SAŽETAK

U rutinskoj medicinskoj praksi, kontrola radiografije pluća i prikaz stanja pacijenata, je uglavnom dovoljan da proveri reagovanje hemoterapije kod SCLC pacijenata, dok se kontrola fiberbronhoskopijom primenjuje na slučajeve kod kojih treba odgovor na potpun terapeutski tretman. Cilj i analiza bronhoskopskog i terapeutskog odgovora na SCLC se upoređuju sa radiografskim zaključcima u liječenju grudnog koša. Testiranje je izvršeno kod 66 pacijenata sa SCLC, prosečan broj godina - 59. PS (ECOG) was 0-1,2 i 3 u 52,10 i kod 4 pacijenta. Centralna lokalizacija tumora je pronađena kod 51 (77%), dok je periferna lokalizacija zabeležena kod 15 (23%) pacijenata. Dijagnostikovanje bronhoskopijom je pokazalo direktne simptome tumora u 44 (67%) slučajeva, a indirektno su registrovani kod 22 (33%) pacijenta. Primena hemoterapijskog protokola bila je CAV kod 59 i PE kod 7 slučajeva. Nakon 3 Ct tretmana, CR je viđen radiografski kod 21 (32%), PR kod 21 (32%), SD i PD kod 24 (36%) slučajeva. Bronhoskopski, Cr je bila prikazana kod 12 (20%), PR kod 32 (48%), SD i PD kod 21 (33%) pacijenata. Prateći sic CT tretmane, kontrola fiberbronhoskopijom je urađena kod polovine slučajena, a totalna kod 34 pacijenta. Radiografija, CR je nastavljena kod 5 (15%) slučajeva, PR kod 17 (50%) tokom vremena, dok je SD i PD viđena kod 12 (35%) pacijenata. Kontrola fiberbronhoskopski je pokazala CR kod 5 (15%), PR kod 14 (41%), dok je progresija pronađena kod 15 (44%9 slučajeva. Prosečno vreme preživljavanja pacijenata je uglavnom dovedeno u vezu sa PS pacijentima, i za PS 0-1,2 i 3, bilo je 19, 12 i 9 mjeseci. Upoređivanje rezultata nakon 3 CT tretmana kod SCLC pacijenata, pokazalo je manje kompletnih i parcijalnih karakteristika tokom fiberbronhoskopske provere u vezi sa radiografijom, a jasnije nakon 6 CT tretmana. Nema kompletne korelacije između evaluacije i radiografije, i odgovora na CT kod SCLC pacijenata.

Ključne reči: bronhoskopija, SCLC, hemioterapija

SUMMARY

In the routine medical practice, control X- ray of lungs and performance status of patient is generally sufficient to monitor the response to chemotherapy in SCLC patients, while control fiberscopy is mainly indicated in the cases of defining the complete therapeutically response. Object the analysis of bronchoscopes of therapeutically response in SCLC and comparison with radiographic findings of chest. Sixty- six patients with SCLC were tested; mean- age of 59 years .PS (ECOG) was 0-1,2 and 3 in 52,10 and 4 patients, respecticly. Centrally localized tumor was found in 51 (77%), while peripheral localized was noted in 15 (23%) pts. Diagnostic bronchoscopy revealed direct tumor signs in 44 (67%) cases, and exclusively the indirect ones were recorded in 22 (33%) patients. The applied chemotherapeutic protocol was CAV in 59, and PE in 7 cases. After 3 CT treatments, CR was seen radio graphically in 21 (32%), PR in 21 (32%), SD and PD in 24(36%) cases. Bonchoscopically, CR was present in 13(20%)PR in 32(48%) , SD and PD in 21 (33%) patients. Following the sic CT treatments, control fiberscopy was performed in half of the cases, a total of 34 pts. Radiographically, CR was maintained in 5(15%) cases, PR in 17 (50%) of the time, while SD and PD were seen in 12 (35%) patients. Control fiberscopic findings showed CR in 5 (15%), PR in 14 (41%), and progressive findings in15 (44%) cases. The mean survival time of patients was mostly associated with PS of patients, and for PS 0-1,2 and 3 it was 19,12 and 9 months, respectively. The comparison of findings after 3 CT treatments in SCLC patients shows less complete and more partial responses during fiberscopic checkups in relation to X - ray findings, while it was less pronounced after 6 CT treatments. There is no complete correlation between evaluation of radiographic and endoscopes response to CT in SCLC patients.

Key words: bronchoscopy, SCLC, chemoterapy

Ass. mr sc med. dr Danko Živković
Specijalna bolnica za plućne bolesti i tuberkulozum, Načelnik Onkološkog odeljenja Bolnice Brezovik, Medicinski fakultet Podgorica