Safety and Effectiveness of Drug-Eluting Embolic Bronchial Arterial Chemoembolization for Lung Cancer: A Systematic Review and Meta-analysis.

Abstract

Objective: To assess the efficacy and safety of drug-eluting embolic bronchial arterial chemoembolization (DEE-BACE) in lung cancer, and to compare its outcomes with those of conventional bronchial arterial chemoembolization (cBACE).

Materials and methods: A comprehensive search was conducted across PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, and Wanfang databases. Random-effects model analysis was applied when I² was ≥ 50%; otherwise, fixed-effects model analysis was used. Subgroup analysis was performed for I² values ≥ 50%. Eighteen studies involving 681 patients were included, with 501 patients receiving DEE-BACE and 110 patients undergoing cBACE.

Results: Among lung cancer patients treated with DEE-BACE, the pooled objective response rates (ORRs) at 1, and 6 months were 64.4%, and 50.3%, respectively; the disease control rates (DCRs) were 93.4%, 74.4%, and 71.7%, respectively. The 1-year overall survival (OS) and progression-free survival (PFS) rate were 48.2%, and 22.5%, respectively. The incidence of adverse events was less than 50%. Compared with the cBACE group, the DEE-BACE group exhibited higher 1-month DCR [pooled relative risk (RR): 1.236, 95% confidence interval (CI): 1.028, 1.486), 6-month (pooled RR: 2.036, 95%CI: 1.226, 3.383) ORR and DCR (pooled RR: 1.824, 95%CI 1.249, 2.662). Both DEE-BACE and cBACE exhibited similar rates of adverse events.

Conclusion: DEE-BACE presents a favorable efficacy and safety profile for lung cancer treatment compared with cBACE, particularly for nonresectable cases or when chemotherapy or radiation therapy options are limited. However, the lack of direct comparisons to standard treatments require cautious interpretation of these results.