Intratumoral Hyperthermic Chemotherapy Injection in Peripheral Non-Small Cell Lung Cancer; a Pilot Study

Abstract

Assess efficacy &safety of transthoracic injection of hyperthermic chemotherapy with systemic chemotherapy in inoperable NSCLC

Methods: Randomized clinical trial,done at Chest department&Oncology center, Mansoura, Egypt, 2017 -2019. 30 patients with peripheral NSCLC not candidate for surgery randomly divided into 3 groups: A 10 patients subjected to intratumoral injection of hyperthermic cisplatin at 40°-45°C plus systemic chemotherapy, B 10 patients subjected to intratumoral injection of cisplatin at room temperature 20°-25°C plus systemic chemotherapy and C 10 patients were treated with systemic chemotherapy. Patients who were operable, hypersensitive to cisplatin were excluded. Primary end points were quality of life and radiological response. Secondary end point was survival.

Results: Statistically significant improvement in quality of life in group A&B but decreased in group C after 6 months. Radiology after 6 months in group A, 1 patient had complete response, 6 patients had partial response, 1 patient stable response and 2 patients had progression. As regard group B, 6 patients had partial response, 2 patients had stable response and 2 patients had progression. As regard group C 7 patients had progression, 2 patients had partial response and one patient had stable response. There were few immediate controllable complications, systemic complications were low in group A&B than group C. Median survival in group A was 16 months, in group B was 15 months and was 8 months in group C.

Conclusion: Intratumoral hyperthermic chemotherapy is promising effective, safe and inexpensive palliative treatment for patients with inoperable peripheral NSCLC.