Skip to main content

Chemoembolization of Lung Tumors

  • Chapter
  • First Online:
Locoregional Tumor Therapy
  • 499 Accesses

Abstract

The incidence of lung cancer has increased enormously in the last century [1], and lung cancer is now one of the most common malignant diseases worldwide. In the United States, bronchogenic carcinoma is the second most common cancer for both men and women. In 2002, 169,400 new cases of bronchogenic carcinoma were diagnosed in the United States, and 154,900 people died of this disease, making bronchogenic carcinoma the leading cause of cancer-related death [2]. Pulmonary metastases from primary tumors at other sites are also a major problem: between 20 and 30 % of patients suffering from cancer develop pulmonary metastases [3]. The prognosis for patients with bronchogenic carcinomas or pulmonary metastases is poor. In patients with stage I and II bronchogenic carcinoma, resection offers the best chance for long-term survival [4–7], but only 25–30 % of such tumors are resectable [2, 4, 5]. The mean survival duration after diagnosis is 12 months for patients with bronchogenic carcinomas and less than 1 year for patients with unresectable pulmonary metastases. Five-year survival rates are 10 % for patients with bronchogenic carcinoma overall [4], 23–50 % for patients with bronchogenic carcinoma who undergo resection [6–9], and 1 %1 for patients with unresectable bronchogenic carcinomas. In patients who undergo resection of pulmonary metastases, the 5-year survival rate is 20–46 % [10–17].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 24.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Zutić H. Karcinom bronha–pregled. Med Arh. 1999;53:27–31.

    PubMed  Google Scholar 

  2. American Cancer Society. Cancer facts and figures. Atlanta: American Cancer Society; 2002.

    Google Scholar 

  3. Weiss W, Boucot KR, Cooper DA. The Philadelphia pulmonary neoplasm research project. Survival factors in bronchogenic carcinoma. JAMA. 1971;216:2119–23.

    Article  CAS  PubMed  Google Scholar 

  4. Frommhold W, Gerhardt P. Klinisch-radiologisches Seminar, Band 17, Tumoren der Lunge. New York/Stuttgart: Georg-Thiemeverlag; 1987.

    Google Scholar 

  5. McCormack P. Surgical resection of pulmonary metastases. Semin Surg Oncol. 1990;6:297–302.

    Article  CAS  PubMed  Google Scholar 

  6. Müller M. Chirurgie für Studium und Praxis: unter Berücksichtigung des Gegenstandskataloges und der münlichen Examinain der ärzlichen Prüfung 2002/03. Markus Müller und Mitarbeiter. 6 Aufl. Breisach/Rh: Med Verl./Informationsdienste; 2001. p. 101.

    Google Scholar 

  7. American Cancer Society. Cancer facts and figures. Atlanta: American Cancer Society; 2004.

    Google Scholar 

  8. Plickova K, Spidlen V, Pesek M, Mukensnabl P. Patient survival analysis in surgery of bronchogenic carcinoma from 1986 to 1997. Rozhl Chir. 2003;82(6):293–9.

    CAS  PubMed  Google Scholar 

  9. Hendriks JMH, Grootenboers MJJH, Schramel FMNH, van Boven WJ, Stockman B, Seldenrijk CA, ten Broecke P, Knibbe CAJ, Slee P, de Bruijn E, Vlaeminck R, Heeren J, Vermorken JB, van Putte B, Romijn S, van Marck E, van Schil PEY. Isolated lung perfusion with melphalan for resectable lung metastases: a phase I clinical trial. Ann Thorac Surg. 2004;78:1919–26; discussion 1926–7.

    Article  PubMed  Google Scholar 

  10. Vogt-Moykopf I, Bulzebruck H, Kryza S, Kruschinski H, Branscheid D, Schirren J. Results in surgery of pulmonary metastases. Chirurgie. 1992;118:263–71.

    CAS  PubMed  Google Scholar 

  11. Friedl G, Pastorino U, Buyse M. Resection of lung metastases: long-term results and prognostic analyses based on 5.206 cases, The international Registry of Lung Metastases. Zentralbl Chir. 1999;96103.

    Google Scholar 

  12. Hendriks JM, Romijn S, van Putte B, Eyskens E, Vermorken JB, van Marck E, van Schil PE. Long-term results of surgical resection of lung metastases. Acta Chir Belg. 2001;101:267–72.

    CAS  PubMed  Google Scholar 

  13. Abecasis N, Cortez F, Bettencourt A, Costa CS, Orvalho F, de Almeida JM. Surgical treatment of lung metastases: prognostic factors for long-term survival. J Surg Oncol. 1999;72:193–8.

    Article  CAS  PubMed  Google Scholar 

  14. Lanza LA, Putnam JB, Benjamin RS, Roth JA. Response to chemotherapy does not predict survival after resection of sarcomatous pulmonary metastases. Ann Thorac Surg. 1991;51:219–24.

