title: Remote afterloading brachytherapy for the local control of endobronchial carcinoma.
abstract: OBJECTIVE
  The study was designed to, (a) standardize endobronchial brachytherapy and, (b) to evaluate the relief of obstructive signs and symptoms.
  
  
  METHODS
  Patients with endobronchial carcinoma were treated on a protocol (n = 342) with remote afterloading brachytherapy. Group 1 patients were treated with medium dose rate and received 1000 cGy at 5 mm depth for three fractions (n = 47). Group 2 were treated with high dose rate, 1000 cGy to a 10 mm depth for three fractions (n = 144) and Group 3 received 750 cGy delivered to a 10 mm depth for three fractions (n = 151). Each group was divided into curative, palliative, and recurrent categories. Neodymium yttrium aluminum garnet photoresection was used in 24% of patients prior to brachytherapy.
  
  
  RESULTS
  Evaluation consisted of symptom index scoring with weighted responses of hemoptysis 99%, obstructive pneumonia 99%, cough 85%, and dyspnea 86%. Obstruction improvement was 80% overall, curative 87%, palliative 84%, and recurrent 70% of mean pretreatment scores. Survival 10% alive, 88% expired, and 2% lost to follow-up. Cause of death was intrathoracic carcinoma 41%, metastatic carcinoma 38%, intercurrent disease 9%, and unknown cause 13%. Survival from diagnosis and first treatment was, respectively, for curative 10.8 and 9.5 months, palliative 14 and 5.6 months, and recurrent 25.6 and 6.2 months. Significant complications were fatal hemoptysis 7%, and radiation bronchitis and stenosis 11%.
  
  
  CONCLUSIONS
  Endoluminal brachytherapy provides excellent palliation of the endobronchial portion of neoplastic disease.
authors.affiliation: Department of Radiation Oncology, St. Joseph's Hospital, Phoenix, AZ 85013.
authors.forename: B L
authors.initials: BL
authors.lastname: Speiser
authors.forename: L
authors.initials: L
authors.lastname: Spratling
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors