Efficacy of bronchoscopic ablation combined with local injection of endostatin in advanced non-small cell lung cancer patients with intratracheal metastasis

Abstract

Objective To explore the efficacy and safety of bronchoscopic ablation combined with local injection of endostatin in patients with intratracheal metastasis of advanced non-small cell lung cancer(NSCLC). Methods A retrospective study was conducted on 58 patients with airway stenosis caused by NSCLC admitted to the Department of Respiratory in Ankang People's Hospital from December 2021 to December 2022. Thirty cases treated with bronchoscopic ablation alone were served as the control group, and 28 cases treated with bronchoscopic ablation combined with local injection of endostatin were served as the treatment group. Dyspnea index, Karnofsky performance scale (KPS)score, curative effect and the number of intraoperative and postoperative complications of all patients were recorded before and after 1 week of treatment. After 1 month, a bronchoscopic reexamination was performed to evaluate airway stenosis, complications and efficacy. Results Before treatment,there was no significant difference in dyspnea index and KPS score between two groups (P＞0.05). After treatment, the dyspnea indexes decreased and the KPS scores increased in the two groups (P＜0.01), and dyspnea index in the treatment group was lower (1.22±0.72 vs 1.70±0.57, t=3.334, P＜0.05), and the KPS score was higher (85.55±7.04 vs 80.50±5.10, t=3.808, P＜0.05) compared to the control group. Bronchoscopy re-examination 1 month after treatment, the total effective rate of the treatment group was slightly higher than that of the control group, but the difference was not statistically significant (64.29% vs 43.33%, χ2=2.555, P＞0.05). There were 19 cases and 21 cases of hemoptysis of different degrees in the treatment group and the control group, respectively, which improved after local treatment with hemocoagulase and epinephrine, without perforation and dyspnea. Conclusion Bronchoscopic ablation combined with local injection of endostatin is more effective than endoscopic ablation in improving dyspnea and quality of life in patients with advanced NSCLC, without increasing the risk of complications, and whether it can improve the total effective rate remains to be further discussed.

Keywords

• bronchoscopic ablation， endostatin， non-small cell lung cancer， intratracheal metastasis， dyspnea index， quality of life， hemoptysis