[Palliative bronchial deobstruction with kinetic radiotherapy in non-small cell lung cancer].
The palliative treatment of lung atelectasis can significantly improve the quality of life in the patients who are unsuitable for cure. The authors present a new transcutaneous radiotherapy technique for treating this complication of lung cancer. After conventional and CT localization, a treatment is scheduled featuring a small (3-5 cm wide and 4-6 cm long) single 180 degrees arc beam giving 14 Gy to the 90% isodose line in two daily fractions. The treatment is repeated 3 weeks later (dosage: 28 Gy). The mean dosage to the ICRU reference point was 34 Gy; the min., max. and mean dosages to the planning target volume were 31, and 35 Gy, respectively, in 4 fractions over a 3-week period. Lesions were localized best by positioning the distal end of a fiberoscope close to the tumor and by checking its position under fluoroscopic guidance, on two orthogonal projections, immediately after every treatment session. Nine patients with histologically-proven non-small cell lung cancer were treated. They relapsed after surgery and/or full-course radiotherapy. Lung reventilation, demonstrated with fiberbronchoscopy and on chest films, was observed in 8/9 patients, in 1 of them lasting for about 40 days. In the extant 7/8 cases, it lasted longer (range: 60-180 days). Of the latter patients, 5 are alive and 2 died 60 and 86 days after treatment, with no atelectasis. The treatment was very well tolerated and severe symptoms were relieved with no complications.
Divisione di Radioterapia Oncologica, Ospedale Civile Umberto I, Mestre Venezia.
R
R
Polico
S
S
Giannico
M
M
Antonello
M
M
Busetto
G
G
Pizzi
D000368:Aged; D001982:Bronchial Diseases / Q000209:etiology / Q000532:radiotherapy*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000532:radiotherapy*; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D001261:Pulmonary Atelectasis / Q000209:etiology / Q000532:radiotherapy*