Bronchoscopic ablation techniques in the management of lung cancer

Shepherd, Ray Wes; Radchenko, Christopher

doi:10.21037/atm.2019.04.47

Cited by 30 publications

(22 citation statements)

References 55 publications

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“…After 48-72 h, the light source is then applied to the target lesion to generate the reactive oxygen species and initiate tumour destruction through cellular death [20][21][22]. The light application is commonly performed using a fibreoptic laser diffuser and is applied through either flexible or rigid bronchoscopy to achieve a target dose of 50-300 J•cm −1 of airway treated [16,23]. Follow-up bronchoscopy is often required in the days following light application for debridement and removal of necrotic tissue from the airways [24].…”

Section: Photodynamic Therapymentioning

confidence: 99%

“…Like PDT, EBBT is best suited for malignant obstruction that is predominantly endobronchial in nature, though it can be used for some cases of extrinsic compression when the majority of the lesion is adjacent to the airway. EBBT should not be used as first-line treatment for those patients who require rapid relief of airway obstruction as treatment effects will not be fully realised for up to 2-3 weeks [23]. In addition, it is important to acknowledge that EBBT should not be viewed as equivalent to external beam radiotherapy (EBRT), as multiple head-to-head studies have shown that EBRT is superior in terms of symptom relief and potentially disease-free survival in patients with malignant airway obstruction [39,40].…”

Section: Brachytherapymentioning

confidence: 99%

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Bronchoscopic treatment of inoperable nonsmall cell lung cancer

Kniese

Musani

2020

Eur Respir Rev

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Patients with unresectable lung cancer range from those with early-stage or pre-invasive disease with comorbidities that preclude surgery to those with advanced stage disease in whom surgery is contraindicated. In such cases, a multidisciplinary approach to treatment is warranted, and may involve medical specialties including medical oncology, radiation oncology and interventional pulmonology. In this article we review bronchoscopic approaches to surgically unresectable lung cancer, including photodynamic therapy, brachytherapy, endoscopic ablation techniques and airway stenting. Current and past literature is reviewed to provide an overview of the topic, including a highlight of potential emerging approaches.

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Section: Photodynamic Therapymentioning

confidence: 99%

Section: Brachytherapymentioning

confidence: 99%

Bronchoscopic treatment of inoperable nonsmall cell lung cancer

Kniese

Musani

2020

Eur Respir Rev

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“…Recently, a novel electrosurgical device called Core Cath (Medtronic) is available, which combines electrocautery with simultaneous continuous suction for removal of smoke and/or blood. Clinical studies of the Core Cath's effectiveness and safety profile in tumor debulking are currently needed (22).…”

Section: Electrocauterymentioning

confidence: 99%

“…The catheter may be placed intra-nasally or through an existing endotracheal tube alongside the bronchoscope. The distal tip of the catheter is positioned approximately 2cm beyond the distal border of the target endbronchial lesion (22,33). Radiation can be delivered with low, intermediate, or high dose rates.…”

Section: Endobronchial Brachytherapymentioning

confidence: 99%

Advances in endobronchial ablative therapies

Katzman¹,

Argento²

2021

Shanghai Chest

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Endobronchial ablative therapies are standard of care in therapeutic bronchoscopy for management of malignant and non-malignant central airway obstruction and of endobronchial bleeding. In malignant and non-malignant central airway obstruction with endoluminal involvement, a multi-modality bronchoscopic approach combining endobronchial ablative therapies, mechanical debulking, airway dilation, and airway stent placement is often first line treatment. Endobronchial ablative therapies can be utilized in conjunction with chemotherapy, radiation therapy, and surgery to improve quality of life and possibly longterm survival in malignant central airway obstruction. In select cases, endobronchial ablative therapies are treatment options with curative intent for endobronchial carcinoma in situ and early lung cancers. High quality clinical trials directly comparing the efficacy and safety profiles among endobronchial ablative therapies are lacking. Herein, endobronchial ablative therapies are reviewed.

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“…Interventional bronchoscopy procedures, used by both interventional pulmonologists and thoracic surgeons, have a high success rate, with low morbidity and mortality. Rigid bronchoscopy with cryosurgery and/or argon plasma coagulation is the most common treatment method for endobronchial occlusive lesions [1]. Most of these lesions are liable to bleed, and the bronchial tree distal to the lesion may occlude with blood cloths, which can lead to hypoxia.…”

Section: Introductionmentioning

confidence: 99%

Cryosurgery of endobronchial tuberculosis facilitated by foley's catheter usage for both intubation and distal airway safety

Demiröz¹,

Yılmaz²,

Fındık³

2020

Curr Thorac Surg

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A 35-year-old female with a reproductive cough, dyspnea, stridor, and intermittent hemoptysis was evaluated by fiberoptic bronchoscopy (FOB). An endobronchial lesion was observed 2 cm distal to the vocal cords, occluding two-thirds of the tracheal lumen. Rigid bronchoscopy and total excision of the lesion with cryosurgery were planned. Under general anesthesia, a 14-mm rigid bronchoscope (RB) was introduced. As a facilitative new technique, the patient was intubated with an 18F Foley catheter, which was introduced close to the RB. The cuff of the catheter was then inflated distally to the lesion. Subsequently, the catheter was connected to a mechanical ventilator to ensure the safety of the airway while preventing hypoxia. Total excision of the mass was performed via cryosurgery. Immediately after, the catheter balloon was deflated, and a fiberoptic bronchoscope was introduced through the RB to explore the distal bronchial system for aspirated tissue fragments and secretions. With this facilitative approach, the distal airway was kept clean of secretions and tissue fragments. The final pathology of the mass was granulomatous inflammation and necrosis, and the patient was referred to a tuberculosis clinic for medical treatment.

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Bronchoscopic ablation techniques in the management of lung cancer

Cited by 30 publications

References 55 publications

Bronchoscopic treatment of inoperable nonsmall cell lung cancer

Bronchoscopic treatment of inoperable nonsmall cell lung cancer

Advances in endobronchial ablative therapies

Cryosurgery of endobronchial tuberculosis facilitated by foley's catheter usage for both intubation and distal airway safety

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