1986 Volume 8 Issue 2 Pages 251-257
Based on extensive animal experiments, we performed intratumoral injection of 99.5% ethanol via a flexible bronchofiberscope for 11 unresectable lung cancer patients with stenosis or obstruction of central airways in order to evaluate its effects on airway dilatation and hemostasis. The results obtained were as follows : 1) Bronchofiberscopic findings revealed that the tumor changed faintly white immediately after injection of ethanol intratumorally, with slight regression of tumor and promising effect was demonstrated on patients with bleeding from tumors. The injected tumor turned necrotic within several days and histological examination revealed no viable tumor cells in necrotic tissues. 2) This endoscopic treatment was very effective in polypoid tumor protruding intratracheobronchial lumen, but was ineffective in stenosis or obstruction due to compression. 3) Animal experimental studies with muscle relaxant elucidated that intramural injection of ethanol demonstrated no significant change of PaO_2, but its instillation into alveolar space, even in slight amounts, caused hemorrhagic pneumonia with a significant decrease of PaO_2. 4) A small amount of ethanol leaking from the tumor caused a transient cough attack but no severe side effects at all including pneumonia or hypoxemia were demonstrated clinically. 5) Biochemical analysis showed no abnormal data not only experimentally during 6 hours follow-up after intramural injection, but also clinically during and after this therapy. 6) In conclusion, intratumoral injection of ethanol is considered to be a promising endoscopic treatment for malignat diseases invading the central airway.
