Effectiveness of bronchial arterial embolization using N-butyl-2-cyanoacrylate for local control of pulmonary hilar or mediastinal tumors that are refractory to chemotherapy. Issue 131 (October 2020)

• Record Type: Journal Article
• Authors: Nomori, Hiroaki; Yamazaki, Ikuo; Shiraishi, Atsushi; Adachi, Takuya; Otsuki, Ayumu; Oyama, Yu
• Is Part Of: European journal of radiology. Issue 131(2020)
• Publication Date: 2020-10
• Subjects: BA bronchial artery -- BAE bronchial artery embolization -- CT computed tomography -- CR complete response -- NBCA n-butyl-2-cyanoacrylate -- PR partial response -- PD progressive disease -- PVA polyvinyl alcohol -- SD stable disease -- TACE transarterial chemoembolization; Metastasis -- Sarcoma -- Hilum -- Mediastinum -- Bronchial artery embolization -- Cyanoacrylate; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2020.109160
• Languages: English
• ISSNs: 0720-048X

Abstract

Graphical abstract: Highlights: Forty-two patients with hilar or mediastinal tumors refractory to chemo- or chemoradiotherapy were treated by BAE using NBCA. Tumor histology was sarcoma in 22 and carcinoma in 20 patients. BAE was performed using NBCA to shrink tumors for extending life expectancy. Best local responses were CR in 1 patient, PR in 16, SD in 24, and PD in 1. Overall survival was better in CR/PR than in SD/PD (p = 0.006); with 3-year survival rates of 45% and 0%, respectively. Abstract: Purpose: To investigate local control and survival after bronchial artery embolization (BAE) using N-butyl-2-cyanoacrylate (NBCA) for pulmonary hilar or mediastinal tumors that are refractory to chemotherapy or chemoradiotherapy. Method: This is a single center retrospective study involving 42 patients treated between 2015 and 2018 for pulmonary hilar or mediastinal tumors (primary tumors in 5 and metastatic ones in 37). Tumor histology was sarcoma in 22 and carcinoma in 20 patients. All patients had shown tumor progression regardless of previous chemotherapy (n = 37) or chemoradiotherapy (n = 5). Thirty-seven patients (88 %) had respiratory symptoms, such as cough, dyspnea, and hemoptysis. BAE was performed using NBCA to shrink tumors for extending life expectancy. Target tumors were followed with computed tomography at 1, 3, and 6 months after BAE. Endpoints included the best tumor response within 6 months as well as overall survivals in patients with and without tumor responses. Results: Best local responses within 6 months were complete response (CR) in 1 patient, partial response (PR) in 16, stable disease (SD) in 24, and progressive disease (PD) in 1; the CR/PR rate was 40 % (17/42). Median follow-up period was 13 months (range:1−43). Overall survival in patients with CR/PR was significantly better than in those with SD/PD (p = 0.006); with 3-year survival rates of 45 % (8/17) and 0% (0/25), respectively. Conclusions: BAE using NBCA has potential promise for shrinking hilar and/or mediastinal tumors that are refractory to chemotherapy or chemoradiotherapy, and may also improve overall survival in patients who respond.