Efficacy of perioperative administration of long-acting bronchodilator on postoperative pulmonary function and quality of life in lung cancer patients with chronic obstructive pulmonary disease. Preliminary results of a randomized control study
Tóm tắt
Long-acting bronchodilators are recommended as a first-line treatment for chronic obstructive pulmonary disease (COPD), although their effects for postoperative lung cancer patients with COPD are still not well known. A prospective randomized trial was used to examine the efficacy of bronchodilators on postoperative pulmonary function and quality of life (QOL). Twenty lung cancer patients with COPD who had lobectomies were randomized. A control group (n = 10) did not receive bronchodilators. An experimental group (n = 10) received tiotropium and salmeterol. Patients were divided into two COPD grades: stage I COPD and stage II–III COPD. Results for pulmonary function, 6-minute walking test, and the St. George’s Respiratory Questionnaire (SGRQ) were compared. Diaphragmatic motion on dynamic magnetic resonance imaging was also analyzed. The patient demographics were similar in the two groups. Except for pulmonary function results at 2 weeks, no other parameters were significantly different. However, in stage II–III COPD, forced expiratory volume in 1 second, forced vital capacity, inspiratory capacity, the total score of the SGRQ, and diaphragmatic motion in the experimental group (n = 5) were significantly better than those in the control group (n = 4) at various time points (all P < 0.05). The daily inhalation of bronchodilators was effective for maintaining the respiratory function and QOL in lung cancer patients with moderate to severe COPD.
Tài liệu tham khảo
Nakamura H, Haruki T, Adachi Y, Fujioka S, Miwa K, Taniguchi Y. Smoking affects prognosis after lung cancer surgery. Surg Today 2008;38:227–231.
Viegi G, Maio S, Baldacci S, Simoni M, Pistelli F, Carrozzi L. Epidemiology of chronic obstructive pulmonary disease: Health effects of air pollution. Respirology 2006;11:523–532.
Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 2004;23:932–946.
Sekine Y, Iwata T, Chiyo M, Yasufuku K, Motohashi S, Yohida S, et al. Minimal alteration of pulmonary function after lobectomy in lung cancer patients with chronic obstructive pulmonary disease. Ann Thorac Surg 2003;76:356–361.
Sekine Y, Chiyo M, Iwata T, Yasufuku K, Furukawa S, Amada Y, et al. Perioperative rehabilitation and physiotherapy for lung cancer patients with chronic obstructive pulmonary disease. Jpn J Thorac Cardiovasc Surg 2005;53:237–243.
American Thoracic Society. Lung function testing: selection of reference values and interpretative strategies. Am Rev Respir 1991;144:1202–1218.
Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure of health status for chronic airflow limitation. Am Rev Respir 1992;145:1321–1327.
Kondo T, Kobayashi I, Taguchi Y, Ohta Y, Yanagimachi N. A dynamic analysis of chest wall motions with MRI in healthy young subjects. Respirology 2000;5:19–25.
Sekine Y, Kesler KA, Behnia M, Brooks-Brunn J, Sekine E, Brown JW. COPD increases the incidence of refractory supraventricular arrhythmias following pulmonary resection for non-small cell lung cancer. Chest 2001;120:1783–1790.
Casaburi R, Mahler DA, Jones PW, Wanner A, San PG, ZuWallack RL, et al. A long-term evaluation of once-daily inhaled tiotropium in chronic obstructive pulmonary disease. Eur Respir J. 2002;19:217–224.
Vincken W, van Noord JA, Greefhorst AP, Bantje TA, Kesten S, Korducki L, et al. Improved health outcomes in patients with COPD during 1 year’s treatment with tiotropium. Eur Respir J. 2002;19:209–216.
Donohue JF, van Noord JA, Bateman ED, Langley SJ, Lee A, Witek TJ Jr, et al. A 6-month placebo-controlled study comparing lung function and health status changes in COPD patients treated with tiotropium or salmeterol. Chest 2002;122:47–55.
Baloira Villar A, Vilariño Pombo C. Bronchodilator efficacy of combined salmeterol and tiotropium in patients with chronic obstructive pulmonary disease. Arch Bronconeumol 2005;41:130–134.
Sekine Y, Behnia M, Fujisawa T. Impact of COPD on pulmonary complications and on long-term survival of patients undergoing surgery for NSCLC. Lung Cancer 2002;37:95–101.
O’Donnell DE, Sciurba F, Celli B, Mahler DA, Webb KA, Kelberg CJ, et al. Effect of fluticasone propionate/salmeterol on lung hyperinflation and exercise endurance in COPD. Chest 2006;130:647–656.
O’Donnell DE, Flüge T, Gerken F, Hamilton A, Webb K, Aguilaniu B, et al. Effects of tiotropium on lung hyperinflation, dyspnoea and exercise tolerance in COPD. Eur Respir J 2004;23:832–840.
Gorman RB, McKenzie DK, Butler JE, Tolman JF, Gandevia SC. Diaphragm length and neural drive after lung volume reduction surgery. Am J Respir Crit Care Med 2005;15;172 (10):1259–1266.
Lahrmann H, Wild M, Wanke T, Tschernko E, Wisser W, Klepetko W, et al. Neural drive to the diaphragm after lung volume reduction surgery. Chest 1999;116:1593–1600.
Anthonisen NR, Wright EC. Bronchodilator response in chronic obstructive pulmonary disease. Am Rev Respir 1986;133:814–819.
Jones PW, Quirck FH, Baveystock CM, Littlejohns P. A self complete measure of health status for chronic airflow limitation. Am Rev Respir 1992;145:1321–1327.
Korst RJ, Ginsberg RJ, Ailawadi M, Bains MS, Downey RJ Jr, Rusch VW, et al. Lobectomy improves ventilatory function in selected patients with severe COPD. Ann Thorac Surg 1998;66:898–902.
Casaburi R, Kukafka D, Cooper CB, Witek TJ Jr, Kesten S. Improvement in exercise tolerance with the combination of tiotropium and pulmonary rehabilitation in patients with COPD. Chest 2005;127:809–817.
Calverley PM, Anderson JA, Celli B, Ferguson GT, Jenkins C, Jones PW, et al. Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. N Engl J Med 2007;22:775–789.