Efficacy and safety of bronchial artery chemoembolization combined with chemotherapy and immune checkpoint inhibitors for advanced lung squamous cell carcinoma
摘要
To evaluate the efficacy and safety of adding bronchial artery chemoembolization (BACE) to chemotherapy in combination with immune checkpoint inhibitors (ICIs) in patients with lung squamous cell carcinoma (LUSC).
MethodsThis retrospective study included 71 patients with advanced LUSC treated at Lishui Central Hospital between January 2020 and March 2025. Patients received either chemotherapy plus ICIs (Chemo + ICIs group) or chemotherapy plus ICIs combined with BACE (Chemo + ICIs + BACE group). All patients were histologically diagnosed with LUSC. Baseline clinical characteristics, including demographics, comorbidities, tumor burden, and performance status, were recorded. Tumor response was evaluated using the response evaluation criteria in solid Tumors (RECIST) version 1.1. Progression-free survival (PFS) and overall survival (OS) were calculated using the Kaplan–Meier method. Prognostic factors were further explored through univariate and multivariate Cox proportional hazards regression analyses. Adverse events (AEs) were recorded throughout the treatment period and graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
ResultsBaseline characteristics were balanced between groups. The objective response rate (ORR) was 59.26% in the Chemo + ICIs + BACE group and 38.64% in the Chemo + ICIs group (p = 0.091). The disease control rate (DCR) was significantly higher in the BACE group (85.19% vs. 61.36%, p = 0.033). Median PFS was significantly longer in the Chemo + ICIs + BACE group (10.8 vs. 5.6 months, p = 0.018). Multivariate Cox analysis identified BACE treatment (HR = 0.53, p = 0.037), number of nodules ≤ 3 and tumors size ≤ 5 cm as independent predictors of prolonged PFS. Although the difference in OS was not statistically significant (23.3 vs. 18.4 months, p = 0.139), a favorable trend was observed in the Chemo + ICIs + BACE group. No grade ≥ 4 adverse events (AEs) were observed, and most AEs were grade 1–2 and manageable with symptomatic treatment.
ConclusionThe addition of BACE to chemotherapy and immunotherapy may improve tumor control and prolong progression-free survival in patients with advanced LUSC. These findings support the integration of BACE into combination treatment strategies and warrant further validation in prospective trials.