Laser Bronchoscopy and the Role of the Physiotherapist

One hundred patients with tracheobronchial tumours were treated with the neodymium YAG (yttrium-aluminium-garnet) or argon laser for symptoms of airways obstruction caused by tumour (59 cases), complete collapse of a lung (17 cases), or recurrent haemoptysis (24 cases). Seventy four of them had relapsed or failed to respond to radiotherapy or chemotherapy and all were inoperable. Objective improvement in results of lung function tests or haemoptysis diary charts was seen in 37 patients with airways obstruction (63%), five (29%) with collapsed lung, and 14 (58%) with haemoptysis. Overall, 68 patients had symptomatic benefit and there was objective improvement in 56. Two deaths occurred in 288 treatment sessions both occurring as a result of asphyxia from minor haemorrhage in patients with advanced cylindromas and critical narrowing of the trachea or single remaining bronchus. In suitable patients with intraluminal tumour laser phototherapy is a valuable addition to conventional treatment.

https://thorax.bmj.com/content/thoraxjnl/40/5/341.full.pdf

Laser therapy in 100 tracheobronchial tumours.

The overall incidence of lung cancer in the western world shows no decline, and in women is becoming inreasingly common. Efforts to improve survival for non-small-cell lung cancers still centre on surgery where improvement in staging has allowed better selection of operable subjects. Radiotherapy and in particular chemotherapy have lesser roles in prolonging survival in non-small-cell tumours. Small-cell lung cancer is regarded as disseminated disease and has considerable sensitivity to cytotoxic agents. The untreated median survival of 2–4 months has been increased to 15–18 months for patients with limited disease during the last few years and an increasing number of patients are cured by chemotherapy. However, the role of additional therapeutic interventions such as irradiation to the primary tumour site and prophylactic cerebral irradiation have less well-defined effects upon survival. Although the treatment of small-cell cancer has shown undoubted benefit, it is unlikely to be improved radically in the future unless currently available drugs are used more aggressively or more effective agents become available.

Laser Bronchoscopy and the Role of the Physiotherapist

References

Laser therapy in 100 tracheobronchial tumours.

The management of lung cancer.

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