High dose rate brachytherapy in patients with local recurrences after radiotherapy of non-small cell lung cancer.
Thirty-one patients with recurrences of locally advanced Stage III lung cancer were treated with high dose rate brachytherapy. All patients had previously received a full course external beam irradiation. All treatments were performed under topical anaesthesia and took 6-14 min depending on the strength of the Iridium-192 source. The high dose rate brachytherapy was calculated as 10 Gy at one cm from the source axis for each session and this was repeated every 2 weeks to a maximum of three sessions. All treatments were well tolerated and no immediate treatment related complications were observed. Response evaluation 6 weeks after high dose rate brachytherapy showed that there was a partial response in 22 patients and nine patients were non-responders. Median survival was 7 and 3 months, respectively. All non-responders had initially presented with a T4N3 tumor. Ten patients died because of fatal pulmonary hemorrhages 2-24 weeks after brachytherapy and three others died because of a bronchial fistula. Endobronchial brachytherapy appears to be a valuable treatment alternative for local palliation. However, the relatively high number of complications at follow-up warrants further investigation to establish the optimal benefit to be derived from high dose rate brachytherapy treatment of locally advanced Stage III tumors.
Sutedja
G
G
Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam.
Baris
G
G
Schaake-Koning
C
C
van Zandwijk
N
N
D000328:Adult; D000368:Aged; D001918:Brachytherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D010166:Palliative Care; D011879:Radiotherapy Dosage
D007496:Iridium Radioisotopes