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Endobronchial Obstruction — SCE Medical Oncology MCQ

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ModerateLung CancerEndobronchial ObstructionSCE Medical Oncology

A 58-year-old woman with NSCLC develops malignant airway obstruction from endobronchial tumour. She is stridulous. What immediate bronchoscopic intervention can restore airway patency?

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Correct answer: CTherapeutic bronchoscopy: endobronchial debulking (laser, electrocautery, cryotherapy) ± airway stent placement for immediate re-establishment of airway patency

Malignant central airway obstruction is managed with interventional bronchoscopy for immediate airway re-establishment: endobronchial tumour debulking (Nd:YAG laser, argon plasma coagulation, electrocautery, mechanical coring), followed by airway stenting (silicone or metallic) for extrinsic compression/airway wall destruction. This provides rapid palliation while definitive oncological therapy (chemotherapy, radiotherapy) takes effect. External beam RT and brachytherapy provide longer-term control. This is a life-saving intervention requiring specialist interventional pulmonology.

Reference: NICE NG122; ESMO 2024 NSCLC; BTS Interventional Bronchoscopy Guidelines