High-dose-rate brachytherapy for small-sized peripherally located lung cancer.
BACKGROUND
The demand for minimally invasive therapies is increasing in the treatment of small peripheral non-small cell lung cancer (NSCLC).


METHODS
Twelve patients with T1-2 N0 M0 peripheral NSCLC were treated by high-dose-rate brachytherapy with (192)Ir radioactive source.


RESULTS
A (192)Ir source was introduced into the tumors percutaneously in five patients (percutaneous brachytherapy) or transbronchially in seven patients (transbronchial brachytherapy). Whereas irradiation was performed with a single fraction of 20 Gy in percutaneous brachytherapy, it was hypofractionated from 5 x 5 Gy to 2 x 12.5 Gy in transbronchial brachytherapy. Complications were generally mild in all patients, although focal radiation pneumonitis was observed in most patients. Primary recurrence occurred in three patients, including one with a T2 tumor and one treated by brachytherapy as a salvage treatment for recurrence after conformal radiotherapy. When brachytherapy is evaluated as a primary treatment for T1 N0 M0 NSCLC, local control rate is 88.9% and estimated 5-year survival rate is between 60% and 70%.


CONCLUSIONS
Brachytherapy has a potential to be a method to treat peripheral T1 N0 M0 NSCLC.
Imamura
Fumio
F
Department of Pulmonary Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. imamura-fu@mc.pref.osaka.jp
Ueno
Kiyonobu
K
Kusunoki
Yoko
Y
Uchida
Junji
J
Yoshimura
Mana
M
Koizumi
Masahiko
M
Yamasaki
Hideya
H
Nishiyama
Kinji
K
D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy; D009367:Neoplasm Staging; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D015996:Survival Rate; D014057:Tomography, X-Ray Computed
D007496:Iridium Radioisotopes