High-dose-rate intraluminal brachytherapy in the treatment of endobronchial malignancy. Work in progress.

Abstract

Remote afterloading high-dose-rate brachytherapy (RAHDRB) was used endobronchially for the management of malignant airway obstruction in 82 patients, 72 of whom had primary disease in the lung. Treatment was palliative (n = 58) or definitive (n = 24). The extent of airway compromise was determined at bronchoscopy and with symptoms of hemoptysis, dyspnea, or cough or with radiographic evidence of atelectasis. RAHDRB doses were 1,000-4,700 cGy in one to five fractions. External beam radiation was used in previously unirradiated patients. A substantial reduction ,N airway disease and an improvement in symptoms were seen in 82% of patients. Obstruction scores showed an overall 74% improvement. Complications occurred in only 10 patients (two of whom died). Median survival was short (palliative group, 5 months; definitive group, 12 months); however, symptoms remained palliated in 62 patients (76%) until death or the last follow-up examination. RAHDRB is effective and can be applied with equal success in all patients with malignant airway obstruction, even those whose disease has recurred after external beam irradiation.

Endobronchial brachytherapy in the treatment of malignant lung tumours

“…In the follow-up biopsy of the target area, the endoscopic evidence was always better than that observed in the last brachytherapy session in all patients who responded. An overall response of 74-87% has been reported [14,16,19]. In the current study, a complete or partial response was observed in 79 patients (97.53%).…”

Brachytherapy in lung cancer

“…They also noted little palliative benefit in patients in poor general condition, i.e., those who are bedridden or with a life expectancy of less than 3 months. A similar observation was made by Zajac et al [21]; patients spending at least one half the day confined to bed seldom experienced palliation except with regard to hemoptysis.…”

“…As expected, initial patient performance status, tumor size and stage, and radiation dose are important predictors of outcome [14,15,21]. Aygun observed response rates of 75% in those patients with tumors not visible radiographically as opposed to 36% for those patients with tumors more than 5 cm in diameter [15].…”

Lung Cancer Brachytherapy: Robotics-Assisted Minimally Invasive Approach

“…Response to brachytherapy was assessed by bronchoscopy 1-3 months from completion of treatment. As expected, initial patient performance status, tumour size and stage, and radiation dose are important predictors of outcome [22,26,28]. Aygun and colleagues [22] observed that response rates favour patients with tumours not visible radiographically.…”

“…The experience of HDR brachytherapy boost is extensive in the literature [21][22][23][24][25][26][27]. Patients selected for definitive external beam radiation and a brachytherapy boost were usually medically fit patients with centrally located stage IIIA or IIIB tumours, without weight loss in 6 months leading up to diagnosis.…”