Safety and Effectiveness of Drug-Eluting Embolic Bronchial Arterial Chemoembolization for Lung Cancer: A Systematic Review and Meta-Analysis.

PURPOSE: To assess the effectiveness and safety of drug-eluting embolic (DEE) bronchial arterial chemoembolization (BACE) in lung cancer and compare its outcomes with those of conventional BACE (cBACE).

MATERIALS AND

METHODS

A comprehensive search was conducted across PubMed, Embase, Cochrane Library, Web of Science, CNKI, VIP, and Wanfang databases. Random-effects model analysis was applied when I2 was ≥50%; otherwise, fixed-effects model analysis was used. Subgroup analysis was performed for I2 values of ≥50%. Eighteen studies involving 681 patients were included, with 501 patients receiving DEE-BACE and 110 patients undergoing cBACE.

RESULTS

Among patients with lung cancer treated with DEE-BACE, the pooled objective response rates (ORRs) at 1 and 6 months were 64.4% and 50.3%, respectively; the disease control rates (DCRs) at 1, 3, and 6 months were 93.4%, 74.4%, and 71.7%, respectively. The 1-year overall survival and progression-free survival rates were 48.2% and 22.5%, respectively. The incidences of adverse events such as cough, fever, chest discomfort, nausea, fatigue, and leukopenia were reported at 30.7%, 22.8%, 22.4%, 29.6%, 7.4%, and 21.8%, respectively. Compared with the cBACE group, the DEE-BACE group exhibited higher 1-month DCR (pooled relative risk [RR], 1.236; 95% confidence interval [CI], 1.028-1.486) and 6-month ORR (pooled RR, 2.036; 95% CI, 1.226-3.383) and DCR (pooled RR, 1.824; 95% CI, 1.249-2.662). Both DEE-BACE and cBACE exhibited similar rates of adverse events.

CONCLUSIONS

DEE-BACE presents a favorable effectiveness and safety profile for lung cancer treatment compared with cBACE, particularly for nonresectable cases or when chemotherapy or radiation therapy options are limited. However, the lack of direct comparisons with standard treatments requires cautious interpretation of these results.