Intra-arterial Chemoperfusion for Lung Cancer Brain Metastases

Purpose The aim of this retrospective single-center study was to evaluate the safety and efficacy of palliative intra-arterial chemoperfusion (IAC) for patients diagnosed with recurrent or post-therapeutic progressive symptomatic lung cancer brain metastases (LCBM). Materials and methods A total of 10 patients (five women and five men; median age: 56 years (range: 40-80 years)) with recurrent or post-therapeutic LCBM were included. Chemotherapy consisted of either carmustine or a combination of mitomycin C, gemcitabine, and cisplatin. The radiological follow-up was performed using magnetic resonance imaging (MRI) according to the Response Evaluation Criteria in Solid Tumors (RECIST) 1.1. The overall survival (OS) was calculated using the Kaplan-Meier method. Results All patients were treated with prior systemic therapy, and seven patients additionally received radiation therapy. A total of 37 sessions of IAC (3.7/patient) were performed. No major complications occurred. The mean sum of the longest diameter (SLD) was 4.5±1.2 cm for all patients prior to treatment. The mean SLD for patients with radiological follow-up was 3.9±2.1 cm after treatment. Four patients (4/8) developed progressive disease. Three patients (3/8) achieved stable disease, and one patient (1/8) showed complete response. None of the patients had partial response. Two patients (2/10) were not assessable due to loss of radiological imaging post-interventional. The mean OS time was 9.7 months (95% CI: 2.4-17.0). Conclusion Although IAC seems to be a safe approach for palliative patients with recurrent or post-therapeutic progressive symptomatic LCBM, further studies with a larger patient population are needed to confirm its efficacy.