Palliative high-dose-rate endobronchial brachytherapy for recurrent carcinoma: the University of Louisville experience

J Palliat Med. 2010 Aug;13(8):981-9. doi: 10.1089/jpm.2009.0411.

Abstract

Purpose: To determine the efficacy and toxicity of iridium-192 high-dose-rate (HDR) endobronchial brachytherapy (EBBT) for symptomatic palliation of respiratory symptoms caused by endobronchial carcinoma.

Methods: We reviewed the treatment outcomes of 52 patients with carcinoma who underwent HDR EBBT between July 1995 and July 2005 for recurrent tumors at the University of Louisville School of Medicine. The subjective clinical response was assessed by patient reports. The objective response was assessed by bronchoscopy and chest computed tomography.

Results: The median actuarial survival measured from the first EBBT treatment session was 7 months. Forty-eight patients (92%) showed improvement in one or more symptoms. The median time to symptomatic relapse was 6 months. Bronchoscopic regression of tumor occurred in 45 patients (87%). Tumor regression as determined by bronchoscopy correlated with symptomatic response. Complications occurred in two patients (one pneumothorax and one fatal hemoptysis).

Conclusions: The results confirm the efficacy of endobronchial brachytherapy in relieving obstructive airway symptoms from endoluminal bronchogenic carcinomas. We demonstrated a low morbidity associated with EBBT treatment and a high objective response (87%) and subjective response (92%).

MeSH terms

  • Actuarial Analysis
  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Health
  • Brachytherapy / adverse effects
  • Brachytherapy / methods*
  • Brachytherapy / psychology
  • Carcinoma, Bronchogenic / mortality
  • Carcinoma, Bronchogenic / psychology
  • Carcinoma, Bronchogenic / radiotherapy*
  • Female
  • Follow-Up Studies
  • Humans
  • Iridium Radioisotopes / therapeutic use*
  • Kaplan-Meier Estimate
  • Karnofsky Performance Status
  • Kentucky / epidemiology
  • Lung Neoplasms / mortality
  • Lung Neoplasms / psychology
  • Lung Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Neoplasm Recurrence, Local / psychology
  • Neoplasm Recurrence, Local / radiotherapy*
  • Palliative Care / methods*
  • Palliative Care / psychology
  • Radiotherapy Dosage
  • Survival Rate
  • Treatment Outcome

Substances

  • Iridium Radioisotopes