Treatment of metastatic cancer, lung cancer in other parts of the primary one of the most vulnerable parts of the transfer.
(A) of the primary foci are from female genital cancer, breast cancer, thyroid cancer, colon cancer, kidney and bladder cancer, stomach cancer, testicular cancer, melanoma and fibrosarcoma, osteosarcoma, hepatocellular carcinoma. Accounted for 70% lung metastasis, sarcoma about 30%.
(B) transfer means transfer of a majority of blood; lymph node metastasis in second place. Most cancer patients were followed up after resection of lung metastasis should pay attention. Transfer time: Some found when the primary cancer and also found to have lung metastasis, while others are first found lung metastasis, primary tumor found Zai. Generally from radical surgery to the diagnosis of lung metastases for 2 months to 13 years, and most of the primary cancer in advanced cancer more than 1 year after surgery of lung metastases.
(C) Clinical manifestations and diagnosis
1. Early and more symptoms.
2. May occur in advanced primary lung cancer with similar symptoms such as coughing, bloody sputum, chest pain.
3. Sputum cytology found only a very small number of malignant cells.
Treatment of metastatic carcinoma of the lung 4. Imageology check, first for X-ray examination, CT and suspicious underwent MRI.
(1) X-ray examination: X-ray film into the following types. pulmonary nodules: pulmonary San I: multiple nodules. Unilateral or bilateral lung fields visible in two or more different sizes of circular shadow, was cotton ball, and part of integration, overlap was lumpish, some edge blur, II: invasive-like, mostly in diameter, 0.5-4cm between the middle and lower lung fields often. hilar mediastinal type: performance of hilar and mediastinal shadow blocks, and some conflict to the lung fields, sometimes accompanied by hilar line-like radiation to the surrounding dense shadow. Type pleural effusion: pleural effusion not seen. mixed: in the above three in a mainly associated with the other one or two types.
(2) CT and MRI: a clear diagnosis can be, location, number, size, and can identify with the inflammatory disease or tuberculosis.
Treatment of metastatic carcinoma of the lung (d) the treatment should be surgery, chemotherapy, radiotherapy combined therapy, according to primary cancer cases, in addition to sites other than lung metastasis and the patient's general condition and age of full measure.
1. Resection
(1) Indications: primary cancer resection has more than 1 year. other sites of metastasis; 3 below or unilateral solitary nodules. well differentiated non-small cell carcinoma, chondrosarcoma, fibrosarcoma, osteosarcoma and so on.
(2) contraindications: lungs multiple transfer, the higher the degree of malignancy. primary tumor resection less than 1 year. body had multiple metastases. high degree of primary malignant melanoma, Ewing's sarcoma. heart, lung, kidney and other major organ function was impaired.
(3) resection: a minimal resection of lung tissue for pulmonary segmental resection, lobectomy, in order to re-operation. Such as the lungs and can also have metastases resection do not advocate the same time a removal can be phased operation.
(4) Prognosis: lung metastasis after 3-year survival rate of about 40%, five-year survival rate of 20% -30%. Primary cancer and metastatic cancer after the longer interval between the postoperative survival is longer.
The treatment of lung metastases, 2. Chemotherapy used in unresectable or radiotherapy, the program to take primary cancer chemotherapy. Can be involved in chemotherapy or intravenous chemotherapy.