The treatment results of 40 patients with localized endobronchial cancer with external beam irradiation and intraluminal irradiation using low dose rate (192)Ir thin wires with a new catheter.
OBJECTIVE
While bronchial intraluminal irradiation is valued highly as a useful palliative treatment for lung cancer, its role as a curative treatment is unclear. The treatment results of 40 localized enbobronchial tumors (including tracheal cancer) who underwent external beam irradiation (EBR) and intraluminal irradiation (IR) as a curative treatment is reported, and the role of combined EBR and IR as a curative potential treatment is examined.


METHODS
Forty patients, including 22 with roentgenographically occult lung cancer (ROLC), 14 (18 lesions) with postoperative recurrent lung cancer (PORLC) and four with tracheal cancer, who underwent EBR and IR from February 1987 to August 1996, were studied. IR was conducted using low dose rate (1.48 GBq) (192)Ir thin wires at a bronchial mucosal dose of 4-6 Gy per fraction, with a total dose of 10-57 Gy (median 28 Gy). All patients were also given combined external Linac X-ray irradiation for a total dose of 30-77 Gy (median 52 Gy).


RESULTS
As for the primary effect, complete response (CR) was obtained in all 22 ROLC cases; CR was obtained in 12 (16 lesions), partial response (PR) in one and minor response (MR) in one of the PORLC cases; and CR was obtained in three and PR in one of the tracheal cancer cases. The 3-year and 5-year local control rate by Kaplan-Meier method was 75 and 65%, respectively. Twenty-two patients survived for 3 years or longer. Complications included one case each of fatal tracheal hemorrhage, bronchial mucosal ulcer and bronchial stenosis.


CONCLUSIONS
Combined EBR and IR is useful as a curative potential treatment, and long-term survival can be expected in ROLC, tracheal cancer and a portion of PORLC cases.
Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusaku, Nagoya, Japan.
N
N
Fuwa
Y
Y
Ito
A
A
Matsumoto
K
K
Morita
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D002283:Carcinoma, Bronchogenic / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D002404:Catheterization; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D008175:Lung Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011829:Radiation Dosage; D011882:Radiotherapy, High-Energy / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome
D007496:Iridium Radioisotopes