Fractionated intraluminal HDR 192Ir brachytherapy as palliative treatment in patients with endobronchial metastases from non-bronchogenic primaries.
OBJECTIVE
To evaluate the efficacy of iridium-192 high-dose rate (HDR) endobronchial brachytherapy for the palliation of symptoms caused by endobronchial metastases of non-bronchogenic primaries.


METHODS
Between 1991 and 1998, eleven patients (female n = 3, male n = 8; age: median 66 years, range 44-81 years) underwent intraluminal HDR brachytherapy for histologically confirmed endobronchial metastases from non-pulmonary primary tumors of various sites like urogenital tract (n = 5), gastrointestinal tract (n = 3), ear/nose/throat (n = 2) and breast (n = 1). The median time between diagnosis of the primary non-bronchogenic tumor and histopathological diagnosis of the endobronchial metastases was 39 months, range 1-99 months. A total dose of 15-20 Gy was delivered in three to four fractions of 5-6 Gy once a week. No palliative chemotherapy was added.


RESULTS
Median follow-up after palliative brachytherapy was 15 months (range 1.4-59 months). Objectively, complete endoscopic response was observed in three (27%) patients, and in five (46%) others partial opening of the initially obstructed airway was achieved. Treatment was judged unsuccessful in three (27%) patients. No patient showed up with local progression. At date of analysis five patients were alive with documented residual tumor (80%) or complete response (20%). Relief of symptoms occurred in the vast majority of patients (n = 8, 73%).


CONCLUSIONS
HDR intraluminal brachytherapy palliates symptoms in patients suffering from endobronchial metastases of non-pulmonary primary tumors. The applied treatment is a safe, effective and well tolerated palliative procedure leading to an improved patient quality of life.
Stranzl
Heidi
H
Department of Radiotherapy, University Medical School of Graz, Austria. heidi.stranzl@klinikum-graz.at
Gabor
Sabine
S
Mayer
Ramona
R
Prettenhofer
Ulrike
U
Wurzinger
Gert
G
Hackl
Arnulf
A
D000230:Adenocarcinoma / Q000532:radiotherapy / Q000556:secondary; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D001943:Breast Neoplasms; D001984:Bronchial Neoplasms / Q000532:radiotherapy* / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000532:radiotherapy / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000556:secondary; D002295:Carcinoma, Transitional Cell / Q000532:radiotherapy / Q000556:secondary; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage*; D007680:Kidney Neoplasms; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011471:Prostatic Neoplasms; D011879:Radiotherapy Dosage; D012004:Rectal Neoplasms; D012811:Sigmoid Neoplasms; D013997:Time Factors; D014062:Tongue Neoplasms; D014067:Tonsillar Neoplasms; D001749:Urinary Bladder Neoplasms; D014594:Uterine Neoplasms
D007496:Iridium Radioisotopes