TITLE:
Effect of Inhaled Tiotropium as the Perioperative Management of Patients Undergoing Pulmonary Resection for Primary Lung Cancer
AUTHORS:
Takanori Ayabe, Masaki Tomita, Eiichi Chosa, Katsuya Kawagoe, Kunihide Nakamura
KEYWORDS:
Tiotropium, Pulmonary Function, Lung Age, Lobectomy, Lung Cancer
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.9,
August
27,
2014
ABSTRACT: Background: The purpose of
this study was to evaluate the effectiveness of perioperative tiotropium
therapy for patients undergoing pulmonary resection for primary lung cancer.
The short-term tiotropium effect was investigated by perioperative pulmonary
function and “lung age”. Methods: The fifty-five patients who underwent a
lobectomy and had tiotropium treatment available from October 2007 through May
2009 were the subjects. The patients were divided into 3 groups according to
their airway limitation such as Chronic Obstructive Pulmonary Disease (COPD) or
a history of smoking; those with COPD (%FEV1 ≤70%, C-group, n = 22), smokers (%FEV1 > 70%, S-group, n = 10) and
non-smokers (%FEV1 >
70%, N-group, n = 23). As the bronchodilator groups, the C- and S-groups
received inhaled tiotropium bromide (18 μg once daily) for 1 week before
surgery until at least 3 weeks after surgery without interruption, and as a
control, the N-group had no treatment. The preoperative baselines, the
predicted postoperative values, and the actual postoperative ones were measured
by the pulmonary function test. The changed rates were calculated and denoted
as ΔVC, ΔFEV1, ΔVC%, and ΔFEV1/FVC, from the
baseline of the predicted postoperative values. The mean “real age” and “lung
age” were calculated. Results: In the S-group, the parameters of ΔVC, ΔFEV1, ΔVC%, and ΔFEV1/FVC significantly
increased compared to those of the N-group. In the C-group, the increased
extents of ΔFEV1 and ΔFEV1/FVC
were lower compared to those in the S-group (not significant). In the N-group,
the parameters of ΔVC, ΔFEV1, and ΔVC% decreased.
The postoperative “lung age” and “real age” were increased to 29.5 ± 18.0
year-old in the C-group, 25.8 ± 18.0 in the S-group, and 24.7 ± 17.0 in the
N-group. Lung resection affected the “lung age”; the aging was a 28.9 ± 12.7
year-old increase in the N-group. In the C- and S-group, the “lung age” was a
14-year-old increase. The effect of tiotropium treatment affected the “lung
age” as a 15-year-old increase. Conclusion: Perioperative interventional
tiotropium contributed to the lobectomy patients with COPD and for smokers with
a non-obstructive airway and played a role of preserving the postoperative lung
function.