Transarterial Embolization for the Management of Emergent Hemoptysis in Patients With Primary and Metastatic Lung Tumors

IF 3.3 3区 医学 Q2 ONCOLOGY Clinical lung cancer Pub Date : 2025-01-01 DOI:10.1016/j.cllc.2024.11.008
Ruben Geevarghese , Elena N. Petre , Etay Ziv , Ernesto Santos , Lee Rodriguez , Ken Zhao , Vlasios S. Sotirchos , Stephen B. Solomon , Erica S. Alexander
{"title":"Transarterial Embolization for the Management of Emergent Hemoptysis in Patients With Primary and Metastatic Lung Tumors","authors":"Ruben Geevarghese ,&nbsp;Elena N. Petre ,&nbsp;Etay Ziv ,&nbsp;Ernesto Santos ,&nbsp;Lee Rodriguez ,&nbsp;Ken Zhao ,&nbsp;Vlasios S. Sotirchos ,&nbsp;Stephen B. Solomon ,&nbsp;Erica S. Alexander","doi":"10.1016/j.cllc.2024.11.008","DOIUrl":null,"url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the role of systemic arterial embolization in patients with primary and metastatic lung tumors presenting with hemoptysis requiring emergent management.</div></div><div><h3>Patients and Methods</h3><div>This retrospective single-center study evaluated patients undergoing transarterial embolization for emergent hemoptysis. Endpoints included technical success, clinical success and overall survival. Clinical success was divided into partial or complete, and defined as absence (complete) or subtotal (partial) reduction in frequency and/or volume of hemoptysis in the first 24-hours following embolization. Predictive factors for clinical outcomes were evaluated using univariate analysis. Adverse events were graded according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0.</div></div><div><h3>Results</h3><div>Thirty-seven patients were identified, including 21/37 (56.8%) patients with primary lung cancer. Clinical success was achieved in 31/37 (83.8%) patients. Median overall survival was 18 days (95% CI, 10-95). Median hemoptysis-free survival was 270 days (95% CI 7 to not reached). No significant predictors of hemoptysis-free survival were identified. Prior chemotherapy (HR 2.69, 95% CI, 1.08-6.67<em>; P = .</em>03) was associated with poorer overall survival. History of primary lung tumor (vs. metastatic tumor) was associated with improved overall survival (HR 0.45, 95% CI, 0.21-0.95; <em>P</em> = 0.04). No serious adverse events (CTCAE Grade ≥ 3) were found to be directly attributable to the embolization.</div></div><div><h3>Conclusion</h3><div>Hemoptysis requiring emergent management in patients with lung malignancy carries a poor prognosis. Transarterial embolization is feasible, safe and may be an effective management option, although further research is warranted to identify which patients are likely to derive the greatest benefit.</div></div>","PeriodicalId":10490,"journal":{"name":"Clinical lung cancer","volume":"26 1","pages":"Pages 45-51.e5"},"PeriodicalIF":3.3000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical lung cancer","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1525730424002547","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objectives

To evaluate the role of systemic arterial embolization in patients with primary and metastatic lung tumors presenting with hemoptysis requiring emergent management.

Patients and Methods

This retrospective single-center study evaluated patients undergoing transarterial embolization for emergent hemoptysis. Endpoints included technical success, clinical success and overall survival. Clinical success was divided into partial or complete, and defined as absence (complete) or subtotal (partial) reduction in frequency and/or volume of hemoptysis in the first 24-hours following embolization. Predictive factors for clinical outcomes were evaluated using univariate analysis. Adverse events were graded according to Common Terminology Criteria for Adverse Events (CTCAE) v5.0.

Results

Thirty-seven patients were identified, including 21/37 (56.8%) patients with primary lung cancer. Clinical success was achieved in 31/37 (83.8%) patients. Median overall survival was 18 days (95% CI, 10-95). Median hemoptysis-free survival was 270 days (95% CI 7 to not reached). No significant predictors of hemoptysis-free survival were identified. Prior chemotherapy (HR 2.69, 95% CI, 1.08-6.67; P = .03) was associated with poorer overall survival. History of primary lung tumor (vs. metastatic tumor) was associated with improved overall survival (HR 0.45, 95% CI, 0.21-0.95; P = 0.04). No serious adverse events (CTCAE Grade ≥ 3) were found to be directly attributable to the embolization.

Conclusion

Hemoptysis requiring emergent management in patients with lung malignancy carries a poor prognosis. Transarterial embolization is feasible, safe and may be an effective management option, although further research is warranted to identify which patients are likely to derive the greatest benefit.
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
经动脉栓塞治疗原发性和转移性肺肿瘤患者的紧急咯血。
目的:评价全身性动脉栓塞在原发性和转移性肺肿瘤伴咯血需要紧急治疗的患者中的作用。患者和方法:本回顾性单中心研究评估了经动脉栓塞治疗急诊咯血的患者。终点包括技术成功、临床成功和总生存期。临床成功分为部分或完全,并定义为栓塞后24小时内咯血频率和/或体积减少(完全)或次全(部分)减少。采用单因素分析评估临床结果的预测因素。根据不良事件通用术语标准(CTCAE) v5.0对不良事件进行分级。结果:37例患者中有21/37(56.8%)为原发性肺癌。临床成功率为31/37(83.8%)。中位总生存期为18天(95% CI, 10-95)。无咯血的中位生存期为270天(95% CI为7至未达到)。没有发现无咯血生存的显著预测因子。既往化疗(HR 2.69, 95% CI, 1.08-6.67;P = .03)与较差的总生存率相关。原发性肺肿瘤病史(相对于转移性肿瘤)与改善的总生存率相关(HR 0.45, 95% CI, 0.21-0.95;P = 0.04)。未发现与栓塞直接相关的严重不良事件(CTCAE分级≥3)。结论:肺恶性肿瘤患者咯血需急诊治疗预后较差。经动脉栓塞是可行的,安全的,可能是一种有效的治疗选择,尽管需要进一步的研究来确定哪些患者可能获得最大的益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Clinical lung cancer
Clinical lung cancer 医学-肿瘤学
CiteScore
7.00
自引率
2.80%
发文量
159
审稿时长
24 days
期刊介绍: Clinical Lung Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of lung cancer. Clinical Lung Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of lung cancer. The main emphasis is on recent scientific developments in all areas related to lung cancer. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.
期刊最新文献
Predicting Severe Radiation Pneumonitis in Patients With Locally-Advanced Non-Small-Cell Lung Cancer After Thoracic Radiotherapy: Development and Validation of a Nomogram Based on the Clinical, Hematological, and Dose-Volume Histogram Parameters. Brief Report: Real-World Clinical Utility of Next-Generation Sequencing of Circulating Tumor DNA for Patients With Advanced Lung Squamous Cell Carcinoma (SQUIN). Racial Diversity and Co-Mutational Analysis of Biologically Relevant Alterations in EGFR Mutant Lung Cancers. The Impact of Radiation Dose to Immune Cells in Stage IV Non-Small Cell Lung Cancer in the Era of Immunotherapy. The PESGA Trial: A Prospective, Open-Label, Single-Arm, Phase II Study to Evaluate First Line Therapy for Extensive-Stage Small Cell Lung Cancer (ES-SCLC) Patients, Treated by Induction Carboplatin/Etoposide/Pembrolizumab Followed by Maintenance of Pembrolizumab/ Sacituzumab Govitecan.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1