A prospective analysis of high-dose-rate endobronchial brachytherapy in the palliation of obstructive symptoms in lung cancer patients: A single-institution experience

Goldberg, Mira; Timotin, Emilia; Farrell, Theo; Puksa, Serge; Donde, Bernard; Sur, Ranjan

doi:10.1016/j.brachy.2015.04.005

Cited by 11 publications

(12 citation statements)

References 35 publications

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“…The combination therapy could guarantee prescribed dose uniformity, suppress tumors in the cavity and surrounding invasive lesion, control potential lymphocytic metastases, and reduce the risk of recurrent airway obstruction by tumor cell infiltration. 20 Regarding a simple bronchus tumor, specifically, a patient with occult lung cancer detected by X-ray radiograph, the PFS after ILBT combined EBRT was 87.3%, and the 5-year survival rate was 72.3%. 21 The combined therapy was less harmful to normal tissues, and was regarded as a promising replacement for surgery.…”

Section: Discussionmentioning

confidence: 97%

“…The differences showed that EBRT contributed to the therapeutic benefits of ILBT for recurrent bronchial cancer treatment, and most researchers agreed that ILBT combined with EBRT was the best way to maximize ILBT. The combination therapy could guarantee prescribed dose uniformity, suppress tumors in the cavity and surrounding invasive lesion, control potential lymphocytic metastases, and reduce the risk of recurrent airway obstruction by tumor cell infiltration . Regarding a simple bronchus tumor, specifically, a patient with occult lung cancer detected by X‐ray radiograph, the PFS after ILBT combined EBRT was 87.3%, and the 5‐year survival rate was 72.3% .…”

Section: Discussionmentioning

confidence: 99%

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Computed tomography‐guided intraluminal brachytherapy in recurrent bronchogenic carcinoma: A clinical trial in a small group

Zhang

Qin

et al. 2017

Precision Radiation Oncology

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Objective The overall survival (OS) of lung cancer patients has been significantly extended as a consequence of chemotherapy and targeted drug utilization, which has resulted in an increase in local recurrences. The present study followed patients to evaluate the short‐term and long‐term efficacies and the safety of high‐dose rate intraluminal brachytherapy (ILBT) in recurrent bronchogenic carcinoma patients, and investigate the factors that influence prognosis. Methods The clinical records, treatment, curable effects, and adverse events of 15 patients treated in the First Affiliated Hospital of Soochow University, Suzhou, China, who were diagnosed with recurrent bronchogenic cancer between 1 June 2009 and 30 September 2015 were reviewed, and survival analysis was assessed by the Kaplan–Meier method. Results A total of 15 recurrent bronchogenic carcinoma patients received ILBT, and information on curable effects and safety was available. The group consisted of two complete response (2/15), 11 partial response (11/15), one stable disease (1/15) and one progression disease (1/15). The response rate was 86.7% (13/15), and disease control (complete response + partial response + stable disease) was 93.3% (14/15). The dyspnea indexes of the patients decreased significantly in weeks 1, 2, 4, and 8 after ILBT treatment (P < 0.001). The average post‐ILBT partial remission period was 5.27 ± 3.35 months, and the median partial remission period was 3.24 months. The combination therapy of ILBT and bronchofiberscope (P = 0.013), and a total ILBT dose of ≥20 Gy could produce a partial effective rate. The progress‐free survival of patients was 9.5 months (95% CI 12.2–16.5 months), average progress‐free survival was 15.8 ± 14.4 months, median OS was 32.0 months (95% CI 25.0–30.0 months), 1‐year OS was 93.3% (14/15), and 3‐year OS was 40.0% (6/15). The main adverse events were bronchospasm and hemoptysis (grade III); others were grade I–II. Conclusion Computed tomography‐guided ILBT is a safe, effective palliative treatment for recurrent bronchogenic carcinoma, but it requires further study in larger groups.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Computed tomography‐guided intraluminal brachytherapy in recurrent bronchogenic carcinoma: A clinical trial in a small group

