Drug-eluting beads bronchial arterial chemoembolization plus intercostals arterial infusion chemotherapy is effective and well-tolerated in treating non-small cell lung cancer patients with refractory malignant pleural effusion

Xiaofei Liu; Hu Lin; Qin Wang; Mi Mu; Pan Pan; Fangfang Tian; Rui Zhang; Weiguo Zhao; Pengtao Bao

doi:10.21037/jtd-20-1603

Drug-eluting beads bronchial arterial chemoembolization plus intercostals arterial infusion chemotherapy is effective and well-tolerated in treating non-small cell lung cancer patients with refractory malignant pleural effusion

J Thorac Dis. 2021 Apr;13(4):2339-2350. doi: 10.21037/jtd-20-1603.

Authors

Xiaofei Liu¹, Hu Lin², Qin Wang³, Mi Mu², Pan Pan², Fangfang Tian², Rui Zhang², Weiguo Zhao², Pengtao Bao^{2

3}

Affiliations

¹ Department of Nuclear Medicine, The Eighth Medical Center of PLA General Hospital, Beijing, China.
² Department of Pulmonary and Critical Care Medicine, The Eighth Medical Center of Chinese PLA General Hospital, College of Pulmonary and Critical Care Medicine, Chinese PLA General Hospital, Beijing, China.
³ Graduate School, Hebei North University, Zhangjiakou, China.

Abstract

Background: The study aimed to explore the efficacy and safety of drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) plus intercostals arterial infusion chemotherapy in non-small cell lung cancer (NSCLC) patients with refractory malignant pleural effusion (MPE).

Methods: 17 NSCLC patients with refractory MPE treated by DEB-BACE plus the intercostals arterial infusion chemotherapy (DEB-BACE group) were recruited. Their treatment response [complete remission (CR), partial remission (PR), overall efficacy, failure] for MPE was assessed at 1 month after therapy; adverse effects were recorded; MPE progression-free survival and overall survival (OS) were calculated. Moreover, 19 NSCLC patients with refractory MPE treated by conventional chemotherapy were reviewed as control (chemotherapy group), then their medical records were collected.

Results: With respect to MPE response, DEB-BACE group exhibited increased CR (82.4% vs. 10.5%, P<0.001) and overall efficacy (100.0% vs. 52.6%, P=0.001), similar PR (17.6% vs. 42.1%, P=0.112) while less failure (0.0% vs. 47.4%, P=0.001) compared to chemotherapy group. Furthermore, OS was prolonged in DEB-BACE group (median: 13.4; 95% CI: 11.0-15.8 months) than chemotherapy group (median: 7.0; 95% CI: 4.4-9.6 months) (P=0.002). Further analyses displayed that in DEB-BACE group, CR was associated with improved ECOG score and longer MPE progression-free survival, and adverse events mainly included fever, chest distress/pain, gastrointestinal side effects, myelosuppression, rash and hemoptysis, which were all mild and tolerable.

Conclusions: DEB-BACE plus intercostals arterial infusion chemotherapy could serve as a salvage treatment option for NSCLC patients with refractory MPE.

Keywords: Non-small cell lung cancer (NSCLC); drug-eluting beads bronchial arterial chemoembolization (DEB-BACE); efficacy; intercostals arterial infusion chemotherapy; refractory malignant pleural effusion (MPE); safety.