A case-control study of drug-eluting microspheres and blank microspheres in bronchial artery embolization for hemoptysis in non-small cell lung cancer

BackgroundReportedly up to 30% of lung cancer patients will develop hemoptysis and 10% will experience massive hemoptysis. Bronchial artery embolization (BAE) is routinely performed in patients with hemoptysis secondary to neoplasm, while associated with a high failure rate and increased mortality. The aim of this study was to compare the efficacy of drug-eluting microspheres BAE (DEM-BAE) with blank microspheres BAE (BM-BAE) for hemoptysis in NSCLC patients.MethodsDEM-BAE was performed in 25 patients with hemoptysis with one vial of 300-500μm Callispheres drug-eluting beads (Gemcitabine 100mg). The BM-BAE group consisted of 25 patients who were treated with blank microspheres of 300-500μm. We categorized the results as technical and clinical success, and also included the mid-term results. Technical success was defined as the complete cessation of the target artery as confirmed by digital subtraction angiography (DSA). Clinical success was defined as the cessation of hemoptysis within 24 h of BAE. Technical success was compared immediately after the procedure. The clinical success and mid-term results (percentage of patients who were free of hemoptysis) were compared at 1 and 6 months after the procedure, respectively.ResultsThere was no significant difference for technical success rates (DEM-BAE group: 90%, BM-BAE group: 85%, P>0.05). However, the clinical success rates (DEM-BAE group: 83.3%, BM-BAE group: 68%, P<0.01) and the mid-term results (DEM-BAE group: 71.4%, BM-BAE group: 64%, P<0.01) showed a significant difference. Moreover, Disease control rate (CR+PR+SD) was higher in DEM-BAE group than control group (DEM-BAE group: 78.5%, BM-BAE group: 48%, P<0.01). The procedure-related complications included mild cough and mild chest pain. There was no special management required for these complications.ConclusionsDEM-BAE appeared to be the more optimal modality to improve the mid-term clinical efficacy compared to blank microspheres BAE for hemoptysis in NSCLC patients. Further studies were warranted.Clinical trial identificationChiCTR2300071106.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.