J Buon
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Talc remains a commonly used agent for pleurodesis malignant pleural effusion. Nevertheless, it is associated with a 3-9% incidence of pulmonary reactions ranging from simple pneumonitis to acute respiratory distress syndrome (ARDS). The underlying lung pathology and the size and rate of talc particle dissemination have been implicated as the cause of these complications. There seems to be an acknowledged lack of evidence regarding detailed very early intrathoracic talc particle migration. ⋯ Large-sized talc particles are deposited on both lungs very early after pleurodesis. At the same time inflammatory pulmonary changes appear bilaterally. Despite contradicting data in the literature, these findings should always be kept in mind when performing this procedure in high risk patients.
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Surgery remains the primary curative treatment for patients who have early-stage non-small cell lung cancer (NSCLC). The proper use of surgical resection depends on a careful assessment of the extent of disease and the cardiopulmonary function. Because lung cancer is more common in patients who have chronic obstructive pulmonary disease (COPD), it is important to select carefully those patients who can safely undergo potentially curative therapy, thereby minimizing postoperative morbidity and mortality. This article discusses the preoperative pulmonary assessment for patient selection, the preparation of high-risk patients, special surgical considerations, and patient management in the immediate postoperative period.
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The objective of this study was to evaluate the palliation of pain of bone metastases with biphosphonates and different radiotherapy protocols in 372 cancer patients. ⋯ When combined with palliative radiotherapy, biphosphonates did not have any additive effects on pain palliation in the management of painful bone metastases. In addition, a single radiotherapy fraction provides equal pain palliation as multiple fractions.
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Case Reports
Leptomeningeal carcinomatosis presenting as bilateral sensorineural deafness and unilateral facial palsy.
This paper describes the case of a 56-year-old man with a history of small cell lung cancer under chemotherapy, who presented with left-sided peripheral facial palsy and progressive bilateral sensorineural deafness due to leptomeningeal carcinomatosis (LMC). Brain magnetic resonance imaging (MRI) of the petrosal bones and posterior cranial fossa revealed 2 solid lesions in the internal acoustic meatuses bilaterally and LMC of the skull base. Whole brain radiation therapy and methotrexate intrathecally were applied to the patient.
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To determine reirradiation results of patients with recurrent non-metastatic non-small cell lung cancer (NSCLC). ⋯ In initially non-metastatic NSCLC patients, reirradiation can be a safe and effective treatment for palliation after recurrence. Large prospective studies are needed to confirm the safety, effectiveness and economical advantages of this modality.