Impact of Interventional Bronchoscopy on Quality of Life in Malignant Airway ObstructionAmjadi K.a, b · Voduc N.b · Cruysberghs Y.a · Lemmens R.a · Fergusson D.A.c · Doucette S.c · Noppen M.a
aInterventional Endoscopy Clinic and Respiratory Division, University Hospital AZ-VUB, Brussels, Belgium; bDivision of Respirology, University of Ottawa, cClinical Epidemiology Program, Ottawa Health Research Institute, Ottawa, Ont., Canada
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Background: Interventional bronchoscopic procedures can re-establish airway patency in the majority of individuals suffering from endobronchial obstruction. However, literature provides limited data on the impact of these procedures on the individual’s quality of life (QoL). Objectives: We evaluated the impact of interventional bronchoscopic procedures aimed at re-establishing airway patency on symptoms and QoL of individuals who do not receive concomitant chemotherapy or radiation therapy. Methods: Over a 6-month period, we prospectively enrolled patients with symptomatic central airway obstruction related to malignancy and performed laser ablation, cryotherapy, and/or airway stenting in order to re-establish airway patency. QoL was evaluated by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire at one day before, 7 days after, and 1 month after procedure. Dyspnea was also assessed by the Borg scale before the procedure and one day after. Results: Final analysis could be performed on 83% (20/24) of the participants. Improvement in airway diameter was achieved in all patients, and >80% patency was established in 80% (16/20) of the patients. Dyspnea scores had improved in 85% of participants (p = 0.01). Thirteen patients experienced an improvement in QoL, although QoL scores remained stable for the group as a whole. Conclusion: Endoscopic procedures can effectively reduce dyspnea associated with malignant central airway obstruction, but this may not always translate into improvements in overall QoL. Administration of QoL questionnaires is feasible, and may help identify domains contributing to patient’s decline, and thereby improve overall patient care.
© 2008 S. Karger AG, Basel
- Ernst A, Feller-Kopman D, Becker HD, Mehta AC: Central airway obstruction. Am J Respir Crit Care Med 2004;169:1278–1297.
- Jemal A, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, Feuer EJ, Thun MJ, American Cancer Society: Cancer statistics. CA Cancer J Clin 2004;54:8–29.
Ginsberg RJ, Vokes EE, Ruben A: Non-small cell lung cancer; in Devita VT, Hellman S, Rosenberg SA (eds): Cancer: Principles and Practice of Oncology. Philadelphia, Lippincott-Raven, 1997, pp 858–911.
- Noppen M, Meysman M, D’Haese J, Schleser M, Vincken W: Interventional bronchoscopy: 5-year experience at the Academic Hospital of the Vrije Universiteit Brussel (AZ-VUB). Acta Clin Belg 1997;52:371–380.
- Gelb AF, Epstein JD: Laser in treatment of lung cancer. Chest 1984;86:662–666.
- Gelb AF, Epstein JD: Neodymium-yttrium-aluminum-garnet laser in lung cancer. Ann Thorac Surg 1987;43:164–167.
- Ross DJ, Mohsenifar Z, Koerner SK: Survival characteristics after neodymium: YAG laser photoresection in advanced stage lung cancer. Chest 1990;98:581–585.
- George PJ, Clarke G, Tolfree S, Garrett CP, Hetzel MR: Changes in regional ventilation and perfusion of the lung after endoscopic laser treatment. Thorax 1990;45:248–253.
Tan BS, Watkinson AF, Dussek JE, Adam AN: Metallic endoprostheses for malignant tracheobronchial obstruction: initial experience. Cardiovasc Res 1996;19:91–96.
- Zwischenberger JB, Wittich GR, vanSonnenberg E, Johnson RF, Alpard SK, Anand SK, Morrison RJ: Airway simulation to guide stent placement for tracheobronchial obstruction in lung cancer. Ann Thorac Surg 1997;64:1619–1625.
- Wilson GE, Walshaw MJ, Hind CR: Treatment of large airway obstruction in lung cancer using expandable metal stents inserted under direct vision via the fibreoptic bronchoscope. Thorax 1996;51:248–252.
- Nakajima Y, Kurihara Y, Niimi H, Konno S, Ishikawa T, Osada H, Kojima H. Efficacy and complications of the Gianturco-Z tracheobronchial stent for malignant airway stenosis. Cardiovasc Intervent Radiol 1999;22:287–292.
- Tanigawa N, Sawada S, Okuda Y, Kobayashi M, Mishima K: Symptomatic improvement in dyspnea following tracheobronchial metallic stenting for malignant airway obstruction. Acta Radiol 2000;41:425–428.
