[High-dose brachytherapy in endobronchial neoplastic stenoses].
Form March, 1991, to September, 1995, twenty-nine patients with endobronchial neoplastic stenosis were treated with high dose rate (HDR) brachytherapy at the Casa Sollievo della Sofferenza Hospital in San Giovanni Rotondo (Foggia, Italy). Fifteen patients had hemoptysis, 10 dyspnea, 6 constant cough and 6 lung atelectasis. The total dose, specified at 1 cm from the source, ranged 5 to 21 Gy and the fraction doses 5 to 15 Gy. Fourteen of 29 patients (48%) died. The mean survival is 7 months, with the follow-up ranging 1 to 22 months. Subjective responses were achieved in 78.4% of cases, with 67.6% complete and 10.8% partial remission rates. Complete remission of hemoptysis was observed in 100% of patients. Dyspnea improved in 70%, cough in 46.4% and atelectasis in 83.2%. Endoscopic findings, 1 month after the end of brachytherapy, showed a response in 79.4% of patients. The complication rate was 13.8% (1 tracheoesophageal fistula, 2 pulmonary hemorrhages and 1 cavitary necrosis). Even though the number of treated patients is small, our experience confirms the efficacy of HDR endobronchial brachytherapy in the palliation of lung cancer-related symptoms. Literature data show that brachytherapy improves the quality of life in the patients with poor prognosis who are otherwise untreatable. The HDR technique is more accurate than the LDR technique and therapy is better tolerated also because execution time is shorter. Prospective clinical trials are needed to investigate the most effective total doses and fractionations and to better define the role of brachytherapy in the curative treatment of lung cancer.
Corsa
P
P
Servizio di Radioterapia, Ospedale I.R.C.C.S. Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG.
Parisi
S S
SS
Raguso
A
A
el Jaouni
M
M
Fusco
V
V
Maiorana
A
A
Lauriola
P
P
Di Corcia
A
A
Di Cosmo
V
V
Albano
A
A
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D001982:Bronchial Diseases / Q000209:etiology / Q000532:radiotherapy*; D001984:Bronchial Neoplasms / Q000150:complications / Q000532:radiotherapy*; D003251:Constriction, Pathologic / Q000532:radiotherapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged