Intratumoral administration of cisplatin through a bronchoscope followed by irradiation for treatment of inoperable non-small cell obstructive lung cancer

Abstract

Purpose: Patients presenting-with inoperable non-small cell carcinoma of the lung associated with severe bronchial'obstruction are at a high risk for developing post-obstructive pneumonia or respiratory failure. This often Leads to death in weeks to months. Several studies suggest that initial use of debulking of obstructed airways by Nd-YAG laser photo resection or by cryotherapy lessens morbidity by reducing infections and respiratory insufficiencies. This can shorten hospitalization, improve the quality of life, and prolong survival. It has also been demonstrated that patients first treated for debulking and then by irradiation have better survival than similar patients treated with irradiation atone. Intratumoral (IT) injection of cytotoxic drugs (IT chemotherapy) has also been successfully used to debulk airways. The aim of the present work was to study the effectiveness, safety, and feasibility of initial debulking by IT chemotherapy with cisplatin combined with irradiation with a curative intent in the treatment of obstructive inoperable non-small cell lung cancer.