High-dose-rate brachytherapy in symptom palliation due to malignant endobronchial obstruction: A quantitative assessment

Gorayeb, Melissa Martins de Aquino; Gregório, Marcelo Gervilla; Oliveira, Eduardo Quintino de; Aisen, Salim; Carvalho, Heloísa de Andrade

doi:10.1016/j.brachy.2012.10.007

Cited by 20 publications

(9 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Consequently, full attention should be focused on treating the lesion(s) causing obstruction. Several options to accomplish this are available including low- or high-dose-rate brachytherapy, cryotherapy, laser therapy, electro-cautery, and the placement of airways stents [27, 28]. Unfortunately, despite these measures, progressive, ultimately fatal, disease is the norm [14].…”

Section: Specific Syndromes/sites Of Infectionmentioning

confidence: 99%

Infections in Cancer Patients with Solid Tumors: A Review

2017

View full text Add to dashboard Cite

Solid tumors are much more common than hematologic malignancies. Although severe and prolonged neutropenia is uncommon, several factors increase the risk of infection in patients with solid tumors, and the presence of multiple risk factors in the same patient is not uncommon. These include obstruction (most often caused by progression of the tumor), disruption of natural anatomic barriers such as the skin and mucosal surfaces, and treatment-related factors such as chemotherapy, radiation, diagnostic and/or therapeutic surgical procedures, and the increasing use of medical devices such as various catheters, stents, and prostheses. Common sites of infection include the skin and skin structures (including surgical site infections), the bloodstream (including infections associated with central venous catheters), the lungs, the hepato-biliary and intestinal tracts, and the urinary tract, and include distinct clinical syndromes such as post-obstructive pneumonia, obstructive uropathy, and neutropenic enterocolitis. The epidemiology of most of these infections is changing with resistant organisms [MRSA, Pseudomonas aeruginosa, extended spectrum beta-lactamase (ESBL)-producing organisms] being isolated more often than in the past. Polymicrobial infections now predominate when deep tissue sites are involved. Conservative management of most of these infections (antibiotics, fluid and electrolyte replacement, bowel rest when needed) is generally effective, with surgical intervention being reserved for the drainage of deep abscesses, or to deal with complications such as intestinal obstruction or hemorrhage. Infected prostheses often need to be removed. Reactivation of certain viral infections (HBV, HCV, and occasionally CMV) has become an important issue, and screening, prevention and treatment strategies are being developed. Infection prevention, infection control, and antimicrobial stewardship are important strategies in the overall management of infections in patients with solid tumors. Occasionally, infections mimic solid tumors and cause diagnostic and therapeutic challenges.

show abstract

Section: Specific Syndromes/sites Of Infectionmentioning

confidence: 99%

Infections in Cancer Patients with Solid Tumors: A Review

2017

View full text Add to dashboard Cite

show abstract

“…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

jcb

View full text Add to dashboard Cite

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.

show abstract

“…Tumor debulking and airway reestablishment through interventional bronchoscopic techniques (argon plasma anticoagulation) help reduce mass effect and facilitate antibiotic penetration. Although it was studied as a palliative form of tumor burden, de Aquino Gorayeb et al were able to demonstrate an improvement in performance status and postobstructive pneumonia (80% response) to high-dose brachytherapy [42].…”

Section: Postobstructive Pneumoniamentioning

confidence: 99%

Oncological Airway Emergencies in the Critical Care Unit

Abramian¹,

Kolman²,

Abramian³

2016

Oncology Critical Care

View full text Add to dashboard Cite

Malignancies involving the upper and lower airways can be presented as acute and/ or acute-on-chronic life-threatening emergencies. Most of them require intensive care unit (ICU) admission and acute intervention. Such emergencies include but are not exhaustive to epistaxis, massive hemoptysis, central airways obstruction, postobstructive pneumonia, tracheoesophageal fistula, and pleural disease. These are frequent consequences of disease, iatrogenicity, and various pleural diseases causing respiratory failure. The incidence, physiology, symptoms, and sequelae of each disease will be outlined in addition to potential surgical, pharmacologic, and conservative interventions. An anatomical approach from the upper airway, lower airway, mediastinum, and pleura will be taken. Here, we discuss interventions such as emergent cautery, nasal packing, emergent airways, and tracheostomy in addition to a brief glance at other surgical modalities. We will also detail central airway complications such as obstructing endobronchial tumors, massive hemoptysis, bronchoscopy, rigid bronchoscopy, stent placement, and other interventions (cautery, cryotherapy, one-way valves). Finally, pleural disorders such as tension pneumothorax, bronchopleural fistulas, massive pleural effusion, and hemothorax will be reviewed.

show abstract

High-dose-rate brachytherapy in symptom palliation due to malignant endobronchial obstruction: A quantitative assessment

Cited by 20 publications

References 27 publications

Infections in Cancer Patients with Solid Tumors: A Review

Infections in Cancer Patients with Solid Tumors: A Review

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

Oncological Airway Emergencies in the Critical Care Unit

Contact Info

Product

Resources

About