The use of high dose rate endobronchial brachytherapy to palliate symptomatic endobronchial recurrence of previously irradiated bronchogenic carcinoma

Bedwinek, John M.; Petty, I Albert; Bruton, Charles; Sofield, Jack; Lee, Larry

doi:10.1016/0360-3016(92)90978-q

Cited by 147 publications

(74 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…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%).…”

Section: Discussionsupporting

confidence: 57%

“…The causes of variability in the endoscopic response are unclear, but a relationship with the extrabronchial size of the tumour has been postulated [19], suggesting that tumours w5 cm in diameter have a less satisfactory response. It has been remarked that patients with extrinsic compression by an extrabronchial tumour are poor candidates for HDREB [13,14].…”

Section: Discussionmentioning

confidence: 99%

“…The risk depended on the endobronchial site of the tumour and its relationship with large vessels. The highest risk was associated with HDREB applied to the bronchus of the right upper lobe and left upper lobe, which can be affected by tumour infiltration during the natural progression of the neoplasm [1,5,8,19], particularly in the case of recurrences [19]. Later studies concluded that the use of a less aggressive technique would reduce the frequency of major complications, some of which would be as a result of progression of the neoplasm [3,14,17,18,21,26].…”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Endobronchial brachytherapy in the treatment of malignant lung tumours

Escobar-Sacristan¹

2004

Eur Respir J

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Endobronchial brachytherapy in the treatment of malignant lung tumours

Escobar-Sacristan¹

2004

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…1,2) Metastatic lesions are mainly localized in the lung parenchyma, and in rare case, in the tracheobronchial tree. 3) Most lung patients have airway obstruction due to the tumor. 4) Symptoms such as cough, dyspnea, and hemoptysis are generally reported in these patient.…”

Section: Introductionmentioning

confidence: 99%