Abstract: Slide Presentations |


Daniel A. Nader, DO, FCCP*
Author and Funding Information

Cancer Treatment Center of Tulsa, Tulsa, OK


Chest. 2007;132(4_MeetingAbstracts):459. doi:10.1378/chest.132.4_MeetingAbstracts.459
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PURPOSE: Cisplatin is a known radiosensitizer for radiation therapy in non-small cell lung cancer. Eleven patients with stage IIIB or IV lung cancer with significant endobronchial disease were treated with intratumoral cisplatin (ITC) as an adjunct to endobronchial brachytherapy with endoscopically observed benefits.

METHODS: Eleven patients were selected, which had greater than 75% endoluminal obstruction of a main or lobar airway to recieve intratumoral injection of cisplatin at the same setting as placement of brachytherapy catheter. Cisplatin solution was administered to the entire endoscopically visible tumor through a flexible 21 gauge retractable needle placed through the bronchoscope. Cisplatin (1 mglml) was injected with volumes of 0.5 to 2.0 ml with each session in which a brachytherapy catheter was placed. All patients received weekly brachytherapy of 500 cGy at one cm diameter for four sessions.

RESULTS: All patients were re-evaluated bronchoscopically 4 to 6 weeks following their last brachytherapy. All 11 patients had complete clearing of endobronchial disease grossly and confirmed cytologically. No adverse events or complications related to bronchoscopy, cisplatin or brachytherapy were identified. Clinical follow-up (median 9 months, range 3 to 17 months) revealed 3 deaths (10 months, 9 months and 3 months) all related to progression of distant disease. Significantly, none of the treated patients have shown endobronchial recurrence at the site of treatment.

CONCLUSION: Intratumoral adminstration of cisplatin, as an adjunct to brachytherapy, was shown to be a safe and potentially useful modality to assist in management of tumoral endobronchial obstruction and possibly long term control. Further studies assessing benefits of this management compared with brachytherapy without ITC will be required.

CLINICAL IMPLICATIONS: ITC may be a useful adjunctive therapy with endobronchial brachytherapy in the mangement of non-small cell lung cancer endobroncial obstruction.

DISCLOSURE: Daniel Nader, No Financial Disclosure Information; No Product/Research Disclosure Information

Tuesday, October 23, 2007

10:30 AM - 12:00 PM




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