title: Endoluminal high dose rate brachytherapy in the treatment of primary and recurrent bronchogenic tree malignancies.
abstract: BACKGROUND
  Locally advanced tumours as the initial form of presentation of tumours in the bronchial tree are not a rare event. Bronchogenic recurrence is frequent in the natural history of some tumours. The choice of therapeutic options from the raft available depends on such variables as initial therapy, place of recurrence, symptoms and patient's physical status.
  
  
  OBJECTIVE
  To demonstrate the advantages of endoluminal brachytherapy (EBT) with high dose rate (HDR) in primary and recurrent tumour of the bronchial tree.
  
  
  METHODS
  A retrospective study of seven patients (pts) with primary tumours of the colon, trachea and lung. Tracheobronchial recurrence (trachea, two pts, bronchus, five pts) occurred between March 2003 and September 2004. Patients under- went EBT with HDR for primary or recurrent therapy in association with external radiotherapy, laser therapy and chemotherapy with palliative or curative intention. EBT with HDR doses of 5 to 7 Gy in 2 to 4 fractions at 1 cm from the source axis were given. Treatment included endoluminal application of Ir192 with a French 6 catheter.
  
  
  RESULTS
  There was symptomatic relief related to reduction of tumour in six of the seven patients treated. In one of the six patients studied, there was progression of the local disease between the second and third fractions of the treatment (obstruction of the trachea). In a mean follow up of 17 (2-40) months between EBT and this study, three patients are alive, one has no evidence of disease while two have had bronchial recurrence, four patients have died, one after massive haemoptysis and three due to disease progression.
  
  
  CONCLUSIONS
  Patients undergoing brachytherapy for symptomatic primary tumours or endobronchial recurrence show good tolerance, important symptom relief and improved quality of life. Despite the small size of our sample, it is clear that EBT with HDR plays an important role in the palliative/ curative treatment of these patients.
authors.affiliation: Hospital de Santa Maria, Serviço de Radioterapia, Lisboa, Portugal. mfortunatoruivo@hotmail.com
authors.forename: Maria
authors.initials: M
authors.lastname: Fortunato
authors.forename: Salvato
authors.initials: S
authors.lastname: Feijó
authors.forename: Telma
authors.initials: T
authors.lastname: Almeida
authors.forename: Vera
authors.initials: V
authors.lastname: Mendonça
authors.forename: Margarida
authors.initials: M
authors.lastname: Aguiar
authors.forename: Marília
authors.initials: M
authors.lastname: Jorge
authors.forename: Isabel
authors.initials: I
authors.lastname: Monteiro Grillo
mesh_terms: D000368:Aged; D001918:Brachytherapy; D001984:Bronchial Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies