High Dose-Rate Intraluminal Irradiation in Bronchogenic Carcinoma

Nori, Dattatreyudu; Allison, Ron R.; Kaplan, Barry A.; Samala, E.; Osian, Adrian; Karbowitz, Stephen

doi:10.1378/chest.104.4.1006

Cited by 76 publications

(27 citation statements)

References 9 publications

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“…The two symptoms most directly related with obstruction, stridor and dyspnoea had a clinical response of 100% and 75%, respectively. The current findings confirm that symptoms respond well to brachytherapy [14,17], with haemoptysis being the symptom that most often disappears [14,15,[17][18][19][20]. Dyspnoea improved in 75% of patients, as has also been reported in other studies [14,15,[17][18][19].…”

Section: Discussionsupporting

confidence: 90%

Endobronchial brachytherapy in the treatment of malignant lung tumours

Escobar-Sacristan¹

2004

Eur Respir J

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A prospective study was made to assess the short-term clinical and endoscopic response to high-dose-rate endobronchial brachytherapy (HDREB) in patients with malignant endobronchial tumours.From July 1995 to May 2000, 288 HDREB sessions were carried out on 81 patients. The mean patient age was 61.57 yrs (range 34-82); males were predominant (87.65%). Tumours were primary in 76 patients (93.82%) and metastatic in five patients (6.18%). The inclusion criteria were malignant endobronchial tumour and either palliative treatment for incurable disease or intent-to-cure treatment for residual malignancy on the bronchial resection surface after surgery or an inoperable tumour. The exclusion criteria were as follows: impediments to catheter placement, expected survival v2 months, Karnofsky index v60, or absence of informed consent. The clinical response of a symptom was categorised as complete (disappearance of the symptom), partial (less than complete) or absent. The endoscopic response was considered to be complete if lesions disappeared and biopsy findings remained negative 1 month after the last radiation session; partial if lesions improved to some extent, but the biopsy findings were positive; and absent if there was no change in relation to baseline. The technique consisted of delivering high-dose irradiation from an Ir 192 source to a target volume using one or two endobronchial catheters inserted under optical or video bronchoscopic guidance. Four sessions were scheduled at weekly intervals and 500 cGy was applied per session over a length of 1-9 cm, measured 0.5-1 cm from the centre of the source.In total, 85% of the symptoms analysed (haemoptysis, cough, dyspnoea, expectoration, and stridor) disappeared with HDREB, which was categorised as a complete response. The endoscopic response was complete in 56.79% of patients, partial or less than complete in 40.74% and absent in 2.46%. One major complication occurred (bronchial fistula 1.2%), but no lethal haemoptysis. Minor complications (pneumonitis, bronchospasm and bronchial stenosis) each occurred in one patient (1.2%).High-dose-rate endobronchial brachytherapy is a good palliative treatment for endoluminal lung neoplasms, effectively alleviating symptoms and endoscopic evidence in many cases with an acceptable rate of complications. High-dose-rate endobronchial brachytherapy can be carried out as an intent-to-cure procedure in highly selected cases.

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Section: Discussionsupporting

confidence: 90%

Endobronchial brachytherapy in the treatment of malignant lung tumours

Escobar-Sacristan¹

2004

Eur Respir J

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“…According to Nori et al [143], the risk of complications is related to the fraction size applied during the HDR brachytherapy. In this study symptomatic improvement was achieved in all the patients presenting with hemoptysis and/or dyspnea without any acute or late complications such as fistula formation or fatal pulmonary hemorrhage.…”

Section: Diagnosismentioning

confidence: 99%

Respiratory problems in advanced cancer

Ripamonti¹,

Fusco²

2002

Support Care Cancer

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Respiratory problems are an important issue in the palliative care setting, not only from a diagnostic and therapeutic point of view but also from emotion-related aspects involving both the patients and their families and also caregivers. In this paper we consider some of the most common respiratory problems, such as dyspnea, infections, hemoptysis, hiccup. A review of the literature was performed with reference to the frequency, diagnosis and management of the above respiratory problems in patients in advanced and terminal stages of the disease. Particular emphasis was given to the importance of communication with the patients and their families, which is considered a crucial point in the care and the cure of such patients.

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“…Typically, a sausageshaped volume approximately 10 cm in length and 2 cm in diameter can be irradiated with a single endobronchial catheter [63]. Transversal, coronal, and sagittal reconstructions of the isodose distribution for an endobronchial treatment can be calculated [64] and applied to 2D reformations in order to precisely measure the dose distributed to the organs. The rapid fall-off of the radiation dose delivered with endobronchial brachytherapy, while sparing normal and vital surrounding tissues such as pulmonary vessels, fully justifies both the accurate assessment of the volume of small tumors and the dose optimization [65].…”

Section: Intraluminal Bronchoscopic Therapymentioning

confidence: 99%

Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases

et al. 1998

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The purpose of this review is to capture the current state-of-the art of the technical aspects of multiplanar and three-dimensional (3D) images and their thoracic applications. Planimetric and volumetric analysis resulting from volumetric data acquisitions obviates the limitations of segmented transverse images. Among the 3D reconstruction techniques currently available, the most recently introduced technique, i. e., volume rendering, has to be evaluated in comparison with 3D shaded surface display and maximum or minimum intensity projection. Slabs are useful in detecting and localizing micronodular or microtubular patterns and in analyzing mild forms of uneven attenuation of the lungs. Three-dimensional angiography is helpful in the pretherapeutic evaluation and posttreatment follow-up of pulmonary arteriovenous malformations, in the comprehension of the postoperative reorientation of the pulmonary vessels, in the surgical planning of pulmonary tumors, and in the diagnosis of marginated thrombi. The systemic supply to the lung and superior vena cava syndromes are also relevant to these techniques. In acquired or congenital tracheobronchial diseases including stenosis, extraluminal air and complex airway anatomy, multiplanar and 3D reformations have a complementary role to both transaxial images and endoscopy. New developments are also expected in various topics such as 3D conformal radiation therapy, planning of intraluminal bronchoscopic therapy, virtual endoscopy, and functional imaging of the bronchial tree. Miscellaneous clinical applications are promising in the analysis of diaphragmatic morphology and pathophysiology, in the volumetric quantification of the lung parenchyma, and in the vascular components of the thoracic outlet syndromes.

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High Dose-Rate Intraluminal Irradiation in Bronchogenic Carcinoma

Cited by 76 publications

References 9 publications

Endobronchial brachytherapy in the treatment of malignant lung tumours

Endobronchial brachytherapy in the treatment of malignant lung tumours

Respiratory problems in advanced cancer

Multiplanar and three-dimensional reconstruction techniques in CT: impact on chest diseases

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