Assessment of endobronchial chemotherapy in patients with bronchogenic carcinoma

BackgroundMalignant airway obstruction is commonly found in patients with lung cancer and is associated with significant morbidity and mortality. Relieving malignant obstruction may improve symptoms, quality of life, and life expectancy. The aim of the present work is to determine the efficacy of endobronchial intratumoral injection of 5-Fluorouracil as a chemotherapeutic agent in palliative care for patients with inoperable nonsmall-cell lung cancer (NSCLC).Patients and methodsA total of 30 patients diagnosed as inoperable advanced-stage NSCLC were included into this randomized prospective controlled comparative study and divided into two groups (group A: 15 patients received the conventional sessions of systemic chemotherapy only and group B: 15 patients received the conventional sessions of systemic chemotherapy in addition to two to three sessions of local endobronchial intratumoral chemotherapy using 5-fluorouracil). Patient characteristics, histology, airways infiltrated with the tumor, performance status, treatment cycles, complications, and therapeutic outcomes were evaluated. Tumor response was analyzed based on bronchoscopic evaluation performed on completion of the final treatment session.ResultsThere was no significant difference in the total objective response between patients who used systemic chemotherapy alone for treatment of advanced NSCLC and those who used systemic chemotherapy in addition to sessions of local chemotherapy using 5-fluorouracil that was injected intratumorally through bronchoscopy in multiple sessions.ConclusionWe concluded that endobronchial intratumoral chemotherapy using 5-fluorouracil is not an effective promising treatment approach for palliative treatment of patients with advanced malignant endobronchial NSCLC.