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ENDOBRONCHIAL PALLIATION USING ND:YAG LASER IS ASSOCIATED WITH IMPROVED SURVIVAL WHEN COMBINED WITH MULTIMODAL ADJUVANT TREATMENTS
Author(s) -
Han C.,
Wright G.,
Praseyatpo D.
Publication year - 2007
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2007.04115_20.x
Subject(s) - medicine , laser therapy , surgery , laser , nd:yag laser , adjuvant therapy , chemotherapy , physics , optics
Purpose This study aims to confirm the safety and effectiveness of Nd:YAG laser therapy in the contemporary setting and investigate the effectiveness of multi‐modal therapy compared to laser alone. Methology 153 Nd:YAG laser treatments on 110 patients between 1999 and 2004 were reviewed retrospectively. Symptom scores for dyspnoea, haemoptysis and cough before and after the procedure were compared. Survival and time to reintervention were analysed using the Kaplan‐Meier method. Multimodality treatment was compared to Nd:YAG laser therapy alone to determine differences in survival and time to reintervention. P values less than 0.05 were considered significant. Results There were no operative mortality directly caused by laser intervention, however 30 day mortality was 6.5%. Deaths were due to progression of advanced neoplastic processes rather than laser intervention, 6.5% of patients had some post‐operative morbidity. After Nd:YAG laser intervention, 76% of patients reported improvement to dyspnoea, 94% for haemoptysis and 75% for cough. Median survival after Nd:YAG laser treatment was 6.64 months, 21% requiring repeated laser. Compared to Nd:YAG laser treatment alone, multimodality treatments significantly prolonged median time to reintervention by 1.7 months (p = 0.002) and prolonged median survival by 4.9 months (p < 0.001) in patients with NSCLC. Conclusion Nd:YAG laser intervention is safe and effective for palliation of endobronchial malignancies. In most cases it is only required to be performed once. Multimodal treatment prolonged survival compared to Nd:YAG laser therapy alone.