Bronchial artery perfusion for treatment of advanced lung cancer

Abstract

Twenty‐one patients with advanced lung cancer, limited to the chest, were treated by bronchial artery perfusion using 0.4 to 0.6 mg/kg of HN2 using a double lumen, double balloon aortic catheter. The infusion was made into the aorta between levels T4 and T8. Two patients were infused 2 times. There were no serious complications in these 21 patients. Average survival of the 21 treated patients was 8 months with a range from one day to 45 months. Symptoms were improved in the majority of treated patients. Cough was improved in 80%. Pain was completely relieved in 3, almost completely relieved in 2, and improved in 4–a total 9 of the 15 patients with severe, persistent pain. There was objective evidence of improvement in 12 patients. Five had objective measured improvement in pulmonary function and, in 7 of the 21 patients (32%), there was decrease in the size of the tumor mass as recorded on official x‐ray reports. Average survival in 6 patients considered for perfusion but not completed, because of technical difficulties, was 1.8 months with a range from 1 to 3 months.

Interventional Aspects of Chest Radiology

“…85 Adriamycin was infused in this study; mitromycin-C, 5 FU, HN2, chloramine mustard, and even proteolytic enzymes have been employed on other occasions. [86][87][88] In addition to isolated pulmonary arteries, such infusions have been performed into selective bronchial arteries as well as into a segment of the aorta from which the bronchial arteries arise, using a double balloon triple lumen catheter. 86 Infusion into the bronchial circulation in this manner is thought, at least in some circles, to capitalize on the principle of selective drug delivery into the vascular supply of a bronchogenic, if not metastatic, carcinoma.…”

“…[86][87][88] In addition to isolated pulmonary arteries, such infusions have been performed into selective bronchial arteries as well as into a segment of the aorta from which the bronchial arteries arise, using a double balloon triple lumen catheter. 86 Infusion into the bronchial circulation in this manner is thought, at least in some circles, to capitalize on the principle of selective drug delivery into the vascular supply of a bronchogenic, if not metastatic, carcinoma. 89,90 This practice is analogous to that used in the liver, where 69 it is thought that selective chemotherapy administration into one of the dual blood supplies of the organ provides a therapeutic advantage.…”

“…Limited experience with these techniques in the lung, over ten years old now, suggests that salvage of surgical and radiation failures is possible. Clifton, 86 for ex-ample, described subjective and objective palliation of hemoptysis, cough, dyspnea, and pain in about 57 percent of 21 patients receiving HNZ by bronchial artery perfusion. The average survival was 8 months in treated patients, compared with 1.8 months in a group of 6 patients who could not be treated for technical reasons.…”

Regional chemotherapy via the pulmonary artery for pulmonary metastases

“…Regional chemotherapy to malignant tumors in the lung has been given through the bronchial arteries [3,4].…”