    Article  CAS  PubMed  Google Scholar 

  15. Casson AG, Putnam JB, Natarajan G, Johnston DA, Mountain C, McMurtrey M, Roth JA. Five-year survival after pulmonary metastasectomy for adult soft tissue sarcoma. Cancer. 1992;69:662–8.

    Article  CAS  PubMed  Google Scholar 

  16. Ueda T, Uchida A, Kodama K, Doi O, Nakahara K, Fujii Y, Komatsubara Y, Ono K. Aggressive pulmonary metastasectomy for soft tissue sarcomas. Cancer. 1993;72:1919–25.

    Article  CAS  PubMed  Google Scholar 

  17. Weksler B, Ng B, Lenert JT, Burt ME. Isolated single-lung perfusion with doxorubicin is pharmacokinetically superior to intravenous injection. Ann Thorac Surg. 1993;56:209–14.

    Article  CAS  PubMed  Google Scholar 

  18. Mentzer SJ, Antman KH, Attinger C, Shemin R, Corson JM, Sugarbaker DJ. Selected benefits of thoracotomy and chemotherapy for sarcoma metastatic to the lung. J Surg Oncol. 1993;53:54–9.

    Article  CAS  PubMed  Google Scholar 

  19. Greenall MJ, Magill GB, DeCosse JJ, Brennan MF. Chemotherapy for soft tissue sarcoma. Surg Gynecol Obstet. 1986;162:193–8.

    CAS  PubMed  Google Scholar 

  20. Dirix LY, van Oosterom AT. Diagnosis and treatment of soft tissue sarcomas in adults. Curr Opin Oncol. 1994;6:372–83.

    Article  CAS  PubMed  Google Scholar 

  21. van Schil PE. Surgical treatment for pulmonary metastases. Acta Clin Belg. 2002;57:333–9.

    Article  PubMed  Google Scholar 

  22. Pan Y, Krueger T, Tran N, Yan H, Ris H-B, McKee TA. Evaluation of tumour vascularisation in two rat sarcoma models for studying isolated lung perfusion. Injection route determines the origin of tumour vessels. Eur Surg Res. 2005;37:92–9.

    Article  CAS  PubMed  Google Scholar 

  23. van Putte BP, Hendriks JMH, Romijn S, van Schil PEY. Isolated lung perfusion for the treatment of pulmonary metastases current mini-review of work in progress. Surg Oncol. 2003;12:187–93.

    Article  PubMed  Google Scholar 

  24. Romijn S, Hendriks JMH, van Putte BP, Weyler J, Guetens G, de Boeck G, de Bruijn EA, van Schil PEY. Anterograde versus retrograde isolated lung perfusion with melphalan in the WAG-Rij rat. Eur J Cardiothorac Surg. 2005;27:1083–5.

    Article  PubMed  Google Scholar 

  25. Hendriks JMH, Romijn S, van Putte B, Stockman B, ten Broecke P, van Schil P. Isolated lung perfusion for the treatment of pulmonary metastatic disease: a review. Acta Chir Belg. 2005;105:338–43.

    CAS  PubMed  Google Scholar 

  26. Müller H, Hilger R. Curative and palliative aspects of regional chemotherapy in combination with surgery. Support Care Cancer. 2003;11:1–10.

    PubMed  Google Scholar 

  27. van Putte BP, Hendriks JMH, Romijn S, Guetens G, de Boeck G, de Bruijn EA, van Schil PEY. Single-pass isolated lung perfusion versus recirculating isolated lung perfusion with melphalan in a rat model. Ann Thorac Surg. 2002;74:893–8; discussion 898.

    Article  PubMed  Google Scholar 

  28. Romijn S, Hendriks JMH, van Putte BP, Weyler J, Guetens G, de Boeck G, van Schil PEY. Regional differences of melphalan lung levels after isolated lung perfusion in the rat. J Surg Res. 2005;125:157–60.

    Article  CAS  PubMed  Google Scholar 

  29. Franke UFW, Wittwer T, Lessel M, Liebing K, Albert M, Becker V, Schubert H, Wahlers T. Evaluation of isolated lung perfusion as neoadjuvant therapy of lung metastases using a novel in vivo pig model: I. Influence of perfusion pressure and hyperthermia on functional and morphological lung integrity. Eur J Cardiothorac Surg. 2004;26:792–9.

    Article  PubMed  Google Scholar 

  30. Demmy TL, Wagner-Mann C, Allen A. Isolated lung chemotherapeutic infusions for treatment of pulmonary metastases: a pilot study. J Biomed Sci. 2002;9:334–8.

    Article  CAS  PubMed  Google Scholar 

  31. Burt ME, Liu D, Abolhoda A, Ross HM, Kaneda Y, Jara E, Casper ES, Ginsberg RJ, Brennan MF. Isolated lung perfusion for patients with unresectable metastases from sarcoma: a phase I trial. Ann Thorac Surg. 2000;69:1542–9.

    Article  CAS  PubMed  Google Scholar 

  32. Johnston MR, Minchen RF, Dawson CA. Lung perfusion with chemotherapy in patients with unresectable metastatic sarcoma to the lung or diffuse bronchioloalveolar carcinoma. J Thorac Cardiovasc Surg. 1995;110:368–73.

