Background/objectives:This study aimed to investigate the impact of single-inhaler triple therapy on selecting treatment for lung cancer and the perioperative period in lung cancer patients with chronic obstructive pulmonary disease (COPD) and a forced expiratory volume in 1 s (FEV1) <1.5 L.Methods: All patients had baseline FEV1< 1.5 L. The therapeutic drug for COPD, fluticasone furoate/umeclidinium/vilanterol, was initiated 2 weeks preoperatively and continued until 3 months postoperatively. Radical surgery was actively recommended for patients with an FEV1≥ 1.5 L after COPD treatment; otherwise, palliative surgery and postoperative complication risks were discussed.Results: Among 675 lung cancer patients, 214 (31.7%) had COPD, 41 of whom with FEV1< 1.5 L were enrolled. After triple-inhaler therapy, FEV1improved to ≥1.5 L in 63.4% of patients. Significant differences in the Brinkman index (840 vs. 1120,p= 0.0058) and radical resection (88.5% vs. 40.0%,p= 0.0030) were observed between patients with FEV1≥ 1.5 L and <1.5 L post-treatment. Pneumonia and home oxygen therapy occurred in two cases (4.9%) and one case (2.4%), respectively, all of which were patients with FEV1< 1.5 L post-treatment. Among patients undergoing anatomical lung resection, triple-inhaler therapy significantly improved not only post-inhalation FEV1(1.26 vs. 1.55 L,p< 0.0001), but also FEV1at 3 months postoperatively compared to the value before inhalation (1.31 vs. 1.26 L,p= 0.042).Conclusions: Preoperative triple therapy in lung cancer patients with untreated COPD and FEV1< 1.5 L improved respiratory function and increased the feasibility of performing radical resection surgery. Furthermore, it was considered safe and effective, indicating the potential to maintain preoperative respiratory function without increasing perioperative complications.
背景/目的：本研究旨在探讨单吸入器三联疗法对慢性阻塞性肺疾病（COPD）且第一秒用力呼气容积（FEV1）<1.5升的肺癌患者治疗方案选择及围手术期的影响。方法：所有患者基线FEV1均<1.5升。COPD治疗药物糠酸氟替卡松/乌美溴铵/维兰特罗于术前2周开始使用并持续至术后3个月。对于COPD治疗后FEV1≥1.5升的患者积极推荐根治性手术；否则将讨论姑息性手术及术后并发症风险。结果：在675例肺癌患者中，214例（31.7%）合并COPD，其中41例FEV1<1.5升者纳入研究。经三联吸入治疗后，63.4%的患者FEV1提升至≥1.5升。治疗后FEV1≥1.5升与<1.5升的患者在布林克曼指数（840 vs. 1120，p=0.0058）和根治性切除率（88.5% vs. 40.0%，p=0.0030）方面存在显著差异。肺炎和家庭氧疗分别发生2例（4.9%）和1例（2.4%），均为治疗后FEV1<1.5升的患者。在接受解剖性肺切除的患者中，三联吸入疗法不仅显著改善吸入后FEV1（1.26 vs. 1.55升，p<0.0001），术后3个月FEV1较吸入前亦有显著提升（1.31 vs. 1.26升，p=0.042）。结论：对于未治疗COPD且FEV1<1.5升的肺癌患者，术前三联疗法可改善呼吸功能并提高根治性切除手术的可行性。该疗法安全有效，在未增加围手术期并发症的同时，显示出维持术前呼吸功能的潜力。
肿瘤(癌症)患者之家