ABSTRACT
Context: Spirometry is an important tool to monitor treatment response in diseases such as chronic obstructive pulmonary disease and asthma. However, there is lack of evidence to support its application to evaluate response to chemotherapy in advanced lung cancer. It might be a useful adjunct to the imaging-based response evaluation which lacks functional assessment of lungs. Aims: The study was conducted to evaluate the change in spirometry in lung cancer patients after chemotherapy and to find its correlation with change in physical tumor size. Subjects and Methods: Sixty-two advanced lung cancer patients who were eligible for palliative chemotherapy were enrolled. Baseline tumor size evaluation using Response Evaluation Criteria in Solid Tumor (RECIST)-based scoring system, and spirometry was done. Four cycles of double agent (platinum doublets) chemotherapy were administered, after which treatment response was evaluated. Repeat spirometry was analyzed and correlated with changes in physical tumor size. Results: Twenty-five patients showed a response (all partial response) to four cycles of chemotherapy. Small cell carcinoma showed a better response rate than non-small cell carcinoma (78% vs. 39%). There was statistically significant improvement in forced expiratory volume in 1 (FEV1) (P = 0.01) and forced vital capacity (P = 0.03) in responders as compared to nonresponders. Change in FEV1 showed a statistically significant correlation with the change in tumor size (RECIST score) (r = –0.34; P = 0.04). Conclusions: Improvement in spirometry correlates with the tumor response as judged using RECIST criteria after chemotherapy. Further studies with bigger sample size are required to consolidate the results
ABSTRACT
Foreign body in bronchus is a surgical emergency requiring prompt action. In adults, it usually is associated with specific history or risk factors. We here present a case of 57 years old otherwise healthy male who presented with productive cough of 6 months duration before foreign body (vegetative) was visualized by fibreoptic bronchoscopy. Modalities of diagnosis, management and outcome are discussed.
ABSTRACT
Foreign body in bronchus is a surgical emergency requiring prompt action. In adults, it usually is associated with specific history or risk factors. We here present a case of 57 years old otherwise healthy male who presented with productive cough of 6 months duration before foreign body (vegetative) was visualized by fibreoptic bronchoscopy. Modalities of diagnosis, management and outcome are discussed.
ABSTRACT
Endobronchial tuberculosis (EBTB) is defined as tuberculous infection of the tracheobronchial tree with microbial and histopathological evidence. It is seen in 10-40% of patients with active pulmonary tuberculosis. More than 90% of the patients with EBTB have some degree of bronchial stenosis. Ten to 20 percent have normal chest radiograph. Therefore, a clear chest radiograph does not exclude the diagnosis of EBTB. Bronchoscopic sampling has been the key to the diagnosis producing more than 90% yield on smear as well as on culture. Bronchoscopy and computed tomography are the methods of choice for accurate diagnosis of bronchial involvement and assessment for the surgical interventions. Characteristic HRCT findings of FBTB are patchy asymmetric centrilobular nodules and branching lines (tree-in-bud appearance). Early supervised antituberculosis therapy results in minimal structural and functional residua. Corticosteroid therapy may not influence the outcome of endobronchial tuberculosis. Early diagnosis and prompt treatment, before the development of fibrosis is important to prevent complications of endobronchial tuberculosis, such as bronchostenosis.