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. 2012 Jul 23:7:112.
doi: 10.1186/1748-717X-7-112.

Long-term results of curative intraluminal high dose rate brachytherapy for endobronchial carcinoma

Hidemasa Kawamura  1 , Takeshi Ebara, Hiroyuki Katoh, Tomoaki Tamaki, Hitoshi Ishikawa, Hideyuki Sakurai, Takashi Nakano
Affiliations

Long-term results of curative intraluminal high dose rate brachytherapy for endobronchial carcinoma

Hidemasa Kawamura et al. Radiat Oncol. .

Abstract

Background: The treatment strategy of central lung tumors is not established. Intraluminal brachytherapy (ILBT) is widely used for palliative treatment of endobronchial tumors, however, it is also a promising option for curative treatment with limited data. This study evaluates the results after ILBT for endobronchial carcinoma.

Method: Sixteen-endobronchial carcinoma of 13 patients treated with ILBT in curative intent for 2000 to 2008 were retrospectively reviewed. ILBT using high dose rate 192 iridium thin wire system was performed with 5 Gy/fraction at mucosal surface. The patient age ranged from 57 to 82 years old with median 75 years old. The 16 lesions consisted of 13 central endobronchial cancers including 7 roentgenographically occult lung cancers and 3 of tracheal cancers. Of them, 10 lesions were treated with ILBT of median 20 Gy combined with external beam radiation therapy of median 45 Gy and 6 lesions were treated with ILBT alone of median 25 Gy.

Results: Median follow-up time was 32.5 months. Two-year survival rate and local control rate were 92.3% and 86.2%, respectively. Local recurrences were observed in 2 lesions. Three patients died due to lung cancer (1 patient) and intercurrent disease (2 patients). Complications greater than grade 2 were not observed except for one grade 3 dyspnea.

Conclusions: ILBT combined with or without EBRT might be a curative treatment option in inoperable endobronchial carcinoma patients with tolerable complication.

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Figures

Figure 1
Figure 1
Local control rate after the start of radiation therapy. Kaplan-Meier estimates showing local control rates.
Figure 2
Figure 2
Overall survival rate after the start of first radiation therapy. Kaplan-Meier estimates showing overall survival rates for patients received ILBT. Three patients were treated 2 lesions each in different time point, thus, graph includes overlapping data.
Figure 3
Figure 3
CT based dose distribution. A CT based dose distribution of the recent case. Red thick line is a delineated contour of clinical target volume (CTV) and magenta line indicates 100% of prescribed dose (5 Gy). 95% of the CTV receives more than 90% of the prescribed dose. The unit is cGy/fraction.
See this image and copyright information in PMC

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