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Review
. 2018 Jul;12(7):605-614.
doi: 10.1080/17476348.2018.1486709. Epub 2018 Jun 19.

Minimally invasive palliative interventions in advanced lung cancer

Christopher Mallow  1 , Margaret Hayes  2 , Roy Semaan  3 , Thomas Smith  1 , Russell Hales  1 , Roy Brower  1 , Lonny Yarmus  1
Affiliations
Review

Minimally invasive palliative interventions in advanced lung cancer

Christopher Mallow et al. Expert Rev Respir Med. 2018 Jul.

Abstract

Lung cancer is the leading cause of cancer-related deaths in the United States. Nearly 85% of all lung cancers are diagnosed at a late stage, with an associated five-year survival rate of 4%. Malignant central airway obstruction and malignant pleural effusions occur in upwards of 30% of these patients. Many of these patients are in need of palliative interventions for symptom control and to help improve their quality of life. Areas covered: This review covers the treatment modalities of malignant central airway obstruction and malignant pleural effusion. PubMed was used to search for the most up to date and clinically relevant articles that guide current treatment strategies. This review focuses on rigid bronchoscopy and the tools used for the relief of central airway obstruction, as well as intra-pleural catheter use and pleurodesis for the management of malignant pleural effusions. Expert commentary: There are multiple treatment modalities that may be used to help alleviate the symptoms of malignant central airway obstruction and pleural effusion. The modality used depends on the urgency of the situation, and specific patient's goals. An open dialog to understand the patient's end of life goals is an important factor when choosing the appropriate treatment strategy.

Keywords: Malignant central airway obstruction; interventional pulmonology; lung cancer; malignant pleural effusion; palliative care.

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Conflict of interest statement

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Figures

Figure 1.
Figure 1.
Survival graph of Lung cancer (Based on SEER Cancer Stat Facts: Lung and Bronchus Cancer).
Figure 2.
Figure 2.
Intrinsic, Extrinsic and Mixed Central Airway Obstruction.
Figure 3.
Figure 3.
Panel A demonstrates multiple different sized rigid bronchoscopes. Panel B shows two different forceps used through the inner cannula of the rigid bronchoscope.
Figure 4.
Figure 4.
Balloon dilation. Panel A shows the catheter traversing the stenotic airway. Panel B demonstrates the initial inflation of the balloon to dilate the airway. Panel C displays maximal inflation of the balloon used to re-establish airway patency.
Figure 5.
Figure 5.
In order: Silicone Y stent, Silicone white stent, Silicone translucent stent, Covered self-expanding metallic stent, Uncovered self-expanding metallic stent.
Figure 6.
Figure 6.
Rocket® Intra pleural catheter with attached metal tunneler and blue drainage port.
See this image and copyright information in PMC

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