Embolization for Lung Tumors

Lung chemoembolization can safely and effectively treat large and multifocal lung tumors (including mediastinal lymph nodes), in patients with no other good treatment options. Most lung tumors are supplied by the bronchial artery, but they can also be supplied by a nonbronchial systemic artery, or the pulmonary artery. The angiograms must be carefully reviewed for tiny vessels that supply the spinal cord or esophagus. Cone beam CT or helical CT (in an integrated angiography/CT suite) must be performed to confirm that the artery supplies the tumor, and does not supply esophagus or spinal cord. The optimal intra-arterial drug and embolic for lung chemoembolization are unknown. Response rates range from 7–78%, but it is not known whether radiographic response will translate into improved survival or quality of life. We recommend that this new technique should generally be performed in the setting of a clinical trial.