Definitive high-dose-rate endobronchial brachytherapy of bronchial stump for lung cancer after surgery

Skowronek, Janusz; Piorunek, Tomasz; Kanikowski, Marek; Chicheł, Adam; Bielęda, Grzegorz

doi:10.1016/j.brachy.2013.05.002

Cited by 17 publications

(9 citation statements)

References 29 publications

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“…Endobronchial brachytherapy (EBBT) is an established treatment method for patients with tumors of the tracheobronchial system either as a palliative [ 1 , 2 , 3 , 4 , 5 ] or a definitive treatment [ 6 , 7 , 8 , 9 ]. Fatal hemoptysis, ulcer, necrosis, or stenosis of the bronchi have been reported as late severe respiratory complications related with EBBT [ 10 , 11 , 12 ].…”

Section: Purposementioning

confidence: 99%

A total EQD 2 greater than 85 Gy for trachea and main bronchus D 2cc being associated with severe late complications after definitive endobronchial brachytherapy

Murakami¹,

Kobayashi²,

Nakamura³

et al. 2015

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PurposeThe endobronchial brachytherapy (EBBT) is an established treatment method for tumors of the tracheobronchial system, however, little is known about the tolerance dose for organ at risk (OAR) in EBBT. The purpose of this study is to analyze patients with superficial bronchial carcinoma treated with definitive EBBT, and to investigate a relationship between late complications and dose for OAR.Material and methodsEndobronchial brachytherapy was performed 6 Gy per fraction for three to four fractions with or without external beam radiation therapy (EBRT). For the purpose of dosimetric analysis, the wall of the lower respiratory tract (LRT: trachea, main bronchus, and lobar bronchiole), trachea, and main bronchus (TMB) was extracted. D0.5cc, D1cc, and D2cc of LRT and TMB were calculated in each EBBT session and added together. V100, V150, and V200 of LRT were also calculated.ResultsBetween March 2008 and April 2014, EBBT was performed in 14 patients for curative intent. The 2-year overall survival (OS), progression-free survival (PFS), and local recurrence free survival (LRFS) was 82.1%, 77.9%, and 91.7%, respectively. There was one patient with grade 5, one grade 4, and three grade 3 obstruction of trachea or bronchus. The mean EQD2 of LRT D2cc, TMB D2cc, D1cc, and D0.5cc of patients with or without late severe respiratory complications was significantly different between two groups (p = 0.018, 0.008, 0.009, and 0.013, respectively). The 2-year incidence rates of late severe complications in patients with TMB D2cc ≤ 85 Gy in EQD2 and > 85 Gy were 0% and 83.3%, respectively with a statistically significance (p = 0.014).ConclusionsIt was discovered that TMB D2cc > 85 Gy in EQD2 is a strong risk factor for severe late respiratory complication after EBBT.

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Section: Purposementioning

confidence: 99%

A total EQD 2 greater than 85 Gy for trachea and main bronchus D 2cc being associated with severe late complications after definitive endobronchial brachytherapy

Murakami¹,

Kobayashi²,

Nakamura³

et al. 2015

jcb

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“…A relatively rare indication is interstitial BT of peripheral tumors using permanent implants [ 64 , 65 ]. Lack of clear consensus regarding the value of doses used in brachytherapy is the reason why different fraction doses are used in clinical treatment [ 66 , 67 , 68 , 69 ].…”

Section: Clinical Indicationsmentioning

confidence: 99%

Current status of brachytherapy in cancer treatment – short overview

Skowronek

2017

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Cancer incidence and mortality depend on a number of factors, including age, socio-economic status and geographical location, and its prevalence is growing around the world. Most of cancer treatments include external beam radiotherapy or brachytherapy. Brachytherapy, a type of radiotherapy with energy from radionuclides inserted directly into the tumor, is increasingly used in cancer treatment. For cervical and skin cancers, it has become a standard therapy for more than 100 years as well as an important part of the treatment guidelines for other malignancies, including head and neck, skin, breast, and prostate cancers. Compared to external beam radiotherapy, brachytherapy has the potential to deliver an ablative radiation dose over a short period of time directly to the altered tissue area with the advantage of a rapid fall-off in dose, and consequently, sparing of adjacent organs. As a result, the patient is able to complete the treatment earlier, and the risks of occurrence of another cancer are lower than in conventional radiotherapy treatment. Brachytherapy has increased its use as a radical or palliative treatment, and become more advanced with the spread of pulsed-dose-rate and high-dose-rate afterloading machines; the use of new 3D/4D planning systems has additionally improved the quality of the treatment. The aim of the present study was to present short summaries of current studies on brachytherapy for the most frequently diagnosed tumors. Data presented in this manuscript should help especially young physicians or physicists to explore and introduce brachytherapy in cancer treatments.

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“…On the other hand, weekly repeated treatment enable to achieve a better local control visualized with the use of bronchoscopy. Brachytherapy plays a limited but specific role in definitive treatment with curative intent in selected cases of early endobronchial disease, in selected advanced inoperable tumors combined with EBRT or in the postoperative treatment of small residual peribronchial disease [ 16 ]. A relatively rare indication is interstitial BT of peripheral tumors using permanent implants.…”

Section: Purposementioning

confidence: 99%

“…Indications include: Postoperative external radiotherapy and/or intraluminal brachytherapy of the bronchial stump after resection with positive resection margins [ 16 ]. Endobronchial brachytherapy with curative intent is considered as a boost for minor residual disease within a combined non-surgical radical approach.…”

Section: Clinical Indicationsmentioning

confidence: 99%

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Brachytherapy in the treatment of lung cancer – a valuable solution

Skowronek¹

2015

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The majority of patients with lung cancer are diagnosed with clinically advanced disease. Many of these patients have a short life expectancy and are treated with palliative aim. Because of uncontrolled local or recurrent disease, patients may have significant symptoms such as: cough, dyspnea, hemoptysis, obstructive pneumonia, or atelectasis. Brachytherapy is one of the most efficient methods in overcoming difficulties in breathing that is caused by endobronchial obstruction in palliative treatment of bronchus cancer. Efforts to relieve this obstructive process are worthwhile, because patients may experience improved quality of their life (QoL). Brachytherapy plays a limited but specific role in definitive treatment with curative intent in selected cases of early endobronchial disease as well as in the postoperative treatment of small residual peribronchial disease. Depending on the location of the lesion, in some cases brachytherapy is a treatment of choice. This option is fast, inexpensive, and easy to perform on an outpatient basis.Clinical indications, different techniques, results, and complications are presented in this work.

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Definitive high-dose-rate endobronchial brachytherapy of bronchial stump for lung cancer after surgery

Cited by 17 publications

References 29 publications

A total EQD 2 greater than 85 Gy for trachea and main bronchus D 2cc being associated with severe late complications after definitive endobronchial brachytherapy

A total EQD 2 greater than 85 Gy for trachea and main bronchus D 2cc being associated with severe late complications after definitive endobronchial brachytherapy

Current status of brachytherapy in cancer treatment – short overview

Brachytherapy in the treatment of lung cancer – a valuable solution

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