Lung Cancer.pdf

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Palliative Care in Patients with <strong>Lung</strong> <strong>Cancer</strong> 231 A B Figure 12–1. Pleurx catheter. The Pleurx catheter (A) is a soft silastic catheter fenestrated on the end that goes into the pleural cavity. A Teflon sheath provides a foundation for fibroblast ingrowth to minimize the risk of infection. The external arm ends with a 1-way valve and cap. This 1-way valve can be accessed using the “obturator,” which appears much like a stiff 16-gauge Angiocath intravenous catheter (Becton-Dickinson, Franklin Lakes, NJ). (B) A prepackaged vacuum bottle is used to drain the pleural fluid (to a maximum of 600 mL). No more than 1,200 mL of fluid (2 bottles) is removed at any single time. The stiff plastic obturator is used to access the pleural catheter and drain the fluid. The vacuum automatically withdraws sufficient fluid. When the catheter and vacuum source have stopped draining the pleural fluid, the catheter is removed. Typically when less than 10 mL has been drained every other day for 1 week, the catheter may be removed.
232 J.B. Putnam, Jr. A B Figure 12–2. Techniques of inserting a Pleurx pleural catheter. Patients are typically selected on the basis of symptomatic and recurrent pleural effusion. Patients should have a free-flowing pleural effusion that can be easily diagnosed with plain chest roentgenograms (posterior-anterior, lateral, and bilateral decubitus films). In patients without a history of bleeding problems and in patients with no history of thrombocytopenia, coagulation studies and platelet studies are not generally obtained. In patients who have had chemotherapy within the previous 4 weeks, coagulation profiles are obtained. (Legend continues on next page)
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Lung Cancer Frank V. Fossella, MD R
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Frank V. Fossella, MD Department of
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vi Foreword possible. Since the res
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x Contents Chapter 7 Surgical Treat
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xii Contributors Joe B. Putnam, Jr.
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2 J.B. Putnam, Jr., F.V. Fossella,
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26 F.V. Fossella common sites of lu
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28 F.V. Fossella history and physic
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30 F.V. Fossella Computed Tomograph
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32 F.V. Fossella Pulmonary Function
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34 F.V. Fossella The use of flexibl
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36 R.F. Munden and J.J. Erasmus hav
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38 R.F. Munden and J.J. Erasmus che
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40 R.F. Munden and J.J. Erasmus tha
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42 R.F. Munden and J.J. Erasmus (Gu
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44 R.F. Munden and J.J. Erasmus A B
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46 R.F. Munden and J.J. Erasmus in
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48 R.F. Munden and J.J. Erasmus Pat
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50 R.F. Munden and J.J. Erasmus D C
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52 R.F. Munden and J.J. Erasmus A B
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54 R.F. Munden and J.J. Erasmus Bol
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56 R.F. Munden and J.J. Erasmus Swe
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58 P. Tamboli and J.Y. Ro Chapter O
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60 P. Tamboli and J.Y. Ro Figure 4-
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62 P. Tamboli and J.Y. Ro Postopera
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64 P. Tamboli and J.Y. Ro Table 4-1
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66 P. Tamboli and J.Y. Ro Atypical
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68 P. Tamboli and J.Y. Ro Diffuse I
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70 P. Tamboli and J.Y. Ro noma. Cig
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72 P. Tamboli and J.Y. Ro Figure 4-
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74 P. Tamboli and J.Y. Ro alone. BA
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76 P. Tamboli and J.Y. Ro Other Mal
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78 P. Tamboli and J.Y. Ro Electron
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80 P. Tamboli and J.Y. Ro Niho S, Y
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82 Y. De Jesus and G.L. Walsh Chapt
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84 Y. De Jesus and G.L. Walsh Figur
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86 Y. De Jesus and G.L. Walsh guide
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88 Y. De Jesus and G.L. Walsh with
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Figure 5-2. Patient “pathway to r
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94 Y. De Jesus and G.L. Walsh Recov
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98 Y. De Jesus and G.L. Walsh KEY P
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100 Y. De Jesus and G.L. Walsh Jenn
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102 W.R. Smythe nation for these su
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104 W.R. Smythe patient reports of
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106 W.R. Smythe bar or limited lung
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108 W.R. Smythe hospitals for 149 p
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110 W.R. Smythe Figure 6-1. Postsur
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112 W.R. Smythe nant neoplasms has
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114 W.R. Smythe Future Directions F
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116 W.R. Smythe Henschke CI, McCaul
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7 SURGICAL TREATMENT OF LOCALLY ADV
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120 S.G. Swisher Treatment Options
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122 S.G. Swisher Initial Assessment
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124 S.G. Swisher Figure 7-1. Region
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126 S.G. Swisher Table 7-2. (contin
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128 S.G. Swisher upper paratracheal
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130 S.G. Swisher is performed only
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132 S.G. Swisher chance for long-te
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134 S.G. Swisher Pancoast tumors th
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136 S.G. Swisher A B Figure 7-2. Do
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138 S.G. Swisher a combination of t
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140 S.G. Swisher Dartevelle PG, Cha
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8 NONSURGICAL TREATMENT OF EARLY-ST
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144 R. Komaki morbid conditions pre
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146 R. Komaki and 26 patients had c
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148 R. Komaki Around 1998, by using
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150 R. Komaki Table 8-5. Survival a
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152 R. Komaki A total of 610 patien
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154 R. Komaki tially obstructed air
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156 R. Komaki report of Radiation T
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9 TREATMENT OF PATIENTS WITH ADVANC
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160 R. Zinner chemotherapy, in pati
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Table 9-1. Chemotherapy in Older Pa
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164 R. Zinner results of additional
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Table 9-3. Third-Generation-Agent M
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Table 9-4. Third-Generation Agents
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Table 9-5. Third-Generation Platinu
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Table 9-6. Comparisons between Diff
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174 R. Zinner may play an important
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Table 9-8. Third-Generation Cisplat
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178 R. Zinner wards higher survival
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Page 211 and 212: 198 R. Komaki Figure 10-1. Survival
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282 W.N. Hittelman, J.M. Kurie, and
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300 Index Anterior spinal column re
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302 Index Cardiac murmurs, 104 Card
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304 Index Diagnosis. See also under
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306 Index Growth. See Tumor growth
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308 Index Magnetic resonance (MR) i
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310 Index p16 gene, 285 p19 arf gen
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312 Index Pulmonary resection (cont
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314 Index Squamous metaplasia, 263-
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316 Index Vitamin A, 262 Vocal cord
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