Abstract
OBJECTIVE: To investigate the efficacy and safety of bronchial artery chemoembolization (BACE) for the treatment of inoperable non-small cell lung cancer (NSCLC). METHODS: A retrospective review was conducted of 112 patients with NSCLC who received BACE treatment and 120 patients who underwent systemic chemotherapy in our center over the past 10 years. The progression-free survival (PFS), overall survival (OS), objective response rate (ORR), quality of life, and adverse events were compared between the two groups. RESULTS: The complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) rates in the BACE group were 7.14%, 39.29%, 33.04%, and 20.54%, respectively, while those rates in the chemotherapy group were 7.5%, 20.83%, 55.0%, and 16.67%. The ORR in the BACE group was significantly higher than in the chemotherapy group (46.43% vs. 28.33%, P = 0.007). The median PFS was significantly longer in the BACE group (17 months vs. 11 months, P = 0.035) than that of chemotherapy group, as was the median OS (19.5 months vs. 13 months, P = 0.044). The BACE group also showed significantly better results in cough relief (57.0% vs. 41.7%, P = 0.028) and hemoptysis relief (70.3% vs. 47.1%, P = 0.001) compared to the chemotherapy group. The 1-year, 3-year, and 5-year survival rates for the BACE group were 68.0%, 29.1%, and 15.5%, respectively, compared to 49.5%, 15.9%, and 7.5% those of the chemotherapy group, with statistically significant differences (P < 0.05). The BACE group exhibited better tolerability and higher safety, with a lower incidence and severity of adverse events, particularly fatigue, nausea/vomiting, and myelosuppression, which showed statistically significant differences (P < 0.05). CONCLUSION: BACE treatment for inoperable NSCLC offers better clinical outcomes compared to systemic chemotherapy and is safe and well-tolerated, with no severe adverse events. This approach warrants further prospective randomized controlled trials.