PURPOSE: Chemotherapy has been shown to have rendered a survival advantage in patients with advanced NSCLC and improves quality of life. We asked if patients with malignant central airway obstruction treated with therapeutic bronchoscopy and chemotherapy would behave in a similar manner as patients without central airway obstruction who are treated with chemotherapy alone. Hence, in patients with advanced non-small cell lung cancer (NSCLC) treated with chemotherapy, we compared survival in patients with treated central airway obstruction to those who did not have central airway obstruction.
METHODS: One hundred and forty four patients with advanced and inoperable NSCLC were included. These consisted of 52 consecutive patients treated with therapeutic bronchoscopy plus chemotherapy with or without radiotherapy (Group A) and 92 consecutive patients who did not have central airway obstruction treated with chemotherapy alone (Group B). Chemotherapy consisted of cisplatin or carboplatin, and one of the third-generation chemotherapy agent.
RESULTS: There was no significant difference in the survival of patients with and without central airway obstruction (p = 0.395). There was no influence of histological subtype on survival. Median survival in patients with central airway obstruction was 8.4 months and those without central airway obstruction was 8.2 months. Three, six and twelve months survival in patients in Group A were 90%, 71% and 40% respectively and those in Group B were 82%, 63% and 34% respectively.
CONCLUSION: Patients having advanced NSCLC with locally treated malignant central airway obstruction in combination with chemotherapy do not have a worse survival compared to those with advanced NSCLC without central airway obstruction.
CLINICAL IMPLICATIONS: Therapeutic bronchoscopy should be offered to patients with NSCLC having central airway obstruction.
DISCLOSURE: Prashant Chhajed, None.