title: The role of high-dose-rate brachytherapy in the palliation of symptoms in patients with non-small-cell lung cancer: a systematic review.
abstract: OBJECTIVE
  This review addresses the role of high-dose-rate endobronchial brachytherapy (HDREB) for symptom palliation in patients with non-small-cell lung cancer.
  
  
  METHODS
  Relevant trials were identified through a systematic search of the literature.
  
  
  RESULTS
  Twenty-nine trials were eligible. Six randomized trials involved HDREB alone or with external beam radiation therapy (EBR) or laser therapy. Median and 1-year survival ranged from 4 to 10 months and from 11% to 38%, respectively. Symptoms controlled by HDREB were dyspnea, cough, chest pain, and hemoptysis. Fatal hemoptysis ranged from 7% to 22%. Better overall symptom palliation and fewer retreatments were required in previously untreated patients using EBR alone or EBR with HDREB.
  
  
  CONCLUSIONS
  EBR alone is more effective than HDREB for symptom palliation in previously untreated patients with endobronchial non-small-cell lung cancer. HDREB with EBR seems to provide better symptom relief than EBR alone. HDREB is recommended for symptomatic patients with recurrent endobronchial obstruction previously treated by EBR, providing it is technically feasible.
authors.affiliation: Toronto-Sunnybrook Regional Cancer Centre, Toronto, ON, Canada. vanderja@mcmaster.ca
authors.forename: Yee C
authors.initials: YC
authors.lastname: Ung
authors.forename: Edward
authors.initials: E
authors.lastname: Yu
authors.forename: Conrad
authors.initials: C
authors.lastname: Falkson
authors.forename: Adam E
authors.initials: AE
authors.lastname: Haynes
authors.forename: Denise
authors.initials: D
authors.lastname: Stys-Norman
authors.forename: William K
authors.initials: WK
authors.lastname: Evans
mesh_terms: D001918:Brachytherapy / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000473:pathology / Q000532:radiotherapy*; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods*; D016896:Treatment Outcome