Zhang

Qin

et al. 2017

Precision Radiation Oncology

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“…Squamous lung cancer was the dominant lung cancer type in both examined groups in our study, correlating with the results reported by other authors [ 26 ], explained by the fact this tumor type takes a central and endoluminal localization more frequently than other LC histology types [ 27 ]. In several studies, HDR EBBT has been proven an efficient palliative procedure, as well as an excellent procedure to achieve local control of the disease, providing longer survival in certain cases [ 4 , 28 ]. In our study, aimed at correlating and comparing the 2D and 3D EBBT planning, brachytherapy was used as a palliative treatment as the patients in both examined groups had advanced LC stage: stage IIIB predominated in the 3D EBBT planning (applied more recently) group, while more patients of the 2D EBBT planning (formerly applied) group had stage IV disease, suggesting that better control of the disease and fewer patients with metastatic disease are due to the newer 3D EBBT planning.…”

Section: Discussionmentioning

confidence: 99%

Effective Differences between 2D and 3D Planned Brachytherapy in Lung Cancer: An Institutional Retrospective Study

Lalić,

Bojović,

Ivanov

et al. 2024

Medicina

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Background and Objectives: Advanced lung cancer is usually manifested by endoluminal tumor propagation, resulting in central airway obstruction. The objective of this study is to compare the high dose rate brachytherapy treatment outcomes in non-small-cell lung cancer (NSCLC) depending on the treatment planning pattern—two-dimension (2D) or three-dimension (3D) treatment planning. Materials and Methods: The study was retrospective and two groups of patients were compared in it (a group of 101 patients who underwent 2D planned high-dose-rate endobronchial brachytherapy (HDR-EBBT) in 2017/18 and a group of 83 patients who underwent 3D planned HDR-EBBT between January 2021 and June 2023). Results: In the group of 3D planned brachytherapy patients, there was a significant improvement in terms of loss of symptoms of bronchial obstruction (p = 0.038), but no improvement in terms of ECOG PS (European Cooperative Oncology Group Performance Status) of the patient (p = 0.847) and loss of lung atelectasis (if there was any at the beginning of the disease) (p = 0.781). Two-year overall survival and time-to-progression periods were similar for both groups of patients (p = 0.110 and 0.154). Fewer treatment complications were observed, and 91.4% were in 3D planned brachytherapy (BT) patients. Conclusions: Three-dimensionally planned HDR-EBBT is a suggestive, effective palliative method for the disobstruction of large airways caused by endobronchial lung tumor growth. Independent or more often combined with other types of specific oncological treatment, it certainly leads to the loss of symptoms caused by bronchial obstruction and the improvement of the quality of life of patients with advanced NSCLC. Complications of the procedure with 3D planning are less compared to 2D planned HDR-EBBT.

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“…High-dose-rate intraluminal BT to lung and esophagus involved a higher risk of COVID-19 exposure during AGMP: procedure involved the use of bronchoscope and endoscope [34 , 35] under conscious sedation, the duration of AGMP is typically a 30-minute scoping and 15-minute treatment delivery with an opened airway, and therefore was terminated during the study period due to elevated COVID-19 exposure risk.…”

Section: Discussionmentioning

confidence: 99%

A two-center experience: The impact of COVID-19 on two brachytherapy programs in Ontario - virtual care, service suspension and radiation therapy workflow

Chan

Timotin

Chung

et al. 2023

Journal of Medical Imaging and Radiation Sciences

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A prospective analysis of high-dose-rate endobronchial brachytherapy in the palliation of obstructive symptoms in lung cancer patients: A single-institution experience

Cited by 11 publications

References 35 publications

Computed tomography‐guided intraluminal brachytherapy in recurrent bronchogenic carcinoma: A clinical trial in a small group

Computed tomography‐guided intraluminal brachytherapy in recurrent bronchogenic carcinoma: A clinical trial in a small group

Effective Differences between 2D and 3D Planned Brachytherapy in Lung Cancer: An Institutional Retrospective Study

A two-center experience: The impact of COVID-19 on two brachytherapy programs in Ontario - virtual care, service suspension and radiation therapy workflow

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