RT Journal Article
SR Electronic
T1 Is a stent required after the initial resection of an obstructive lung cancer? The lessons of the SPOC trial, the first randomized study in interventional bronchoscopy
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P3752
VO 42
IS Suppl 57
A1 Jean-Michel Vergnon
A1 Yoann Thibout
A1 Herve Dutau
A1 Michel Febvre
A1 Laurent Cellerin
A1 Christophe Hermant
A1 Fabrice Di Palma
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P3752.abstract
AB SPOC is a first randomized trial designed to test the functional and survival benefit of a silicone stent insertion after resection of an obstructive cancer. This trial included 75 patients from 8 academic hospitals in France with a grant of the national cancer institute (INCA) After the successful resection of the bronchial tumor, patients were randomized between 2 arms (with stent or without stent) and a silicone stent (Novatech company) was inserted in 39 patients. Other treatments applied (first line chemotherapy with Platin, other lines or palliative care, radio-chemotherapy) were taken in count to obtain a well-balanced randomization. Quality of life was recorded with several questionnaires including QLC 30 LC-13, before and after the initial resection, at 3, 6 and 12 months later. Each local recurrence was recorded on photographs and could be retreated. The one-year survival without symptomatic recurrence (more than 50% of obstruction in the treated zone) was the main endpoint. Survival and stent tolerance were secondary endpoints.The initial tumor resection induces in the 2 arms the same dramatic improvement in dyspnea score and in quality of life but the benefit was maintained longer in stent arm. The stents induced no significant side effects. The recurrence rate of local obstruction is strongly decreased in stent arm but do not change the survival at one year. Among the initial 75 patients, 19 were still in life at one year and 15 without local recurrence.This study proves the symptomatic benefit of interventional bronchoscopy and the barrier role of silicone stent to prevent a local recurrence.