Thomas Josef Vogl MD, PhD, Presenter: Nothing to Disclose

Sonja Frewert, Abstract Co-Author: Nothing to Disclose

Nagy Naguib Naeem Naguib MD, MSc, Abstract Co-Author: Nothing to Disclose

To evaluate tumor response after treating primary and secondary lung cancer with transpulmonary chemoembolization (TPCE) or transarterial chemoperfusion (TACP) in a curative, neoadjuvant, palliative or symptomatic intention.

 From 2005 to 2013, 417 patients (202 males/215 females) were treated with a mean of 5.29 (range:1-25) TPCE or TACP sessions in 4-week intervals. Patients suffered from primary lung tumors (small cell carcinoma (n=9), non-small cell carcinoma (n=62), bronchial carcinoma with unknown histology (n=34) and lung metastases from different primaries (colorectal carcinoma (n=117), breast cancer (n=40), renal cellular carcinoma (n=17), and others (n=138)). In case of embolization the femoral vein was punctured and tumor-supplying pulmonary arteries were explored. A combination of different chemotherapeutic drugs, lipiodol and microspheres were applied via balloon protection. In case of perfusion the femoral artery was punctured and the catheter was placed in the thoracic aorta above the tumor feeding bronchial and intercostal arteries which were identified with DSA and C-arm CT. Chemotherapeutic drugs were applied manually with a speed of injection according to patient pain level.  

Treatment was well tolerated in all patients without any major complications. After evaluation of the tumor volume partial response (PR) was achieved in 17.75% (n=74), stable disease (SD) in 33.09% (n=138) and progressive disease (PD) was found in 49.16% (n=205) according to the RECIST criteria. 1.68% (n=7) of all patients were treated in a curative intention, 42.86% of who had PR (n=3) or SD (n=3), 14.29% (n=1) PD. Of the patients treated in neoadjuvant intention (n=26; 6.24%) 46.15% (n=12) had PR, 34.62% (n=9) SD and 19.23% (n=5) PD. 83.45% of the patients (n=348) treated in palliative intention 16.33% (n=57) had PR, 33.52% (n=117) SD and 50.14% (n=175) PD. Of the 36 patients (8.63%) treated in a symptomatic intention 2 patients showed PR (5.52%), 27.78% (n=10) had SD and 66.67% (n=24) PD.

TPCE and TACP are well-tolerated treatment options for patients with primary and secondary lung tumors, especially in palliative and symptomatic intentions. Even in neoadjuvant and curative intentions they seem to be a proper preparation for tumor downsizing for following thermal ablation.

TPCE and TACP provide good treatment option in patients with primary and secondary lung cancer

Vogl, T, Frewert, S, Naguib, N, Transpulmonary Chemoembolization (TPCE) and Transarterial Chemoperfusion (TACP) in the Interventional Treatment of Primary and Secondary Lung Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016785.html