Tumor expectoration following drug-eluting bead bronchial artery chemoembolization for advanced non-small cell lung cancer.
- 1Department of Oncology, The Second Xiangya Hospital of Central South University, Changsha, China.
- 2Department of Interventional Radiology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
- 3Department of Pulmonary and Critical Care Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
Abstract
Drug-eluting bead bronchial artery chemoembolization (DEB-BACE) has been investigated as a locoregional salvage treatment for advanced non-small cell lung cancer (NSCLC). It may be considered for treatment-refractory or symptomatic central tumors. We retrospectively describe case of three patients with centrally located, treatment-refractory NSCLC who underwent DEB-BACE. All three subsequently expectorated soft-tissue material. Clinical features, procedures, imaging, pathology, and outcomes were reviewed. Potential bronchial and non-bronchial systemic tumor-feeding arteries were assessed using contrast-enhanced computed tomography and selective digital subtraction angiography (DSA). Lobaplatin was infused intra-arterially. Embolization was then performed with 300 to 500 μm epirubicin-loaded Bead microspheres. The procedural endpoint was marked reduction of tumor blush with stasis or near-stasis. One patient had SMARCA4-deficient NSCLC. Two had squamous cell carcinoma. Soft-tissue expectoration occurred 3 days to 2 weeks after DEB-BACE. Histopathology confirmed carcinoma with extensive necrosis in Cases 1 and 2. Pathological confirmation was unavailable in Case 3. Case 1 achieved a durable partial response during repeated DEB-BACE and continued sintilimab treatment. The tumor decreased from 94 mm × 55 mm to 22 mm × 14 mm at 13 months and remained stable at 29 months. Case 2 developed tumor expectoration 3 days after treatment. Bronchial patency was subsequently restored. The patient died 10 months after diagnosis. Case 3 developed recurrent hemoptysis and underwent emergency hemostatic bronchial artery embolization. The patient subsequently expectorated a soft-tissue mass and died from progressive pulmonary infection 14 months after diagnosis. Tumor expectoration may represent treatment-associated necrosis after DEB-BACE. Careful assessment of vascular anatomy, bleeding risk, infection, and non-target embolization risk is essential.
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BibTeX
@article{deng2026tumor,
title = {{Tumor expectoration following drug-eluting bead bronchial artery chemoembolization for advanced non-small cell lung cancer.}},
author = {Yi Deng and Yanqing Le and Jing Li and Rongde Xu and Wei Cui},
journal = {Quantitative imaging in medicine and surgery},
year = {2026},
month = oct,
doi = {10.21037/qims-2026-1506},
url = {https://europepmc.org/article/MED/42999538},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Tumor expectoration following drug-eluting bead bronchial artery chemoembolization for advanced non-small cell lung cancer.
AU - Yi Deng
AU - Yanqing Le
AU - Jing Li
AU - Rongde Xu
AU - Wei Cui
PY - 2026
DA - 2026/10/15
JO - Quantitative imaging in medicine and surgery
DO - 10.21037/qims-2026-1506
UR - https://europepmc.org/article/MED/42999538
AB - Drug-eluting bead bronchial artery chemoembolization (DEB-BACE) has been investigated as a locoregional salvage treatment for advanced non-small cell lung cancer (NSCLC). It may be considered for treatment-refractory or symptomatic central tumors. We retrospectively describe case of three patients with centrally located, treatment-refractory NSCLC who underwent DEB-BACE. All three subsequently expectorated soft-tissue material. Clinical features, procedures, imaging, pathology, and outcomes were reviewed. Potential bronchial and non-bronchial systemic tumor-feeding arteries were assessed using contrast-enhanced computed tomography and selective digital subtraction angiography (DSA). Lobaplatin was infused intra-arterially. Embolization was then performed with 300 to 500 μm epirubicin-loaded Bead microspheres. The procedural endpoint was marked reduction of tumor blush with stasis or near-stasis. One patient had SMARCA4-deficient NSCLC. Two had squamous cell carcinoma. Soft-tissue expectoration occurred 3 days to 2 weeks after DEB-BACE. Histopathology confirmed carcinoma with extensive necrosis in Cases 1 and 2. Pathological confirmation was unavailable in Case 3. Case 1 achieved a durable partial response during repeated DEB-BACE and continued sintilimab treatment. The tumor decreased from 94 mm × 55 mm to 22 mm × 14 mm at 13 months and remained stable at 29 months. Case 2 developed tumor expectoration 3 days after treatment. Bronchial patency was subsequently restored. The patient died 10 months after diagnosis. Case 3 developed recurrent hemoptysis and underwent emergency hemostatic bronchial artery embolization. The patient subsequently expectorated a soft-tissue mass and died from progressive pulmonary infection 14 months after diagnosis. Tumor expectoration may represent treatment-associated necrosis after DEB-BACE. Careful assessment of vascular anatomy, bleeding risk, infection, and non-target embolization risk is essential.
SN - 2223-4292
SN - 2223-4306
ER -