Efficacy and safety of ethanol injection for endobronchial tumor debulking (a feasibility study)

Abstract

Background: Airway obstruction by malignant tumors may lead to dyspnea, cough, hemoptysis, atelectasis and pneumonia. Aim: The aim was to assess safety and efficacy of ethanol injection in debulking of endobronchial malignant tumors. Patients and methods: It included 20 patients with endobronchial malignant tumors and divided into 2 groups randomly: group A; 10 patients subjected to ethanol injection plus chemotherapy and group B; included 10 patients treated with chemotherapy alone. Results: There was a significant improvement in dyspnea, cough and hemoptysis scores in group A after the end of the study (P1: 0.004, 0.014 and 0.014 respectively) and a significant improvement in group A compared with group B 2 weeks after the last session of chemotherapy as regard dyspnea and cough (P2 < 0.001 and 0.02 respectively) but with no significant difference between both groups two weeks after the last session of chemotherapy (P2: 0.21) for hemoptysis. In group A, there was a significant improvement in Karnofsky performance scale, FEV1 and FEV1/FVC ratio at the end of the procedure (P1 0.002, 0.024 and 0.03 respectively) with a significant improvement compared with group B (P2: 0.003, 0.04 and 0.05 respectively). Two patients in group A showed improvement in CT chest with no improvement in group B. Evaluation of response with revised RECIST; in group A, one patient showed good response, 5 patients showed partial response but in group B, only 2 patients showed partial response. Conclusion: Intratumoral injection of ethanol 95% is effective and safe adjuvant to chemotherapy for tumor debulking.

Keywords

• Lung cancer
• Palliation
• Ethanol