A tumoral obstruction of the main stem bronchus is frequently observed in the follow-up of lung cancers with a high impact on survival and quality of life of these patients. The endoluminal resection of these tumors through interventional bronchoscopy can remove the tumor but fails to prevent the recurrence. A stent insertion could achieve this goal but this option was never proved in a prospective protocol. The aim of this study is to analyze the impact of stent insertion on the survival without symptoms of bronchial obstruction in patients treated for their cancer with and without a first line treatment (chemo-radiotherapy or chemotherapy). The patients will be included after resection of the endoluminal symptomatic tumoral obstruction. We will test the effect of the silicone stent insertion ( from NovatechR ) by comparing a stent arm (170 patients with stent insertion) with a control arm (170 patients without stent). The inclusion period will last 3 years with one year of follow-up for each patient. The one-year survival without symptomatic recurrence (proved on bronchoscopy with more than 50% of obstruction in the treated zone) will be the main endpoint. All patients without symptomatic recurrence at one year will be controlled endoscopically. Survival and stent tolerance will be studied as secondary endpoints. All endoscopic events will be depicted on photographs or videos. Each endoscopical situation (before and after resection, recurrence or side effects of stents) will be analyzed and registered by an independent committee of 3 international experts.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
75
Bronchial desobstruction under interventional bronchoscopy, for inclusion, with the insertion of silicone stent trachea-bronchial covering the entire tumor area
Department of pneumology, CHU Amiens
Amiens, France
Departement of pneumology, CHU Brest
Brest, France
Pneumology departement, Hôpital Percy
Clamart, France
Pneumology departement, CHRU Lille
Lille, France
Pneumology departement, CHU Limoges
Limoges, France
Pneumology departement, Sainte Marguerite hospital
Marseille, France
Pneumology departement, CHU Nantes
Nantes, France
Pneumology departement, Saint-Antoine hospital
Paris, France
Department of respiratory diseases and allergic, Thoracic Oncology, CHU Reims
Reims, France
Pneumology Clinic - Albert Calmette hospital- CHU Rouen
Rouen, France
...and 3 more locations
Death and / or symptomatic recurrence (proved on bronchoscopy with more than 50% of obstruction in the treated zone)
Time frame: 12 months
death
Time frame: 12 months
For patients who had no symptomatic recurrence of bronchial obstruction Presence of a bronchial stenosis> 50% on a systematic bronchial endoscopy months.
Time frame: 12 months
Complications of symptomatic trachea-bronchial prosthesis (mobility or migration, granuloma, congestion) motivating endoscopy.
Time frame: 12 months
Quality of life : EORTC
Time frame: 12 months
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