Combination of Bronchial Arterial Infusion Chemotherapy plus Drug-Eluting Embolic Transarterial Chemoembolization for Treatment of Advanced Lung Cancer-A Retrospective Analysis of 23 Patients

J Vasc Interv Radiol. 2020 Oct;31(10):1645-1653. doi: 10.1016/j.jvir.2020.06.007. Epub 2020 Sep 18.

Abstract

Purpose: To determine the efficacy and safety of the combination of bronchial arterial infusion (BAI) chemotherapy and transarterial chemoembolization with the use of drug-eluting embolic (DEE) particles in the treatment of unresectable advanced lung cancer.

Materials and methods: A retrospective review was performed of 23 patients with unresectable lung cancer (stage III/IV) who received BAI chemotherapy and DEE chemoembolization. Treatment response was assessed by enhanced CT and evaluated on the basis of Response Evaluation Criteria In Solid Tumors at 30 d after the last combination treatment. Patients were followed up until death or March 15, 2020, whichever was first. Overall survival (OS) was estimated by Kaplan-Meier analysis, and factors associated with OS were evaluated by Cox proportional-hazards test.

Results: Complete response, partial response, stable disease, and progressive disease were seen in 2, 16, 5, and 0 patients at 30 d after the last combination treatment, respectively; therefore, the overall response rate was 78.3% and the disease control rate was 100%. Preprocedure symptoms (hemoptysis in 7 patients and dyspnea in 10) resolved in all cases after combination therapy. Nineteen patients died during follow-up, and 4 survived. Median OS was 15.6 mo (95% confidence interval, 10.1-21.1 mo). On univariate analysis and multivariate analysis, tumor/node/metastasis staging was an independent risk factor for prognosis. There were no serious adverse events during the procedures.

Conclusions: The combination of BAI chemotherapy plus DEE chemoembolization appears to be a promising method for treatment of advanced lung cancer.

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bronchial Arteries*
  • Chemoembolization, Therapeutic* / adverse effects
  • Chemoembolization, Therapeutic* / mortality
  • Disease Progression
  • Doxorubicin / administration & dosage
  • Doxorubicin / adverse effects
  • Doxorubicin / analogs & derivatives*
  • Female
  • Humans
  • Infusions, Intra-Arterial
  • Irinotecan / administration & dosage*
  • Irinotecan / adverse effects
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Lung Neoplasms / therapy*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Topoisomerase I Inhibitors / administration & dosage*
  • Topoisomerase I Inhibitors / adverse effects
  • Topoisomerase II Inhibitors / administration & dosage*
  • Topoisomerase II Inhibitors / adverse effects
  • Treatment Outcome

Substances

  • Topoisomerase I Inhibitors
  • Topoisomerase II Inhibitors
  • Irinotecan
  • Doxorubicin
  • pirarubicin