Effect of topical application with mitomycin C in the management of benign cicatricial airway stenosis

Abstract

To assess the efficacy and safety of topical application of mitomycin-C in the management of benign cicatricial airway stenosis (BCAS), and to discuss the feasibility of catheter drip to achieve the topical application of mitomycin-C. Twenty patients with BCAS were divided into control group and experimental group (topical application of mitomycin-C). Patients in control group were treated only with interventional bronchoscopy which including balloon dilation, argon plasma coagulation/electrotomy, cryotherapy, stent placement and so on, while patients in experimental group were treated with interventional bronchoscopy adjuncted with topical application of mitomycin-C (0.4 mg/ml). According to the length of airway lesion, the dosage was 1 ml/cm. Topical application of mitomycin-C was achieved by catheter drip. Photographs were taken at the place above the proximal end of airway stenosis and a software called Digimizer was used to measure the cross sectional area of stenosed airway. A 3-month follow-up was done to observe the safety and curative effect of topical application mitomycin-C in airway. Ten patients (3 male and 7 female) ranging in age from 20 to 71 years [mean (36 ± 17) years] enrolled in control group and 10 patients (5 male and 5 female) ranging in age from 20 to 74 years [mean (42 ± 18) years] enrolled in experimental group. The average airway cross-sectional areas before and after treatment of 2 groups were (22 ± 13) mm(2), (23 ± 11) mm(2) (control group) and (20 ± 8) mm(2), (34 ± 12) mm(2) (experimental group), respectively. The average increased airway cross-sectional areas of experimental group and control group before and after treatment were (15 ± 13) mm(2) and (1 ± 10) mm(2) respectively, which had statistical differences. The average times of treatment during 3 months were (2.8 ± 1.5) in control group vs (1.8 ± 0.9) in experimental group which had statistical differences. The 3-month effective rate was 90% of experimental group vs 40% of control group, and the symptom improvement rate was 80% of experimental group vs 30% of control group. There were significant differences in outcomes between two groups. No drug-related complications occurred in experimental group during the follow-up period. Mitomycin-C is an effective adjuvant treatment method in the management of BCAS. Topical application of mitomycin-C in airway is safety. Catheter drip to achieve the topical application of mitomycin-C in airway is a convenient, economical and effective method.