Application of Paclitaxel as Adjuvant Treatment for Benign Cicatricial Airway Stenosis

Benign cicatricial airway stenosis（BCAS） is a potentially life-threatening disease.Recurrence occurs frequently after endoscopic treatment.Paclitaxel is known to prevent restenosis,but its clinical efficacy and safety is undetermined.Therefore,in this study,we investigated the efficacy and associated complications of paclitaxel as adjuvant treatment for BCAS of different etiologies.The study cohort included 28 patients with BCAS resulting from tuberculosis,intubation,tracheotomy,and other etiologies.All patients were treated at the Department of Respiratory Diseases,Beijing Tian Tan Hospital,Capital Medical University,China,between January 2010 and August 2014.After primary treatment by balloon dilation,cryotherapy,and/or high-frequency needle-knife treatment,paclitaxel was applied to the airway mucosa at the site of stenosis using a newly developed local instillation catheter.The primary outcome measures were the therapeutic efficacy of paclitaxel as adjuvant treatment,and the incidence of complications was observed as well.According to our criteria for evaluating the clinical effects on BCAS,24 of the 28 cases achieved durable remission,three cases had remission,and one case showed no remission.Thus,the durable remission rate was 85.7%,and the combined effective rate was 96.4%.No differences in outcomes were observed among the different BCAS etiologies（P=0.144）,and few complications were observed.Our results indicated that paclitaxel as an adjuvant treatment has greater efficacy than previously reported BCAS treatment methods.

Nonstent Combination Interventional Therapy for Treatment of Benign Cicatricial Airway Stenosis

Background：Benign cicatricial airway stenosis （BCAS） is a life-threatening disease.While there are numerous therapies,all have their defects,and stenosis can easily become recurrent.This study aimed to investigate the efficacy and complications of nonstent combination interventional therapy （NSCIT） when used for the treatment of BCAS of different causes and types.Methods：This study enrolled a cohort of patients with BCAS resulting from tuberculosis,intubation,tracheotomy,and other origins.The patients were assigned to three groups determined by their type of stenosis：Web-like stenosis,granulation stenosis,and complex stenosis,and all patients received NSCIT.The efficacy and complications of treatment in each group of patients were observed.The Chi-square test,one-factor analysis of variance （ANOVA）,and the paired t-test were used to analyze different parameters.Results：The 10 patients with web-like stenosis and six patients with granulation stenosis exhibited durable remission rates of 100%.Among 41 patients with complex stenosis,36 cases （88%） experienced remission and 29 cases （71%） experienced durable remission.When five patients with airway collapse were eliminated from the analysis,the overall remission rate was 97%.The average treatment durations for patients with web-like stenosis,granulation stenosis,and complex stenosis were 101,21,and 110 days,respectively,and the average number of treatments was five,two,and five,respectively.Conclusions：NSCIT demonstrated good therapeutic efficacy and was associated with few complications.However,this approach was ineffective for treating patients with airway collapse or malacia.