PubMed · 5359912
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1969-12-13. Lung scanning.. https://pubmed.ncbi.nlm.nih.gov/5359912/
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Forty-five lung cancer patients who had recurrence and/or endobronchial obstruction were treated with intrabronchial radiotherapy (IBRT). The majority had been heavily treated previously, mainly by external radiotherapy; six patients were treated surgically. IBRT was given with high-dose-rate equipment, either 18 Gy in three fractions or 15 Gy as a single dose was originally planned. For different reasons several patients received other regimens. Palliation of dyspnoea was obtained in 64% of the patients. Palliation of hemoptysis (12/14) and cough (11/17) was registered, as well as improvement in atelectasis in 11/26 patients. Palliation of dyspnoea was enhanced with an IBRT dose > 15 Gy. The median survival after IBRT was 13 weeks. Fatal hemoptysis (FH) occurred in 12 patients; 10 of these within 6 months after treatment. The risk of FH significantly increased with an IBRT dose > 15 Gy.
Bronchoscopic manipulation of an endobronchial carcinoid can precipitate a carcinoid crisis. Coronary artery spasm is an uncommon manifestation of carcinoid crisis, and has never been reported as a complication of flexible bronchoscopy. We report a case of a 10-year-old girl who developed coronary artery spasm and cardiac arrest during neodymiumyttrium aluminum garnet (Nd-YAG) laser photoresection of an endobronchial carcinoid. Recognition of this unusual presentation of a carcinoid crisis is important as the treatment approach differs from standard resuscitation protocols.