Masahide Oki1, Hideo Saka1. 1. Department of Respiratory Medicine, Nagoya Medical Center, Nagoya, Japan.
Abstract
BACKGROUND: Airway stenting has been reported to be useful for patients with malignant airway stenosis as a bridge to tumour-specific therapy, such as chemotherapy and radiation therapy, as well as palliative therapy. However, its role in patients with small-cell lung cancer (SCLC), the most aggressive lung cancer subtype, is unclear. We investigated the efficacy of airway stenting for patients with airway stenosis resulting from SCLC. METHODS: All stenting procedures were performed using both rigid and flexible bronchoscopes under general anaesthesia. Among 512 patients who underwent rigid bronchoscopy during a 9-year period at a single centre, those who underwent airway stenting for airway stenosis because of SCLC were retrospectively reviewed. RESULTS: Twenty-one SCLC patients with airway stenosis who underwent stenting were eligible for analysis. Twelve patients (57%) were chemoradiotherapy-naïve. Supplemental oxygen was reduced after the procedure in 11 out of 12 patients (92%) who had previously required it. Fourteen patients (67%) received tumour-specific therapy after the procedure. The median post-procedural survival was 47 days (range, 5-617 days). Longer survival was associated with the performance of post-procedural tumour-specific therapy, low serum lactate dehydrogenase levels and either tracheal or bronchial stenosis. CONCLUSIONS: SCLC patients with airway stenting experienced longer survival when post-procedural tumour-specific therapy was performed, when they showed low serum lactate dehydrogenase levels, and when they had either tracheal or bronchial stenosis.
BACKGROUND: Airway stenting has been reported to be useful for patients with malignant airway stenosis as a bridge to tumour-specific therapy, such as chemotherapy and radiation therapy, as well as palliative therapy. However, its role in patients with small-cell lung cancer (SCLC), the most aggressive lung cancer subtype, is unclear. We investigated the efficacy of airway stenting for patients with airway stenosis resulting from SCLC. METHODS: All stenting procedures were performed using both rigid and flexible bronchoscopes under general anaesthesia. Among 512 patients who underwent rigid bronchoscopy during a 9-year period at a single centre, those who underwent airway stenting for airway stenosis because of SCLC were retrospectively reviewed. RESULTS: Twenty-one SCLCpatients with airway stenosis who underwent stenting were eligible for analysis. Twelve patients (57%) were chemoradiotherapy-naïve. Supplemental oxygen was reduced after the procedure in 11 out of 12 patients (92%) who had previously required it. Fourteen patients (67%) received tumour-specific therapy after the procedure. The median post-procedural survival was 47 days (range, 5-617 days). Longer survival was associated with the performance of post-procedural tumour-specific therapy, low serum lactate dehydrogenase levels and either tracheal or bronchial stenosis. CONCLUSIONS:SCLCpatients with airway stenting experienced longer survival when post-procedural tumour-specific therapy was performed, when they showed low serum lactate dehydrogenase levels, and when they had either tracheal or bronchial stenosis.