Abstract
Although endoscopic management of malignant central airway obstruction (mCAO) is well established, not enough survival and quality of life (QoL) data exist comparing it with sole chemo-radiotherapy.
We prospectively studied patients referred to our unit for mCAO using the EORTC QoL questionnaire, at one day before, 1 week after and every following month.
40 patients (31 males) aged 66.2±12.3 (mean ± st.dev) with either non-small cell lung cancer (n:35) or metastatic malignancies, were included.
31 patients (intervention group) underwent extensive interventional bronchoscopic management as indicated, whereas 9 declined endoscopic treatment (control group). Patients of the two groups did not statistically differ in age, comorbidities, type of malignancy and level of obstruction. Overall follow up time was 6±6.2 (range 1-26) months. 13 patients are still alive followed for 6.6±7.6 months (range 1-26).
QoL and dyspnea significantly improved in all patients of the intervention group up to 1 month after the procedure (p<0.05). Improvement was greater in those initially presenting with atelectasis and tracheal obstruction. Dyspnea remained significantly improved in treated patients up to the 6th month. For those surviving over the 9th month (n:11) and those surviving over the 12th month (n:6), QoL and dyspnea, did not significantly deteriorate. In all time points, control patients had worse QoL and dyspnea (p<0.05). Mean survival time for intervention and control group were 20.47±23.57 and 6.33±7.03 months respectively.
Interventional bronchoscopy, may achieve prolonged survival, significant and sustained QoL and dyspnea improvement, in patients with airway obstructing malignancies.
- © 2011 ERS