Treatment of roentgenographically occult endobronchial carcinoma with external beam radiotherapy and intraluminal low-dose-rate brachytherapy: second report.
OBJECTIVE
To evaluate the efficacy and toxicity of treatment with external beam radiotherapy and intraluminal low-dose-rate brachytherapy for roentgenographically occult endobronchial carcinoma (ROEC).


METHODS
A total of 79 lesions (71 cases) of ROEC were treated with external beam radiotherapy and intraluminal low-dose-rate brachytherapy from July 1991 to December 1998. Of these lesions, 68 (64 cases) were treated with our standard dose (external beam radiotherapy of 40 Gy and intraluminal low-dose-rate brachytherapy of 25 Gy) and are the subject of this report. All 64 patients were males, and their ages ranged from 55 to 80 (median, 68) years. The histologic diagnosis was squamous cell carcinoma in all patients.


RESULTS
In all cases, the scheduled treatment was carried out within 2 months. Follow-up period ranged from 4 to 91 (median, 44) months from the beginning of this treatment. Acute toxicity was tolerable. Grade 2 radiation pneumonitis was observed in 4 cases, and there was no case of greater than Grade 2 radiation fibrosis. Nineteen cases of bronchial stenosis and 23 cases of bronchial obstruction were observed on follow-up bronchoscopy. However, no Grade 2 or greater deterioration of respiratory function due to radiotherapy, prolonged symptoms, or fatal toxicity was observed. Nine patients suffered recurrence, 5 of whom were rescued by surgery and external beam radiotherapy, and 4 of whom died of disease. The 5-year cause-specific survival, overall-survival, and disease-free rate were 96.1%, 72.3%, and 87.3%, respectively.


CONCLUSIONS
Combined treatment with external beam radiotherapy and intraluminal low-dose-rate brachytherapy is effective and results in acceptable complications for ROEC.
Saito
M
M
Department of Radiology and Internal Medicine, Niigata Cancer Center Hospital, Japan.
Yokoyama
A
A
Kurita
Y
Y
Uematsu
T
T
Tsukada
H
H
Yamanoi
T
T
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D001982:Bronchial Diseases / Q000209:etiology; D001984:Bronchial Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D001991:Bronchitis / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*; D002423:Cause of Death; D003251:Constriction, Pathologic / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011446:Prospective Studies; D017564:Radiation Pneumonitis / Q000209:etiology; D011859:Radiography; D011879:Radiotherapy Dosage; D014134:Tracheal Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality / Q000532:radiotherapy*