    Article  CAS  PubMed  Google Scholar 

  33. Pass HI, Mew DJ, Kranda KC, Temeck BK, Donington JS, Rosenberg SA. Isolated lung perfusion with tumor necrosis factor for pulmonary metastases. Ann Thorac Surg. 1996;61:1609–17.

    Article  CAS  PubMed  Google Scholar 

  34. Schneider P, Kampfer S, Loddenkemper C, Foitzik T, Buhr HJ. Chemoembolization of the lung improves tumor control in a rat model. Clin Cancer Res. 2002;8:2463–8.

    CAS  PubMed  Google Scholar 

  35. Ratto GB, Toma S, Civalleri D, Passerone GC, Esposito M, Zaccheo D, Canepa M, Romano P, Palumbo R, de Cian F, Scarano F, Vannozzi M, Spessa E, Fantino G. Isolated lung perfusion with platinum in the treatment of pulmonary metastases from soft tissue sarcomas. J Thorac Cardiovasc Surg. 1996;112:614–22.

    Article  CAS  PubMed  Google Scholar 

  36. Vogl TJ, Trapp M, Schroeder H, Mack M, Schuster A, Schmitt J, Neuhaus P, Felix R. Transarterial chemoembolization for hepatocellular carcinoma: volumetric and morphologic CT criteria for assessment of prognosis and therapeutic success-results from a liver transplantation center. Radiology. 2000;214:349–57.

    Article  CAS  PubMed  Google Scholar 

  37. Miller BJ, Rosenbaum AS. The vascular supply to metastatic tumors of the lung. Surg Gynecol Obstet. 1967;125:1009–12.

    CAS  PubMed  Google Scholar 

  38. Huppert PE, Geissler F, Duda SH, Lauchart W, Dette S, Dietz K, Brambs HJ, Claussen CD. Chemoembolisation des hepatozellulären Karzinoms: computertomographische Befunde und klinische Resultate bei prospektiv repetitiver Therapie. Rofo. 1994;160:425–32.

    Article  CAS  PubMed  Google Scholar 

  39. Schneider P, Foitzik T, Pohlen U, Golder W, Buhr HJ. Temporary unilateral microembolization of the lung – a new approach to regional chemotherapy for pulmonary metastases. J Surg Res. 2002;107:159–66.

    Article  CAS  PubMed  Google Scholar 

  40. Pohlen U, Rieger H, Meyer BT, Loddenkemper C, Buhr HJ, Heitland P, Koester HD, Schneider P. Chemoembolization of lung metastases – pharmacokinetic behaviour of carboplatin in a rat model. Anticancer Res. 2007;27:809–15.

    CAS  PubMed  Google Scholar 

  41. Pohlen U, Rieger H, Albrecht T, Loddenkemper C, Buhr HJ, Schneider P. Chemoembolization with carboplatin of the lung. Feasibility and toxicity in a pig model. Anticancer Res. 2007;27:1503–8.

    CAS  PubMed  Google Scholar 

  42. van Putte BP, Grootenboers M, van Boven W-J, Hendriks JMH, van Schil PEY, Guetens G, de Boeck G, Pasterkamp G, Schramel F, Folkerts G. Pharmacokinetics of gemcitabine when delivered by selective pulmonary artery perfusion for the treatment of lung cancer. Drug Metab Dispos. 2008;36:676–81.

    Article  PubMed  Google Scholar 

  43. Schröder C, Fisher S, Pieck AC, Müller A, Jaehde U, Kirchner H, Haverich A, Macchiarini P. Technique and results of hyperthermic (41 degrees C) isolated lung perfusion with high-doses of cisplatin for the treatment of surgically relapsing or unresectable lung sarcoma metastasis. Eur J Cardiothorac Surg. 2002;22:41–6.

    Article  PubMed  Google Scholar 

  44. Vogl TJ, Wetter A, Lindemayr S, Zangos S. Treatment of unresectable lung metastases with transpulmonary chemoembolization: preliminary experience. Radiology. 2005;234:917–22.

    Article  PubMed  Google Scholar 

  45. Lindemayr S, Lehnert T, Korkusuz H, Hammerstingl R, Vogl TJ. Transpulmonary chemoembolization: a novel approach for the treatment of unresectable lung tumors. Tech Vasc Interv Radiol. 2007;10:114–9.

    Article  PubMed  Google Scholar 

  46. Vogl TJ, Lehnert T, Zangos S, Eichler K, Hammerstingl R, Korkusuz H, Lindemayr S. Transpulmonary chemoembolization (TPCE) as a treatment for unresectable lung metastases. Eur Radiol. 2008;18:2449–55.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Thomas J. Vogl .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Vogl, T.J. (2015). Chemoembolization of Lung Tumors. In: Van Cutsem, E., Vogl, T., Orsi, F., Sobrero, A. (eds) Locoregional Tumor Therapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36572-0_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-36572-0_8

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-36571-3

  • Online ISBN: 978-3-642-36572-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics