Page 78 - ECBIP 2021_Program

6th European Congress ECBIP 15 - 17
Book of Abstracts
for Bronchology and
Interventional Pulmonology ATHENS - GREECE 2021
OCTOBER
MODERATED e-POSTER SESSION 07:
Lung Cancer
A DISCORDANT NOTE IN A WELL-ORCHESTRATED MECHANISM: STRESS AND CANCER PAIR UP
Georgios Lolas, Arianna Bianchi, George Evangelou, Konstantinos Syrigos
3rd Department of Medicine, National & Kapodistrian University of Athens, Athens, Greece
PP49
In the past ten years there has been an increasing amount of evidence that strongly sug-gests the neuronal system is a key player in cancer initiation, progression and dissemina-tion. It is believed that in the same way that the nervous system can influences growth, development, and maintenance in normal tissue, it can contribute to the development and spread of cancer. As such, the formation of new neural tissue has been identified as a hallmark of cancer and can be correlated with cancer severity. Signaling molecules such as norepinephrine, axon guidance molecules and neurotransmitters have been shown to have a strong implication in cancer.
Furthermore, the cross talk between nerves and cancer cells has an important role on promoting tumor outgrowth and expansion. Metastasis is a multistep process in which tumor cells spread throughout the body via a process of detachment, intravasation, transit through systemic circulation, extravasation and colonization. The Sympathetic Nervous System (SNS) has been identified as an important component of tumor micro-environment that is involved in several of the aforementioned steps of metastasis. Most importantly, SNS mediates the stress response by releasing neurotransmitters such as norepinephrine.These neurotransmitters bind to adrenoreceptors that are present in sev-eral types of cells such as cancer cells, endothelial cells, macrophages and fibroblasts.
In the current work we will present a mathematical model for better understanding the intricate relationships among lymphatic vasculature (represented by lymphatic endotheli-al cell density), tumor (described by tumor cell density) and stress (measured by nore-pinephrine levels) by investigating the
• role of Vascular Endothelial Growth Factor-C (which seems to be the key factor in connecting tumor cells and lymphatics, particularly when high levels of stress are regis-tered)
• role and that of Prostaglandin (an important inflammatory signal driving lymphatic re-modeling around the primary tumor). • The model also assess the potential impact of the immune system (represented by mac-rophages and prostaglandin)
PP50
Backround: Brachytherapy is one of the most efficient methods in overcoming difficulties in breathing that is caused by endobronchial obstruction in palliative treatment of bronchus cancer. It is fast, inexpensive, and easy to perform on an outpatient basis.
Aim: To promote the use of EBBT as a tool for endobronchial neoplastic tumors. Removal of the tumor mass by endoscopic biopsy forceps combined with cryosurgery, electrocautery, or laser ablation can achieve only limited clearance and short – term palliation. Therefore, EBBT is the option of treatment endobronchial tumors, which can increase the efficiency of the control of malignant airway obstruction and the duration of palliation.
Methods: The presence of endoluminal disease suitable for brachytherapy is determined at bronchoscopy. A narrow bore brachytherapytubeisplacedusingthesideportofthebronchoscopewithatleast2cmpassingdistaltothelesion.Thetubeisfirmly secured at the nostril with tape.A marker wire is placed in the tube to identify the position accurately.High dose rate endobronchial brachytherapy delivered weekly for two times and a bronchoscopy one month later is performed in order to count the result. We present two cases in which we performed EBBT with important improvement to existing
symptoms. The first patient was a young man aged 43 with squamous cell lung cancer with a single brain metastase and a central endobronchial mass in right main bronchus where a stent was placed in another hospital. He reffered to us because of hemoptysis and dyspnoea. He underwent bronchoscopy and a big bleeding mass over the proximal edge of stent was inserting inside the trachea (image 1). He underwent two subsequent sessions of EBBT with major relief of his symptoms. One month later the bronchoscopy revealed a shrinking of the mass and a surface with no neoplastic vascularity. The second patient was a lady aged 74 with a history of endometrium cancer and endobronchial metastase with a mass which caused almost complete obstruction to bronchus intermedius (image 2). She suffered of continuous dry cough and dyspnoea. She also received two subsequent sessions of EBBT with major relief of her symptoms. One month later the bronchoscopy revealed an open bronchus intermedius.
Conclusions: In order to palliate symptoms and improve the quality of life, it is preferable to use a method that is relatively easy to perform and has minimal complications.
ENDOBRONCHIAL BRACHYTHERAPY (EBBT) AS A USEFUL TOOL FOR LUNG CANCER AND ENDOBRONCHIAL METASTASES OF OTHER PRIMARY TUMORS WITH PALLIATION INTENT, IN COMBINATION WITH OTHER MODALITIES
Danai Bisirtzoglou1,Konstantina Papalla2,Athanasios Zetos1,Vasiliki Petta1,Maria Salomidou1, Evanthia Vasilakou2, Georgios Politis1, Haralampos Marketos1
1 Pulmonology Department, General Anticancer Hospital of Athens “Agios Savvas”, Athens, Greece 2 Radiotherapy Department, General Anticancer Hospital Of Athens “Agios Savvas”, Athens, Greece
78 6th European Congress for Bronchology and Interventional Pulmonology