Treatment of isolated mediastinal and hilar recurrence of lung cancer with bronchoscopic endobronchial ultrasound guided intratumoral injection of chemotherapy with cisplatin
| Autor: | Jessica Cope, Hiren J. Mehta, Michael A. Jantz, Andrea M. Penley, Jonathan J. Shuster, Abbie Begnaud, John Wynne, Paras Malhotra, Sebastian Fernandez-Bussy |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine Cancer Research medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Fistula Antineoplastic Agents Kaplan-Meier Estimate Injections Intralesional Mediastinal Neoplasms Article medicine Humans Progression-free survival Lung cancer Aged Neoplasm Staging Ultrasonography Cisplatin Chemotherapy medicine.diagnostic_test business.industry Unevaluable Middle Aged medicine.disease Treatment Outcome Oncology Positron emission tomography Female Radiology Neoplasm Recurrence Local business Progressive disease medicine.drug |
| Zdroj: | Lung Cancer |
| ISSN: | 0169-5002 |
| DOI: | 10.1016/j.lungcan.2015.10.009 |
| Popis: | 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% CI 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. |
| Databáze: | OpenAIRE |
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