TY - JOUR
T1 - External beam radiation therapy combined with airway stenting leads to better survival in patients with malignant airway obstruction
AU - Mallow, Christopher
AU - Thiboutot, Jeffrey
AU - Semaan, Roy
AU - Hayes, Margaret M.
AU - Hales, Russell
AU - Ram, Ashwin
AU - Feller-Kopman, David
AU - Lee, Hans
AU - Yarmus, Lonny
N1 - Funding Information:
This study was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number T32HL007534. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Publisher Copyright:
© 2018 Asian Pacific Society of Respirology
PY - 2018/9
Y1 - 2018/9
N2 - Background and objective: Malignant airway obstruction (MAO), a common complication of patients with advanced lung cancer, causes debilitating dyspnoea and poor quality of life. Two common interventions used in the treatment of MAO include bronchoscopy with airway stenting and external beam radiotherapy (EBRT). Data are limited regarding their clinical effectiveness and overall effect on survival. Methods: A retrospective chart review of patients treated with airway stenting and/or EBRT at the Johns Hopkins Hospital for MAO between July 2010 and January 2017 was reviewed. Demographics, performance status, cancer histology, therapeutic intervention and date of death were recorded. Survival was calculated using cox regression analysis. Results: Of the 606 patients who were treated for MAO, 237 were identified as having MAO and included in the study. Sixty-eight patients underwent rigid bronchoscopy and stenting, 102 EBRT and 67 a combined approach. Patients who underwent stenting hand an increased hazard ratio (HR) of death in comparison to those who received combination therapy (HR: 2.12, 95% CI: 1.02, 4.39), while there was a trend towards significance in the EBRT alone group in comparison to the combination therapy group (HR: 1.62, 95% CI: 0.93, 2.83). Conclusion: In this retrospective analysis, combination therapy with stenting and EBRT led to better survival in comparison to stenting or EBRT alone. Prospective cohort trials are needed to confirm these results.
AB - Background and objective: Malignant airway obstruction (MAO), a common complication of patients with advanced lung cancer, causes debilitating dyspnoea and poor quality of life. Two common interventions used in the treatment of MAO include bronchoscopy with airway stenting and external beam radiotherapy (EBRT). Data are limited regarding their clinical effectiveness and overall effect on survival. Methods: A retrospective chart review of patients treated with airway stenting and/or EBRT at the Johns Hopkins Hospital for MAO between July 2010 and January 2017 was reviewed. Demographics, performance status, cancer histology, therapeutic intervention and date of death were recorded. Survival was calculated using cox regression analysis. Results: Of the 606 patients who were treated for MAO, 237 were identified as having MAO and included in the study. Sixty-eight patients underwent rigid bronchoscopy and stenting, 102 EBRT and 67 a combined approach. Patients who underwent stenting hand an increased hazard ratio (HR) of death in comparison to those who received combination therapy (HR: 2.12, 95% CI: 1.02, 4.39), while there was a trend towards significance in the EBRT alone group in comparison to the combination therapy group (HR: 1.62, 95% CI: 0.93, 2.83). Conclusion: In this retrospective analysis, combination therapy with stenting and EBRT led to better survival in comparison to stenting or EBRT alone. Prospective cohort trials are needed to confirm these results.
KW - airway stent
KW - external beam radiotherapy
KW - lung cancer
KW - malignant airway obstruction
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U2 - 10.1111/resp.13292
DO - 10.1111/resp.13292
M3 - Article
C2 - 29532563
AN - SCOPUS:85043600571
SN - 1323-7799
VL - 23
SP - 860
EP - 865
JO - Respirology
JF - Respirology
IS - 9
ER -