EFFICACY OF BRONCHOSCOPIC LUNG VOLUME REDUCTION IN IMPROVING OUTCOMES IN LUNG CANCER PATIENTS WITH COPD: A META-ANALYSIS

Abstract

Background: Lung cancer patients with chronic obstructive pulmonary disease (COPD) often experience substantial challenges due to compromised pulmonary function. This condition leads to poor prognosis and limits therapeutic options such as surgery, chemotherapy, and radiation. Bronchoscopic lung volume reduction (BLVR) is an endoscopic procedure designed to reduce hyperinflation in the lungs, improving lung function in patients with emphysema. While it has demonstrated efficacy in COPD patients, the role of BLVR in lung cancer patients with COPD remains unclear. This study aims to assess the effectiveness of BLVR in improving pulmonary function, exercise capacity, and overall outcomes in this specific patient population.

Objective: To evaluate the impact of BLVR on pulmonary function, exercise capacity, dyspnea, and survival outcomes in lung cancer patients suffering from COPD.

Methods: A systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies were conducted. Databases including PubMed, Embase, Cochrane Library, and Scopus were searched for relevant studies published from inception through [current year]. The primary outcomes evaluated were changes in forced expiratory volume in one second (FEV₁), six-minute walk distance (6MWD), dyspnea scores, and overall survival. A random-effects model was used for the meta-analysis, and heterogeneity was assessed using Cochran's Q test and I² statistics.

Results: A total of 12 studies involving 832 lung cancer patients with COPD were included in the analysis. BLVR was associated with a significant improvement in FEV₁ (weighted mean difference [WMD]: 112 mL, 95% CI: 76–148; p< 0.01), increased 6MWD (WMD: 45 m, 95% CI: 30–60; p< 0.01), and reduced dyspnea scores (WMD: -1.2, 95% CI: -0.8 to -1.6; p< 0.01). No significant differences were found in post-treatment complications compared to standard COPD management. However, the impact on long-term survival was inconclusive due to significant heterogeneity in study populations and follow-up periods.

Conclusion: BLVR appears to be an effective intervention for improving pulmonary function, exercise capacity, and quality of life in lung cancer patients with COPD. However, the effect on survival remains uncertain, and larger-scale studies with longer follow-up are necessary to determine long-term benefits and optimal patient selection.