IR-192, low dose rate endobronchial brachytherapy in the treatment of malignant airway obstruction.
OBJECTIVE
To assess the value of low-dose-rate endobronchial brachytherapy in the treatment of malignant airway obstruction.


METHODS
Between September 1986 and April 1989, 39 patients with malignant airway obstruction had 49 catheter placements for an afterloading, low-dose-rate Ir-192 endobronchial brachytherapy. A flexible fiberoptic bronchoscope with fluoroscopic guidance was used for positioning. Thirty-eight of 39 (97%) patients completed the prescribed treatments. Ninety-seven percent had received previous external radiation in doses ranging from 36-60 Gy. One patient had metastatic renal cell carcinoma; the remainder had recurrent lung cancer. Endobronchial laser treatments were given to three patients 2-3 weeks prior to endobronchial brachytherapy. All patients were followed until death. The median dose delivered in 48 of the 49 placements was 20 Gy at 1 cm.


RESULTS
Follow-up bronchoscopy was performed in 28 (72%) of 39 patients. Of these, 13 (46%) had a complete response, 12 (43%) had a partial response, and 3 (17%) had a minor response. Dyspnea improved in 30 of 37 patients (82%); hemoptysis in 17 of 19 patients (89%); cough in 31 of 39 patients (79%); and postobstructive pneumonia in 21 of 23 patients (92%). The median survival for the entire group was 5 months (range 1-31 months).


CONCLUSIONS
This technique is simple, well-tolerated and offered significant palliation.
Raju
P I
PI
Department of Radiation Oncology, Saint Louis University Medical Center, MO 63110-0250.
Roy
T
T
McDonald
R D
RD
Harrison
B R
BR
Crim
C
C
Hyers
T M
TM
Marshall
S J
SJ
Ohar
J A
JA
Naunheim
K S
KS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000532:radiotherapy*; D001918:Brachytherapy; D002292:Carcinoma, Renal Cell / Q000556:secondary; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000532:radiotherapy; D008175:Lung Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D015996:Survival Rate
D007496:Iridium Radioisotopes