PURPOSE: Purpose of the study was to evaluate the effect of Nd:YAG laser resection of centrally located tumors on various symptoms, signs, time to progression and survival in lung cancer patients.The question is how effective can laser resection be in symptom control, time to progression and can it influence survival of lung cancer patients?.
METHODS: In a prospective non randomized study we have evaluated effects of Nd:YAG laser resection in combination with brachytherapy and external beam radiotherapy (EBRT) vs. combination of brachytherapy and EBRT on lung cancer symptoms and signs (cough,dyspnoea,thoracic pain,haemoptisys,body weight loss,atelectasis,postobstructive pneumonia),pulmonary function tests, endoscopic findings, performance status, time to progression and survival rate in lung cancer patients. 178 patients were divided in two groups. Patients in group I (n=81) were treated with combination of brachytherapy and EBRT, patients in group II (n=97) were treated with Nd:YAG laser in combination with brachytherapy and EBRT. Patients have been evaluated before and after the treatment, and on regular control every 3 moths until the end of life. All patients received standard institutional first line chemoradiotherapy regiment and best supportive care during the course of disease.
RESULTS: After the treatment in both groups we have observed significant improvement in all investigated parameters. Improvement in dyspnoea, thoracic pain, body weight loss and ECOG status was significantly better in group II (p≤; 0.00005). Time to progression and survival, using Kaplan-Meier cumulative proportion, Cox-Mantel and Peto and Peto Wilcoxon test are significantly better in group II (p≤; 0.00005).
CONCLUSION: Laser resection improves symptom control in lung cancer patients with central airway obstruction. Longer time to progression and survival of lung cancer patients, could be the result of imminent airway desobstruction accomplished with Nd:YAG laser.
CLINICAL IMPLICATIONS: Combination of interventional pulmonology techniques with standard chemotherapy and radiotherapy regiments, whenever possible, is the best option for the treatment of selected lung cancer patients. Urgent debulking of central airways, using interventional pulmonology techniques may improve the quality of life and survival in lung cancer patients.
DISCLOSURE: Bojan Zaric, No Financial Disclosure Information; No Product/Research Disclosure Information