Therapeutic Rigid Bronchoscopy Intervention for Malignant Central Airway Obstruction Improves Performance Status to...

Area of Science:

• Pulmonology
• Interventional Pulmonology
• Oncology

Background:

• Malignant central airway obstruction (MCAO) can lead to poor Eastern Cooperative Oncology Group Performance Status (ECOG PS), preventing systemic therapy.
• Evaluating rigid bronchoscopy outcomes for MCAO is crucial for improving patient eligibility for treatments.

Purpose of the Study:

• To assess the outcomes of rigid bronchoscopy in patients with MCAO.
• To determine the impact of rigid bronchoscopy on ECOG PS and subsequent systemic therapy access.

Main Methods:

• Retrospective observational study of 77 patients undergoing rigid bronchoscopy for MCAO (March 2015-November 2019).
• Data collected included procedural details, pre/post-procedure ECOG PS, complications, and systemic therapy administration.

Main Results:

• Most patients presented with ECOG PS 2-3 (62%); squamous cell carcinoma was the most common cause of MCAO.
• Rigid bronchoscopy significantly improved ECOG PS, particularly in patients with baseline ECOG PS 3-4 (P<0.0001).
• 70% of patients with ECOG PS 3-4 received systemic therapies post-procedure, which would have been contraindicated otherwise. Bleeding was the main complication, managed bronchoscopically.

Conclusions:

• Therapeutic rigid bronchoscopy is a safe and effective treatment for MCAO.
• Improved ECOG PS following rigid bronchoscopy facilitates the administration of systemic therapies, including immunotherapy and targeted treatments.
• This approach is vital for enhancing survival benefits in the era of advanced cancer therapies.