Abstract
Symptoms such as dyspnoea, haemoptysis, coughing frequently occur in patients with bronchial carcinoma. Usually, central airway obstruction, pleural effusion or vena cava compression syndrome cause dyspnoea. Interventional bronchoscopy techniques, e.g. laser coagulation, electrocautery and cryosurgery offer very effective means for the re-canalisation of central airway obstruction. Stent placement and high-dose radiation brachytherapy are the procedures of choice for the treatment of extrinsic stenoses. The use of bronchoscopic coagulation, balloon catheters and embolisation of bronchial arteries may control severe haemoptysis. All interventional bronchoscopic techniques show symptomatic improvement and overall survival benefit in patients with bronchial carcinoma. Pleural involvement and effusion reflect progression of disease. Treatment consists of thoracoscopic talc pleurodesis and the use of various types of pleural catheters. Angiographic interventions (bronchial artery embolisation, dilatation and stenting of the vena cava superior) are needed for massive haemoptysis and the cava compression syndrome respectively.
Similar content being viewed by others
Abbreviations
- APC:
-
Argon plasma coagulation
- HF:
-
High-frequency electro cautery
- EBRT:
-
External beam radiotherapy
- SEMS:
-
Self-extendable metal stents
- HDR:
-
High-dose rate
References
Ernst A, Feller-Kopman D, Becker HD, et al. Central airway obstruction. AJRCCM. 2004;169:1278–97.
Bollinger CT, Sutedja TG, Strausz J, et al. Therapeutic bronchoscopy with immediate effect: laser, electrocautery, argon plasma coagulation and stents. Eur Resp J. 2006;27:1258–71.
Seijo LM, Sterman DH. Interventinal pulmonology. N Engl J Med. 2001;344:740.
Han CC, Prasetyo D, Wright GM. Endobronchial palliation using Nd:YAG laser is associated with improved survival when combined with multimodal adjuvant treatments. J Thorac oncol. 2007;2:59–64.
Dutau H, Breen DP. Endobronchial laser treatment: an essential tool in therapeutic bronchoscopy. Eur Resp Mon. 2010;48:149–60.
Schuhmann C, Hetzel M, Babiak AJ, et al. Endobronchial tumor debulking with a flexible cryoprobe for immediate treatment of malignant stenosis. J Thorac Cardiovasc Surg. 2010;139:997.
Marasso A, Gallo E, Massiglia GM, et al. Cryosurgery in bronchoscopic treatment of tracheobronchial stenosis. Indications, limits, personal experience. Chest. 1993;103:472–4.
Cavaliere S, Venuta F, Foccoli P, et al. Endoscopic treatment of malignant airway obstruction in 2008 cases. Chest. 1996;110:1536–42.
Hetzel M, Hetzel J, Schumann C, et al. Cryorecanalization: a new approach for immediate management of tracheobronchial obstruction. J Thorac Cardivasc Surg. 2004;127:1427–31.
Ernst A, Simoff M, Ost D, et al. Prospective risk-adjusted morbidity and mortality outcome analysis after therapeutic bronchoscopic procedures: results of a multi-institutional outcomes database. Chest. 2008;134:514–51.
Chhajed PN, Somandin S, Baty F, et al. Therapeutic bronchoscopy for malignant airway stenoses: choice of modality and survival. J Cancer Res Ther. 2010;6(2):204–9.
Chhajed PN, Baty F, Pless M, et al. Outcome of treated advanced non-small cell lung cancer with and without central airway obstruction. Chest. 2007;130:1803–7.
Gudovsky LM, Koroleva NS, Biryukov YB, et al. Tracheoesophageal fistulas. Ann Thorac Surg. 1993;55:868–75.
Freitag L, Tekoff E, Steveling H, et al. Management of malignant esophago-tracheal fistulas with airway stenting and double stenting. Chest. 1996;110:1155–62.
Nag S, Kelly JF, Horton JL, et al. The American Brachytherapy Society recommendations for brachytherapy for carcinoma of the lung. Oncology. 2001;15:371–81.
Aumont-le Guilcher M, Prevost B, Sunyach MP, et al. High-dose-rate brachytherapy for non-small-cell lung carcinoma: a retrospective study of 226 patients. Int J Radiat Oncol Biol Phys. 2011;79:1112–16.
Michailidou I, Becker HD, Eberhardt R. Bronchoscopic high dose rate brachytherapy. Eur Resp Mon. 2010;48:173–89.
Stout R, Barber P, Burt P, et al. Clinical and quality of life outcomes in the first United Kingdom randomized trialof endobronchial brachytherapy (intraluminal radiotherapy vs.external beam radiotherapy) in the palliative treatment of inoperable non-small-cell long cancer. Radiother Oncol. 2000;56:323–7.
Langendijk H, de Jong J, Tjewa M, et al. External irradiation versus external irridation plus endobronchial brachytherapy in inoperable non-small-cell lung cancer: a prospective randomized study. Radiother Oncol. 2001;58:257–68.
Mal H, Rullon I, Mellot F, et al. Immediate and long-term results of bronchial artery embolization for life-threatening hemoptysis. Chest. 1999;115:996–1010.
Swanson KL, Johnson CM, Prakash UB, et al. Bronchial artery embolization: experience with 54 patients. Chest. 2002;121(3):789–95.
Andersen PE. Imaging and interventional radiological treatment of hemoptysis. Acta Radiol. 2006;47:780–92.
Musani AI, Treatment options for maligant pleural effusion. Curr Opin Pulm Med. 2009;15:380–7
Janssen JP, Collier G, Astoul P. Safety of pleurodesis with talc poudrage in malignant pleural effusion: a prospective cohort study. Lancet. 2007;369:1535–9.
Musani AI, Haas AR, Seijo L. Outpatient management of malignant pleural effusions with small-bore, tunneled pleural catheters. Respiration. 2004 (Nov–Dec);71(6):559–66.
Watkinson AF, Yeow TN, Fraser C. Endovascular stenting to treat obstruction of the superior vena cava. BMJ. 2008;21:(336 (7658)):1434–7.
Acknowledgements
The author declares no conflict of interest concerning the presented techniques. The author wants to thank Prof. Pranav Sinha for correction of the manuscript and various recommendations.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Geltner, C. Interventional therapy for symptomatic bronchial carcinoma. memo 5, 149–153 (2012). https://doi.org/10.1007/s12254-012-0002-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12254-012-0002-7