Chemoembolization for Lung Tumors

Inclusion criteria

• Lung, endobronchial, pleural, or mediastinal metastases that are not responding to systemic chemotherapy, and that are not amenable to ablation, resection, or SBRT.
• At least 18 years old.
• ECOG performance status 0 or 1

Exclusion criteria

• Primary lung cancer
• >50% of a lung is replaced with tumor
• Oxygen saturation <92% on room air
• FEV1 <60%
• Pulmonary hypertension (diagnosed or suspected on echocardiography, CT, MRI, or direct pressure measurement)
• Recent pulmonary embolism (within 3 months)
• Pulmonary arteriovenous malformation
• Active lung infection (pneumonia, empyema, or lung abscess requiring therapy within 1 month)
• Symptomatic heart failure (dyspnea, volume overload)
• Left bundle branch block (contraindication to pulmonary angiography)
• Renal failure (eGFR <30 mL/min/1.73m^2)
• Pregnancy
• Breastfeeding
• Altered mental status that would interfere with consent or follow-up
• Platelets < 100,000 (after transfusion, if needed)
• INR>2 (after transfusion, if needed)
• Hemoglobin <7 (after transfusion, if needed)
• Hyperthyroidism (contraindication to lipiodol)
• Planned radioactive iodine imaging or therapy (contraindication to lipiodol)
• Allergy to lipiodol or mitomycin
• Allergy to iodinated contrast that can not be treated with steroid / diphenhydramine premedication
• Any condition that, in the opinion of the investigator, would interfere with evaluation of the investigational product or interpretation of subject safety or study results