Journal article
Treatment of isolated mediastinal and hilar recurrence of lung cancer with bronchoscopic endobronchial ultrasound guided intratumoral injection of chemotherapy with cisplatin
Lung cancer (Amsterdam, Netherlands), Vol.90(3), pp.542-547
12/01/2015
DOI: 10.1016/j.lungcan.2015.10.009
PMID: 26477968
Abstract
Purpose: A common pattern of recurrence in lung cancer after receiving full dose external beam radiation therapy (EBRT) to targeted sites is isolated mediastinal and hilar recurrence (IMHR). Treatment options for these patients are limited to palliative radiation, chemotherapy, and/or best supportive care. We describe our experience with treating IMHR with bronchoscopic endobronchial ultrasound (EBUS) guided intratumoral injection of cisplatin (ITC).
Methods: Patients treated between Jan 2009-September 2014 with ITC for IMHR were included. Patient demographics, tumor histology, size, concurrent therapy, location, number of sites treated, treatment sessions, and encounters were abstracted. Responses were analyzed on follow-up scans 8-12 weeks after the last treatment session using RECIST 1.1 criteria. Locoregional recurrence, progression-free survival (PFS), and overall survival were measured.
Results: 50 sites were treated in 36 patients (19 males, 17 females) with mean age 61.9 +/- 8.5 years. Eight sites treated on subsequent encounters were excluded and one patient had an unevaluable response, leaving 35 patients and 41 sites for final analysis. 24/35(69%) had complete or partial response (responders), whereas 11/35 (31%) had stable or progressive disease (non-responders). There were no significant differences in response based on histology, size, and concurrent therapy. Median survival for the group was 8 months (95% Cl of 6-11 mo). Responders had significantly higher survival and PFS than non-responders. Two patients treated with concurrent EBRT, developed broncho-mediastinal fistula.
Conclusion: EBUS guided intratumoral cisplatin for IMHR appears to be safe and effective, and may represent a new treatment paradigm for this patient population. (c) 2015 Elsevier Ireland Ltd. All rights reserved.
Details
- Title: Subtitle
- Treatment of isolated mediastinal and hilar recurrence of lung cancer with bronchoscopic endobronchial ultrasound guided intratumoral injection of chemotherapy with 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 M. Cope - UF Health Shands HospitalJonathan J. Shuster - University of FloridaMichael A. Jantz - University of Florida
- Resource Type
- Journal article
- Publication Details
- Lung cancer (Amsterdam, Netherlands), Vol.90(3), pp.542-547
- DOI
- 10.1016/j.lungcan.2015.10.009
- PMID
- 26477968
- NLM abbreviation
- Lung Cancer
- ISSN
- 0169-5002
- eISSN
- 1872-8332
- Publisher
- Elsevier
- Number of pages
- 6
- Grant note
- 1UL1TR000064 / NIH from the National Center for Advancing Translational Sciences
- Language
- English
- Date published
- 12/01/2015
- Academic Unit
- Internal Medicine
- Record Identifier
- 9985179800902771
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