- Sawada S, Tanigawa N, Kobayashi M, Furui S, Ohta Y: Malignant tracheobronchial obstructive lesions: treatment with Gianturco expandable metallic stents. Radiology 1993;188:205–208.
- Miyazawa T, Yamakido M, Ikeda S, Furukawa K, Takiguchi Y, Tada H, Shirakusa T: Implantation of ultraflex nitinol stents in malignant tracheobronchial stenoses. Chest 2000;118:959–965.
- Bolliger CT, Probst R, Tschopp K, Soler M, Perruchoud AP: Silicone stents in the management of inoperable tracheobronchial stenoses. Indications and limitations. Chest 1993;104:1653–1659.
- Bolliger CT, Heitz M, Hauser R, Probst R, Perruchoud AP: An Airway Wallstent for the treatment of tracheobronchial malignancies. Thorax 1996;51:1127–1129.
- Monnier P, Mudry A, Stanzel F, Haeussinger K, Heitz M, Probst R, Bolliger CT: The use of the covered Wallstent for the palliative treatment of inoperable tracheobronchial cancers. A prospective, multicenter study. Chest 1996;110:1161–1168.
- Miyazawa T, Arita K: Airway stenting in Japan. Respirology 1998;3:229–234.
- Mantovani G, Astara G, Manca G, Versace R, Contu P, Carai A: Endoscopic laser ablation as palliative treatment of endobronchial, nonresectable, or recurrent lung cancer: assessment of its impact on quality of life. Clin Lung Cancer 2000;1:277–285.
- Montazeri A, Gillis CR, McEwen J: Quality of life in patients with lung cancer: a review of literature from 1970 to 1995. Chest 1998;113:467–481.
- Montazeri A, Milroy R, Hole D, McEwen J, Gillis CR: Quality of life in lung cancer patients: as an important prognostic factor. Lung Cancer 2001;31:233–240.
- Montazeri A, Milroy R, Hole D, McEwen J, Gillis CR: How quality of life data contribute to our understanding of cancer patients’ experiences? A study of patients with lung cancer. Qual Life Res 2003;12:157–166.
- Gridelli C, Perrone F, Nelli F, Ramponi S, De Marinis F: Quality of life in lung cancer patients. Ann Oncol 2001;12:S21–S25.
- Aaronson NK, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez NJ, Filiberti A, Flechtner H, Fleishman SB, de Haes JC, Kaasa S, Klee M, Osoba D, Razavi D, Rofe PB, Schraub S, Sneeuw K, Sullivan M, Takeda F: The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993;85:365–376.
- Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M: The EORTC QLQ-LC13: a modular supplement to the EORTC Core Quality of Life Questionnaire (QLQ-C30) for use in lung cancer clinical trials. EORTC Study Group on Quality of Life. Eur J Cancer 1994;30A:635–642.
Amjadi K, Cruysberghs Y, Lemmens R, Noppen M: Impact of interventional bronchoscopy on quality of life on patients with advanced symptomatic malignant airway obstruction. Chest 2005;128:210S.
- Noppen M, Dhondt E, Meysman M, Monsieur I, Gepts E, Vincken WG: A simplified insertion technique for tracheobronchial silicone stents. Chest 1994;106:520–523.
- Noppen M, Meysman M, Van Herreweghe R, Lamote J, D’Haese J, Vincken W: Bronchoscopic cryotherapy: preliminary experience. Acta Clin Belg 2001;56:73–77.
Fayers P, Aaronson NK, Bjordal K, Curran D, Groenvold M, the EORTC Quality of Life Study Group: EORTC QLQ-C30 Scoring Manual, ed 2. Brussels, European Organization for Research and Treatment of Cancer, 1999, pp 1–78.
- Sarna L, Evangelista L, Tashkin D, Padilla G, Holmes C, Brecht ML, Grannis F: Impact of respiratory symptoms and pulmonary function on quality of life of long-term survivors of non-small cell lung cancer. Chest 2004;125:439–445.
- Schumacher A, Risenbeck D, Braunheim M, Wewers D, Heinecke A, Semik M, Hoffknecht P, Macha HN, Klinke F, Schmidt EW, Willich N, Berdel WE, Thomas M, German Lung Cancer Cooperative Group: Combined modality treatment for locally advanced non-small cell lung cancer: preoperative chemoradiation does not result in a poorer quality of life. Lung Cancer 2004;44:89–97.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.