2024-03-29T01:41:35Z
https://tsukuba.repo.nii.ac.jp/oai
oai:tsukuba.repo.nii.ac.jp:02001655
2022-08-10T01:09:23Z
2780:1271
2780:2618
2780:5104
2780:5551
2780:6725
2780:7162
2780:7803
3:62:5602:1634711712935
Successful use of extracorporeal membrane oxygenation for airway‐obstructing lung adenocarcinoma
Kitazawa, Shinsuke
小林, 尚寛
コバヤシ, ナオヒロ
KOBAYASHI, Naohiro
Ueda, Sho
榎本, 有希
エノモト, ユウキ
ENOMOTO, Yuki
井上, 貴昭
イノウエ, ヨシアキ
INOUE, Yoshiaki
塩澤, 利博
シオザワ, トシヒロ
SHIOZAWA, Toshihiro
関根, 郁夫
セキネ, イクオ
SEKINE, Ikuo
Kawai, Hitomi
野口, 雅之
ノグチ, マサユキ
NOGUCHI, Masayuki
佐藤, 幸夫
サトウ, ユキオ
SATO, Yukio
Endobronchial-invasive lung cancers are generally diagnosed at advanced stages and may require emergency treatment for airway obstruction. Stent implantation is a common intervention for such obstructed airways but certain subsets of patients cannot receive adequate treatment without respiratory support. Veno-venous extracorporeal membrane oxygenation (ECMO) is a salvage therapy for respiratory failure but its usefulness in managing patients with advanced lung cancer remains unclear given the poor prognosis. In recent years, molecular targeted agents for patients with driver mutations offer rapid responses and may be administered even while under critical care. In this report, we describe the case of 39-year-old female who presented to our emergency department with severe respiratory distress. A computed tomography scan revealed a large mediastinal tumor invading the tracheal carina causing severe stenosis of the left main bronchus and right main pulmonary artery. ECMO support was required as the respiratory condition remained unstable despite high pressure ventilation. Under ECMO support, the patient underwent bronchial stent implantation and was successfully weaned off ECMO. The tumor was histologically diagnosed as pulmonary adenocarcinoma with anaplastic lymphoma kinase gene rearrangement. Treatment with a tyrosine kinase inhibitor, alectinib, induced a marked tumor reduction within a short period. The patient recovered well and is now in remission one year later. This case indicates that intensive respiratory support with ECMO may become a bridge through the critical period for selected patients with respiratory failure secondary to advanced lung cancer.
journal article
Wiley
2020-10
application/pdf
Thoracic Cancer
10
11
3024
3028
1759-7706
https://tsukuba.repo.nii.ac.jp/record/2001655/files/thoraciccancer_11-10-3024.pdf
eng
32844533
https://doi.org/10.1111/1759-7714.13623
© 2020 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
open access