Journal article
Restoration of Patency to Central Airways Occluded by Malignant Endobronchial Tumors Using Intratumoral Injection of Cisplatin
Annals of the American Thoracic Society, Vol.12(9), pp.1345-1350
09/2015
DOI: 10.1513/AnnalsATS.201503-131OC
PMID: 26072968
Abstract
Malignant airway obstruction is commonly found in patients with lung cancer and is associated with significant morbidity and mortality. Relieving malignant obstruction may improve symptoms, quality of life, and life expectancy.
The objective of this study was to analyze our experience with bronchoscopic endobronchial intratumoral injection of cisplatin for malignant airway obstruction.
We conducted a retrospective analysis of patients with malignant airway obstruction treated with bronchoscopic intratumoral injection of cisplatin. Patient characteristics, histology, degree of airway obstruction, procedural methods, treatment cycles, performance status, and therapeutic outcomes were evaluated. Tumor response was analyzed based on bronchoscopic measurements performed on completion the of final treatment session. Adverse events and overall survival were abstracted.
Between January 2009 and September 2014, 22 patients (10 men, 12 women; mean age ± SD, 64.4 ± 9.5 yr) were treated with one to four injections of 40 mg of cisplatin mixed in 40 ml of 0.9% NaCl. Treatments were completed 1 week apart. The primary etiologies of airway obstruction included squamous cell carcinoma (n = 11), adenocarcinoma (n = 6), small cell carcinoma (n = 2), large cell undifferentiated carcinoma (n = 1), and metastatic endobronchial cancer (n = 2). Twenty-one of 22 patients were evaluable for response. The majority of patients (15/21, 71.4%) responded to therapy, defined as greater than 50% relative reduction in obstruction from baseline. Treatment response was obtained regardless of tumor histology, concurrent systemic therapy, number of treatment cycles administered, performance status, or use of additional ablative interventions. Responders had significantly improved overall survival as compared with nonresponders, although the difference was small. Severe treatment-related side effects or complications were not observed.
Subject to the limitations of a single-center retrospective study and a subjective primary outcome measure, we have demonstrated the feasibility of improving the patency of central airways that are largely or completely occluded by endobronchial malignant tumor using intraluminal injection of cisplatin. Additional longer-term, larger-scale safety and comparative effectiveness studies of this palliative treatment modality are warranted.
Details
- Title: Subtitle
- Restoration of Patency to Central Airways Occluded by Malignant Endobronchial Tumors Using Intratumoral Injection of Cisplatin
- Creators
- Hiren J Mehta - University of FloridaAbbie Begnaud - University of MinnesotaAndrea M Penley - University of FloridaJohn Wynne - University of FloridaParas Malhotra - West Virginia UniversitySebastian Fernandez-Bussy - Universidad del DesarrolloJessica Cope - UF Health Shands HospitalJonathan J Shuster - University of FloridaMichael A Jantz - University of Florida
- Resource Type
- Journal article
- Publication Details
- Annals of the American Thoracic Society, Vol.12(9), pp.1345-1350
- DOI
- 10.1513/AnnalsATS.201503-131OC
- PMID
- 26072968
- NLM abbreviation
- Ann Am Thorac Soc
- ISSN
- 2329-6933
- eISSN
- 2325-6621
- Grant note
- UL1 TR000064 / NCATS NIH HHS UL1 TR001427 / NCATS NIH HHS 1UL1TR000064 / NCATS NIH HHS
- Language
- English
- Date published
- 09/2015
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985179800202771
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