Background: Pulmonary sarcoma is a rare malignant tumor in soft tissues. Resection is the preferred option to treat this tumor. The aim of this study is to explore the effect of interventional bronchoscopies in the treatment of pulmonary sarcoma if the patient is inoperable.
Methods: Sixteen cases with pulmonary sarcoma were retrospectively reviewed in our hospital from November 2008 to July 2014. The mean age was (53.1±5.4) years old. Rigid bronchoscopy was applied for the first procedure with general anesthesia, and electronic bronchoscopy was used for the second procedure or slight patients.
Results: Sixteen cases, which include 10 sarcomatoid carcinoma, 2 fibrosarcoma, 2 sarcoma, 1 fibromucoid sarcoma, and 1 spindle cell synovial sarcoma, were collected in this study. Eleven cases (68.8%) were peripheral and mainly located in the right upper lobe and left lower lobe. Five cases (31.2%) were central. Of these cases, 82% (9/11) were mixed and primary tumors in pulmonary tumor. Meanwhile, 56% (9/16) were intraluminal and 69% (11/16) were metastatic in central airway. All of the four cases with whole atelectasis were completely relieved through postbronchoscopic interventions. Three of the seven cases with segment atelectasis were completely reopened; two of them were partially relieved; and the remaining two had no response. The obstructive degree, Karnofsky performance status (KPS), and shortness of breathless score improved significantly after the treatment.
Conclusions: Interventional bronchoscopy could rapidly and efficiently remove endobronchial tumor, relieve airway obstruction, and improve clinical symptoms.
背景与目的 肺肉瘤为发生于肺部少见的软组织恶性肿瘤，常规治疗首选手术。本研究旨在探讨采用支气管镜介入治疗的效果。方法 回顾性分析2008年11月-2014年7月我院收治的16例肺肉瘤患者，平均年龄（53.1±5.4）岁。所有患者首次治疗均选用全凭静脉麻醉下硬质气管镜检查，发现肿瘤后行支气管镜介入治疗。再次检查时行电子支气管镜检查。结果 16例患者中肉瘤样癌10例，纤维肉瘤和肉瘤各2例，纤维粘液性肉瘤和梭性细胞型滑膜肉瘤各1例。周围型11例（占68.8%），主要位于右上叶和左下叶肺内；中央型5例（31.2%）。位于肺内者以混合型多见（9/11, 82%），原发性较多（9/11, 82%）；而位于大气道者以管内型多见（9/16, 56%），转移性较多（11/16, 69%）。支气管镜介入治疗后4例全肺不张均缓解，7例肺叶不张3例完全缓解，部分缓解和无效各2例。患者气道阻塞、卡氏体力状态（Karnofsky performance status, KPS）和气促评分均有明显改善。结论 支气管镜介入治疗能快速、有效地清除气道内肿瘤，缓解气道梗阻，改善症状。.