Fractionated Intraluminal HDR 192 Ir Brachytherapy as Palliative Treatment in Patients with Endobronchial Metastases from Non-Bronchogenic Primaries

Stranzl, Heidi; Gabor, Sabine; Mayer, Ramona; Prettenhofer, Ulrike; Wurzinger, Gert; Hackl, A.

doi:10.1007/s00066-002-0943-6

Cited by 16 publications

(11 citation statements)

References 15 publications

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“…Intraluminal radiotherapy is one of the treatment choices for the palliation of symptoms [21][22][23]. However, its effect on survival time has not yet been fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Metastases from Extrathoracic Malignancies

Akoglu

Uçan

Çelik

et al. 2005

Clin Exp Metastasis

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Endobronchial metastases (EBM) from extrapulmonary malignant tumors are rare. The most common extrathoracic malignancies associated with EBM are breast, renal and colorectal carcinomas. In this study, we aimed to evaluate the clinical, radiographic and bronchoscopic aspects of patients with EBM who were diagnosed between 1992 and 2002. Data about patients' clinical conditions, symptoms, radiographic and endoscopic findings, and histopathological examination results were investigated. EBM was defined as bronchoscopically visible lesions histopathologically identical to the primary tumor in patients with extrapulmonary malignancies. We found 15 cases with EBM. Primary tumors included breast (3), colorectal (3), and renal (2) carcinomas; Malignant Melanoma (2); synovial sarcoma (1), ampulla of Vater adenocarcinoma (1), pheochromocytoma (1), hypernephroma (1), and Hodgkin's Disease (1). The most common symptoms were dyspnea (80%), cough (66.6%) and hemoptysis (33.3%). Multiple (40%) or single (13.3%) pulmonary nodules, mediastinal or hilar lymphadenopathy (40%), and effusion (40%) were the most common radiographic findings. The mean interval from initial diagnosis to diagnosis of EBM was 32.8 months (range, 0-96 months) and median survival time was 18 months (range, 4-84). As a conclusion, various extrapulmonary tumors can metastasize to the bronchus. Symptoms and radiographic findings are similar with those in primary lung cancer. Therefore, EBM should be discriminated from primary lung cancer histopathologically. Although mean survival time is usually short, long-term survivors were reported. Consequently, treatment must be planned according to the histology of the primary tumor, evidence of metastasis to other sites and medical status of the patient.

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“…Intraluminal radiotherapy is one of the treatment choices for the palliation of symptoms [21][22][23]. However, its effect on survival time has not yet been fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Metastases from Extrathoracic Malignancies

Akoglu

Uçan

Çelik

et al. 2005

Clin Exp Metastasis

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“…Although lung metastasis from prostate cancer is rather common, endobronchial metastases are very rare, with only eight cases having been reported in the English language literature [1,[9][10][11][12][13]. The present report describes a patient under complete androgen blockade who developed endobronchial metastases from prostate cancer, despite castration levels of testosterone.…”

Section: Discussionmentioning

confidence: 66%

Endobronchial metastasis from prostate cancer

et al. 2008

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We report a case of endobronchial metastasis from prostate adenocarcinoma. A patient with a history of prostate cancer under complete androgen blockade presented to the respiratory department complaining of dyspnea and dry coughing. Flexible bronchoscopy showed multiple polypoid lesions in the tracheobronchial tree and the immunohistochemical studies on the biopsy specimen determined the diagnosis. The patient was treated with paclitaxel, estramustine phosphate and carboplatine, and experienced symptoms suppression. To our knowledge, this is the first case of endobronchial metastasis of a patient with androgen refractory prostate cancer without any evidence of extrathoracic metastasis. The current report also emphasises the need for a multidisciplinary approach for cases of endobronchial metastases, with the collaboration of pneumologists, urologists, pathologists and oncologists.

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“…Intraluminal brachytherapy, cryotherapy and Nd-Yag laser are efficient treatment options for the palliation of symptoms [17,18,19]. The local treatment of this metastatic lesion should be individualized and aimed at improving symptoms.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Metastases from Colorectal Adenocarcinomas: Clinical and Endoscopic Characteristics and Patient Prognosis

Díaz¹,

Fouchardière²,

Desseigne³

et al. 2007

Oncology

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Background: Endobronchial metastases (EBM) secondary to extrapulmonary solid malignant tumours are rare but may occur. The most common extrathoracic malignancies associated with EBM are breast, renal and colorectal carcinomas. This study aimed to evaluate the clinical and bronchoscopic aspects of EBM from colorectal carcinomas and the prognosis of the patients. Methods: EBM were diagnosed in 7 patients with colorectal carcinomas between 2004 and 2005. All patients underwent colorectal resection at the time of primary tumour diagnosis. Bronchial involvement was proved by bronchoscopy, and the metastatic nature of the lesions was confirmed histopathologically in all patients. EBM patients were compared with a control group of 7 patients with pulmonary metastases from colorectal cancer. Results: Median age at time of colorectal carcinoma was 55 years in EBM patients and 57 years in controls. Distressing airway symptoms caused by EBM were relieved by use of newer intrabronchial therapies: radiotherapy, brachytherapy and cryotherapy. One patient underwent metastasis resection. The median survival after diagnosis of EBM was 18.9 months. All patients had pulmonary metastases. The median survival after diagnosis of pulmonary metastasis from colorectal carcinoma was 55.7 months in EBM patients and 12.7 months in controls (p < 0.005). Discussion: EBM are generally underdiagnosed in patients with colorectal carcinoma. Bronchoscopy is not part of the standard evaluation of these patients. Physicians must be more attentive to pulmonary symptoms, even when patients’ pulmonary metastases are known. Various management options are available for localized endobronchial tumours. Conclusion: On average, EBM are diagnosed about 5 years after the diagnosis of the primary tumour, which is a relatively long lead time. Although this metastatic location usually implies a very negative prognosis regarding life expectancy, it did not seem to significantly reduce survival in our patients. Local treatments allow substantial improvement of pulmonary symptoms.

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Fractionated Intraluminal HDR 192 Ir Brachytherapy as Palliative Treatment in Patients with Endobronchial Metastases from Non-Bronchogenic Primaries

Abstract: HDR intraluminal brachytherapy palliates symptoms in patients suffering from endobronchial metastases of non-pulmonary primary tumors. The applied treatment is a safe, effective and well tolerated palliative procedure leading to an improved patient quality of life.

Cited by 16 publications

References 15 publications

Endobronchial Metastases from Extrathoracic Malignancies

Endobronchial Metastases from Extrathoracic Malignancies

Endobronchial metastasis from prostate cancer

Endobronchial Metastases from Colorectal Adenocarcinomas: Clinical and Endoscopic Characteristics and Patient Prognosis

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