Bronchial Arteries Embolization As An Activator Of Tumor Necrosis Factor
Odessa National Medical University, Odessa, Ukraine.
Aim. Analysis of patients treatment results with the central form of lung cancer using X-ray endovascular embolization of bronchial arteries (EEBA) and endobronchial radiofrequency ablation (RFA) with tumor stenoses recanalization. Matherials and Methods. 125 patients with central lung cancer complicated by tumor bronchial stenosis and pulmonary hemorrhage treatment results were analyzed. The patients were divided into disease stages: IIIA - 25 patients, IIIB - 62 patients, IV - 38 patients. All patients received at the first stage EEBA with polyurethane emboli, the second stage was performed with endobronchial RFA, with tumor stenosis recanalization with Fotek-150 device with 60 W power. Results. As a treatment result with control fibrobronchoscopy, tumor necrosis with purulent endobronchitis was observed. Also, almost all patients experienced hyperthermia reaction with temperature increase from 38 to 390C, a slight decrease in body weight and intoxication symptoms. Most often, these symptoms occurred in patients with tumor localization in right lung, which is associated with the presence of a single right bronchial artery. All patients achieved recanalization of the bronchi, the hemostatic effect was achieved in 90% of patients. As a result of complex treatment with combination of EEBA and RFA, 9 patients with tumor localization on the right had tumor regression with the formation of local pneumofibrosis and pneumosclerosis. Life expectancy in patients with right-sided localization was: 45 months (1 patient, died of pulmonary hemorrhage); 30 months (4 patients, died from concomitant pathology); 3 patients regularly come to the control for more than 27 months; 1 patient died after 1.5 months from intoxication. Conclusions. The EEBA use is causing tumor necrosis to promote the tumor necrosis factor (TNF) activation, which plays a decisive role in patients disease course with a single right bronchial artery. Keywords: lung cancer, tumor necrosis factor, embolization of bronchial arteries.
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