Bronchial arterial chemoembolization with Drug-Eluting beads plus sequential chemotherapy for the treatment of stage III and IV lung squamous cell carcinoma

Linqiang Lai; Fenfen Xu; Dengke Zhang; Jie Chen; Xihui Ying; Li Chen; Jiahao Wu; Jingjing Song; Weiwen Li; Jiansong Ji; Jianfei Tu

doi:10.1016/j.ejrad.2024.111398

Bronchial arterial chemoembolization with Drug-Eluting beads plus sequential chemotherapy for the treatment of stage III and IV lung squamous cell carcinoma

Eur J Radiol. 2024 Mar 1:175:111398. doi: 10.1016/j.ejrad.2024.111398. Online ahead of print.

Authors

Linqiang Lai¹, Fenfen Xu¹, Dengke Zhang¹, Jie Chen¹, Xihui Ying¹, Li Chen¹, Jiahao Wu¹, Jingjing Song¹, Weiwen Li¹, Jiansong Ji², Jianfei Tu³

Affiliations

¹ Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University, Lishui 323000, China; Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China.
² Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University, Lishui 323000, China; Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China. Electronic address: jjstcty@wmu.edu.cn.
³ Key Laboratory of Imaging Diagnosis and Minimally Invasive Intervention Research, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui Hospital of Zhejiang University, Lishui 323000, China; Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui 323000, China. Electronic address: jianfei1133@163.com.

PMID: 38579540
DOI: 10.1016/j.ejrad.2024.111398

Abstract

Purpose: This retrospective study aimed to investigate the effectiveness and safety of bronchial arterial chemoembolization with drug-eluting beads (DEB-BACE) plus chemotherapy versus chemotherapy alone in patients with stage III and IV lung squamous cell carcinoma (LSCC) who are not appropriate candidates for radiochemotherapy.

Materials and methods: In this retrospective analysis, we screened all adult patients undergoing either DEB-BACE plus chemotherapy or chemotherapy alone for stage III or IV LCSS at authors' center from January 2018 to August 2021. Each 21-day chemotherapy cycle consisted of intravenous injection of gemcitabine (1.0 g/m²) on days 1 and 8 and cisplatin 75 (mg/m²) on day 1. The planned cycles were 4. DEB-BACE consisted of microcatheter infusion of CalliSpheres beads carrying cisplatin (75 mg/m²) and gemcitabine (1.0 g/m²), at 3 weeks prior to chemotherapy. The primary outcome was overall survival (OS). The secondary outcomes included progression-free survival (PFS), pulmonary response, and adverse events (AEs).

Results: The final analysis included 95 patients in the chemotherapy group and 41 patients in the combination treatment group. The median OS was 14 months (95 % CI 11.0-17.0) in the chemotherapy group and 19 months (95 % CI 18.0-24.0) in the combination group (P = 0.015). In multivariate Cox regression analysis, DEB-BACE plus chemotherapy was associated with lower risk of death versus chemotherapy only (HR 0.16, 95 % CI 0.05-0.52; log rank test P = 0.003). The median PFS was 6 months (95 % CI 4.0-7.0) in the chemotherapy group and 8 months (95 % CI 6.0-8.0) in the combination group (P = 0.015). The pulmonary objective response rate (ORR) and disease control rate (DCR) were 48.4 % and 62.1 % in chemotherapy group versus 82.9 % and 90.2 % in combination group (P < 0.001 and = 0.001, respectively). AEs occurred in 133 patients (97.8 %). The rate of bone marrow suppression was 48.4 % (46/95) in the chemotherapy group versus 7.3 % (3/41) in the combination group (P < 0.001).

Conclusion: Compared with chemotherapy alone, DEB-BACE plus chemotherapy was associated with longer survival outcomes and lower rate of bone marrow suppression.

Keywords: Bronchial arterial chemoembolization; Chemotherapy; Drug-eluting beads; Lung squamous cell carcinoma.