Chest
Brachytherapy for Non-small Cell Lung Cancer and Selected Neoplasms of the Chest
Section snippets
Interstitial Permanent Volume or Planar Implantation
The optimal technique of intraoperative implantation and the selection of radioactive sources depend on the location of the tumor, the amount of residual gross disease, and the biological behavior of the tumor. When residual tumor volume exceeds 1 cm, a permanent volume implant is usually required. The area to be implanted is determined preoperatively by the surgeon and the radiation oncologist, then reevaluated intraoperatively. The dimensions are recorded. A volume nomogram is applied to
Stage I and II NSCLC
Surgical resection is widely recognized as the treatment of choice for early-stage NSCLC. Although EBRT has historically been used as an acceptable primary treatment for medically inoperable disease, the overall results have generally been inferior to surgical resection, with local control rates ranging from 20 to 90% and 5-year survival rates ranging from 10 to 50% for radiation therapy.15, 15a, 15b Dose-response data for EBRT alone for unresectable early lesions show poor local control for
Conclusion
Despite current advances in multimodality therapy for malignancies arising in the chest, a large proportion of patients develop local and/or regional failures. To improve the therapeutic ratio, radiation oncologists have attempted to develop novel strategies for delivering high-dose radiation to the tumor or tumor bed with selective sparing of surrounding normal structures. Some of these strategies include interstitial permanent and temporary implantation, LDR- and HDR-ILBRT, and intraoperative
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Cited by (26)
Brachytherapy for lung cancer
2021, BrachytherapyCitation Excerpt :The median duration of symptom relief was about 4–6 months, the hemostasis rate was about 50–90%, and the response rate was 50–65% for dyspnea and 60% for intractable cough (21). Nevertheless, complications occurred in around 3–30% of patients, including fistula, radioactive bronchitis, tracheal perforation, ulcers, hemorrhage, and bronchial stenosis or necrosis, with some of the complications being fatal (21). Endobronchial BT is recommended in certain patients with a recurrent symptomatic endobronchial central obstruction or hemoptysis (4,22).
Treatment of central type lung cancer by combined cryotherapy: Experiences of 47 patients
2013, CryobiologyCitation Excerpt :In patients with extratracheal CTLC, airway stenting was considered in those in whom it was impossible to restore more than 50% of the lumen even after airway dilatation or who required repeated airway dilatation. One to three airway stents were used according to the situation of the airway obstruction [22]; Ultraflex tracheobronchial stents (Boston Scientific, Natick, MA), Dynamic (Y) stent systems (Boston Scientific) and AERO stents (Merit Medical Endotek, South Jordan, UT) were used. Ultraflex stents comprise a single strand nitinol alloy and are available in both covered and uncovered models; the AERO tracheobronchial stent is a fully covered hybrid stent (Fig. 1C).
A pilot trial of high-dose-rate intraoperative radiation therapy for malignant pleural mesothelioma
2005, BrachytherapyCitation Excerpt :It can be fixed in place with packing or sutures. Possible position arrays range from 3 × 3 to 20 × 24 cm (8). Intraoperative imaging was not used to assess implant position.
Endoscopic surgery with a flexible bronchoscope and argon plasma coagulation for tracheobronchial tumors
2001, Journal of Thoracic and Cardiovascular SurgeryCitation Excerpt :No complications, either related or unrelated to the procedure, occurred in any of the patients. Recently, various treatments have been reported for the management of bronchial tumors.1-5 All have specific advantages and disadvantages that make them individually suited for particular purposes.
The short and long term effects of intraoperative electron beam radiotherapy (IORT) on thoracic organs after pneumonectomy an experimental study in the canine model
1999, International Journal of Radiation Oncology Biology Physics
Reprint requests: Adam Raben, MD, Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021