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

Radiation Oncology

Takashi Nakano²  Hideyuki Sakurai³  Hitoshi Ishikawa³  Tomoaki Tamaki²  Hiroyuki Katoh²  Takeshi Ebara¹  Hidemasa Kawamura² 

[1] Department of Radiation Oncology, Saitama Medical University International Medical Center, 1397-1 yamane Hidaka-shi, Saitama, Japan;Department of Radiation Oncology, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan;Department of Radiation Oncology and Proton Medical Research Center, Tsukuba University, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan

关键词: Curative intent;    Intraluminal brachytherapy;    High dose rate;    Radiation therapy;    Lung cancer;   

Others  :  1160804
DOI  :  10.1186/1748-717X-7-112

 received in 2012-04-06, accepted in 2012-07-23,  发布年份 2012

【 摘 要 】

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.

【 授权许可】

   
2012 Kawamura et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

【 参考文献 】

• [1]Adebonojo SA, Moritz DM, Danby CA: The results of modern surgical therapy for multiple primary lung cancers. Chest 1997, 112:693-701.
• [2]Okada M, Tsubota N, Yoshimura M, Miyamoto Y: Operative approach for multiple primary lung carcinomas. J Thorac Cardiovasc Surg 1998, 115:836-840.
• [3]Harms W, Becker HD, Krempien R, Wannenmacher M: Contemporary role of modern brachytherapy techniques in the management of malignant thoracic tumors. Semin Surg Oncol 2001, 20:57-65.
• [4]Kubaszewska M, Skowronek J, Chicheł A, Kanikowski M: The use of high dose rate endobronchial brachytherapy to palliate symptomatic recurrence of previously irriadiated lung cancer. Neoplasma 2008, 55:239-245.
• [5]Ozkok S, Karakoyun-Celik O, Goksel T, Mogulkoc N, Yalman D, Gok G, Bolukbasi Y: High dose rate endobronchial brachytherapy in the management of lung cancer: response and toxicity evaluation in 158 patients. Lung Cancer 2008, 62:326-333.
• [6]Zorlu AF, Selek U, Emri S, Gurkaynak M, Akyol FH: Second line palliative endobronchial radiotherapy with HDR Ir 192 in recurrent lung carcinoma. Yonsei Med J 2008, 49:620-624.
• [7]Fuwa N, Matsumoto A, Kamata M, Kodaira T, Furutani K, Ito Y: External irradiation and intraluminal irradiation using middle-dose-rate iridium in patients with roentgenographically occult lung cancer. Int J Radiat Oncol Biol Phys 2001, 49:965-971.
• [8]Saito M, Yokoyama A, Kurita Y, Uematsu T, Tsukada H, Yamanoi T: Treatment of roentgenographically occult endobronchial carcinoma with external beam radiotherapy and intraluminal low-dose-rate brachytherapy: second report. Int J Radiat Oncol Biol Phys 2000, 47:673-680.
• [9]Hennequin C, Bleichner O, Tréaniel J, Quero L, Sergent G, Zalcman G, Maylin C: Long-term results of endobronchial brachytherapy: a curative treatment? Radiat Oncol Biol 2007, 67:425-430.
• [10]Marsiglia H, Baldeyrou P, Lartigau E, Briot E, Haie-Meder C, Le Chevalier T, Sasso G, Gerbaulet A: High-dose-rate brachytherapy as sole modality for early-stage endobronchial carcinoma. Int J Radiat Oncol Biol Phys 2000, 47:665-672.
• [11]Fuwa N, Ito Y, Matsumoto A, Morita K: The treatment results of 40 patients with localized endobronchial cancer with external beam irradiation and intraluminal irradiation using low dose rate (192)Ir thin wires with a new catheter. Radiother Oncol 2000, 56:189-195.
• [12]Sutedja TG, van Boxem AJ, Postmus PE: The curative potential of intraluminal bronchoscopic treatment for early-stage non-small-cell lung cancer. Clin Lung Canc 2001, 2:264-270. discussion 271–2
• [13]Taulelle M, Chauvet B, Vincent P, Féix-Faure C, Buciarelli B, Garcia R, Brewer Y, Reboul F: High dose rate endobronchial brachytherapy: results and complications in 189 patients. Eur Respir J 1998, 11:162-168.
• [14]The Japan Lung Cancer Society: Classification of Lung Cancer 1st English ed. Tokyo: Kanehara & Co., LTD.; 2000.
• [15]Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958, 53:457-481.
• [16]Kato S, Tran DN, Ohno T, Nakano T, Kiyohara H, Ohkubo Y, Kamada T: CT-based 3D dose-volume parameter of the rectum and late rectal complication in patients with cervical cancer treated with high-dose-rate intracavitary brachytherapy. J Radiat Res (Tokyo) 2010, 51:215-221.
• [17]Gay HA, Allison RR, Downie GH, Mota HC, Austerlitz C, Jenkins T, Sibata CH: Toward endobronchial Ir-192 high-dose-rate brachytherapy therapeutic optimization. Phys Med Biol 2007, 52:2987-2999.
• [18]Lagerwaard FJ, Murrer LH, de Pan C, Roos M, Senan S: Mucosal dose prescription in endobronchial brachytherapy: a study based on CT-dosimetry. Radiat Oncol Biol 2000, 46:1051-1059.
• [19]Senan S, Lagerwaard FJ, de Pan C, Sipkema D, Burgers SA, Murrer LH: A CT-assisted method of dosimetry in brachytherapy of lung cancer. Rotterdam Oncological Thoracic Study Group. Radiother Oncol 2000, 55:75-80.
• [20]Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, Ewing M, Abdulrahman R, DesRosiers C, Williams M, Fletcher J: Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol 2006, 24:4833-4839.