstructive and restrictive functional abnormality. In order to implement the treatment of lung cancer resection and maximal expiratory flow measured MEAV curve (V max) and the second is more than 2.5 liters of air flow in the middle of forced vital capacity (V 50) must be more than 1 liter per second. V max and V 50 is reduced in obstructive lung disease. This reduction is proportional to the degree of functional impairment. PA02 and PaC02 for the indication of resection should be measured.
Less than 65 mm Hg for surgical intervention of PA02 and PaC02 of absence must not be more than 45 mm Hg.
Another method for physical ability of the Karnofsky measure provides meaningful information about it. For an indication for surgical intervention of more than 80% of the power of his physical ability is desirable. In this case, the patient can do normal activity, there are signs of the disease. 60-80% of patients with physical strength to work, stay at home, their own personal affairs makes much of, and sometimes need help. In this case, the situation is positive, the patient's lung function tests and cardiac surgery may apply. Physical ability is an indication for surgical intervention in those with 50% or less. Patients with this condition can not look self-help and need hospital treatment, the disease is progressive.
Differential Diagnosis
Bronchus cancer followed in clinical and radiological signs can be seen in the majority of lung diseases. Due to the similarity of clinical and radiological findings in the differential diagnosis of pulmonary tuberculosis and bronchial cancer is often discussed. Differential diagnostic radiographic examination and needle biopsy-siyle bronkospi not definitive, and thoracotomy should be done if any suspicion of cancer. Torakoto-gastric cancer lesion resection were obviously applied.
The main diseases like lung cancer, clinical and radiological findings are summarized below:
Granulomatous lesions (tuberculosis, sarcoidosis, fungi, etc.).
Pneumonia
Hydatid cysts, other cysts, foreign body
Benign tumors, mesotelyoma
Lung metastases
Pulmonary infarction, aneurysm
Pnömokonyozlar (silicosis)
Adenopatiler
Lymphoma, leukemia
Pleurisy
Lung Cancer Treatment
Surgical treatment
Best surgical treatment of lung cancer resection alone can be annoying. Other treatments (radiotherapy and kemotorapi), palliative and disease retarding the course of nature.
30% of lung cancers, but resection is done. Resection of the cancer cases, five year survival rate of those accessing the duration of the type of cancer, the stage and the duration varies.
The poor prognosis of small cell lung cancer. Due to the nature of diagnosis of metastatic small cell lung cancer when yayılıcı and resection and radiation therapy generally is not indicated.
Lung cancer is not a contraindication for surgical intervention should be evaluated thoroughly. The main contraindications are shown below:
1 - near and distant metastases
2 - Lymph nodes metastasis
3 - vena cava obstruction süperiyörün
4 - Karenaya uzaklıkda cancer have less than 2 sm 2 sm or less than karenaya uzaklıkda presence of lymph node metastases.
5 - severe lung function abnormalities
6 - resection survive heart disease and other diseases.
Indication for resection, and 5-year survival time in cases of squamous cell cancer comes first. Surgical treatment is not successful in the near or distant metastasis of cancer is related. Metastases in the liver, other lung, adrenal guddesine, bone, kidney and brain are.
Lung Cancer Radiotherapy (radiation therapy)
If you have a lonely and adjacent lymph nodes hemitoraksda a regional spread of lung cancer has shown that radiation therapy is indicated in inoperable cancer. Nature palliative radiation treatment, patients are anxious amacıyle reduce the symptoms. The main symptoms of bronchial obstruction and atelektaziyle dyspnea, hemoptysis, cough, chest pain, superior vena cava syndrome, and fever. Radiotherapy also increases the patient's life expectancy.
The success of radiotherapy üyüklüğünde tumor reduction, recovery and survival duration of the symptoms of the disease is evaluated.
Radiation therapy is done for the main four objectives: 1.Cerrahi interference is contraindicated in cases of respiratory illness or a serious illness. 2. Cancer-related complications, for example, the pressure of the tumor or the spread of the esophagus, superior vena cava syndrome. 3. Istemiyen patients for surgical intervention. 4. Some cancers, for example, pancoast cancer radiotherapy and resection of the tumor volume is reduced. Furthermore, in some cases, surgical intervention has not been applied together with radiotherapy and drug therapy. This treatment, adjuvant therapy, "adjunctive therapy" (radiation + drug treatment) is called.
Lung Cancer Chemotherapy
Applicable in cases of lung cancer surgery and radiation therapy or surgery and radiotherapy in the treatment of drug is helping. The drugs used in lung cancer is usually palliative nature.
The main effect of chemotherapy drugs used to treat small cell lung kanserine'dir The main cyclophosphamide, vincristine, etopsid, doxorubicin, methotrexate and lomustin (CCNU), 'stop. Usually three or more of these drugs are used in about 6 months.
Kemopeterapiyle be a good outcome (clinical and radiographic signs of cancer is not limited to) small cell lung cancer cases, 50% of these cases are tracked and life expectancy is 15 months. Widespread in small cell lung cancer is 20% of cases and good results in these cases the life time was 7 months.
Prognosis
Lung cancer and chronic quality of life of patients because of advances in different period of time, but very careful and periodic izlenmeleriyle understandable. Sometimes the therapy prolonged life expectancy or property that is connected to the understanding of cancer güçdür.
Clinical and radiological diagnosis of lung cancer for the period (prekli-technical terms) takes months or years. Preclinical period of cancer treatment with the long life time of diagnosis is provided. Diagnosed with cancer during this period, however, is not practical qualifications.
Untreated lung cancer survival time measured in matter of months. Natural course of the disease is located in the five major factors:
1. Anatomical term at the time of diagnosis of the disease
2. Cancer cell type. Small cell lung cancer survival at least, most are squamous cell lung cancer.
3. The growth rate of cancer
4. During the period before diagnosis, the patient's condition
5. Of treatment
Untreated cases of small cell carcinoma is the least time to live. The average survival time of cancer 3 months. A complete resection of the squamous cell lung cancer is 40% 30-5-year survival ratio.
Relationship was found between the duration of life of cancer growth: Tumor size is two-fold for the last time in a short period in the life is short. For example, a tumor cell proliferation in two days time (doubling time - replication time), small cell lung cancer, 30 days, adeno carcinoma 6 months. Disease symptoms, duration of cancer progression and prognosis evaluated by the success of the treatment applied. Lung cancer resection provided the best results in cases of limited disease group.
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