Restoration of Patency to Central Airways Occluded by Malignant Endobronchial Tumors Using Intratumoral Injection of Cisplatin

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dc.contributor.authorMehta, Hiren J
dc.contributor.authorBegnaud, Abbie
dc.contributor.authorPenley, Andrea M
dc.contributor.authorWynne, John
dc.contributor.authorMalhotra, Paras
dc.contributor.authorFernández-Bussy, Sebastián
dc.contributor.authorCope, Jessica
dc.contributor.authorShuster, Jonathan J
dc.contributor.authorJantz, Michael A
dc.date.accessioned2021-12-06T18:46:14Z
dc.date.available2021-12-06T18:46:14Z
dc.date.issued2015
dc.description.abstractRationale: 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. Objectives: The objective of this study was to analyze our experience with bronchoscopic endobronchial intratumoral injection of cisplatin for malignant airway obstruction. Methods: 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. Measurements and Main Results: Between January 2009 and September 2014, 22 patients (10 men, 12 women; mean age 6 SD, 64.4 6 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. Conclusions: 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.es
dc.identifier.citationMehta HJ, Begnaud A, Penley AM, Wynne J, Malhotra P, Fernandez-Bussy S, Cope J, Shuster JJ, Jantz MA. Restoration of Patency to Central Airways Occluded by Malignant Endobronchial Tumors Using Intratumoral Injection of Cisplatin. Ann Am Thorac Soc. 2015 Sep;12(9):1345-50.es
dc.identifier.urihttp://dx.doi.org/10.1513/AnnalsATS.201503-131OCes
dc.identifier.urihttp://hdl.handle.net/11447/5188
dc.language.isoen_USes
dc.subjectEndobronchial injection of chemotherapyes
dc.subjectMalignant airway obstructiones
dc.subjectCisplatines
dc.titleRestoration of Patency to Central Airways Occluded by Malignant Endobronchial Tumors Using Intratumoral Injection of Cisplatines
dc.typeArticlees

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