Analysis of Bronchoscopy and Computed Tomography Findings in Response Evaluation of Lung Cancer Treatment

In the evaluation of the efficacy of chemotherapy and radiotherapy, tumor response to therapy is one of the most important criteria. Bronchoscopy and computerized thorax tomography, two different methods used in the evaluation of tumor response in lung cancer may reveal different results since they evaluate the different phases of the response. The aim of this study was to determine the value of bronchoscophy in evaluation of tumor response and to evaluate the correlation between bronchoscopy and tumor response in computerized tomography. 52 patients with primary lung carcinoma who were treated with chemotherapy (and/or radiotherapy) and had bronchoscopy and computerized tomography for response evaluation were included in the study. The tumor stage, histological types, bronchoscopic and radiological tumor localizations, treatment regimens and the radiological-bronchoscopic findings after treatment were all evaluated. The patients were classified according to radiological and bronchoscopic response to treatment as complete response, partial response, stable disease and progressive disease. In computerized tomography, complete response, partial response, stable response and progressive disease were 21.2%, 48%, 26.9% and 3.8% respectively. In bronchoscopy complete, partial, stable and progressive disease were 0%, 44.2%, 28.8% and 13.5% respectively. We found that partial response (76%) was the leading response pattern in non small cell lung cancer. The complete response in small cell lung cancer(28.6%) was more than nonsmall cell cancer (14.7%). No patient had bronchoscopically complete response. Bronchoscopic partial response rates were found to be higher in both histological types. 40% of patients had concordance with bronchoscopic and tomographic findings. Unrelated to histologic type, most of the patients experiencing tumor regression in bronchoscopy also had regression in tomography. Complete response in tomography was less concordant with complete response in bronchoscopy. We concluded that for tumor response evaluation bronchoscopy and tomography should be used together in order to get the most accurate result.