Palliative high-dose-rate endobronchial brachytherapy for recurrent carcinoma: the University of Louisville experience.
OBJECTIVE
To determine the efficacy and toxicity of iridium-192 high-dose-rate (HDR) endobronchial brachytherapy (EBBT) for symptomatic palliation of respiratory symptoms caused by endobronchial carcinoma.


METHODS
We reviewed the treatment outcomes of 52 patients with carcinoma who underwent HDR EBBT between July 1995 and July 2005 for recurrent tumors at the University of Louisville School of Medicine. The subjective clinical response was assessed by patient reports. The objective response was assessed by bronchoscopy and chest computed tomography.


RESULTS
The median actuarial survival measured from the first EBBT treatment session was 7 months. Forty-eight patients (92%) showed improvement in one or more symptoms. The median time to symptomatic relapse was 6 months. Bronchoscopic regression of tumor occurred in 45 patients (87%). Tumor regression as determined by bronchoscopy correlated with symptomatic response. Complications occurred in two patients (one pneumothorax and one fatal hemoptysis).


CONCLUSIONS
The results confirm the efficacy of endobronchial brachytherapy in relieving obstructive airway symptoms from endoluminal bronchogenic carcinomas. We demonstrated a low morbidity associated with EBBT treatment and a high objective response (87%) and subjective response (92%).
Guarnaschelli
Jessica N
JN
Department of Radiation Oncology, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0757, USA. jess.guarnaschelli@healthall.com
Jose
Bobby O
BO
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods* / Q000523:psychology; D002283:Carcinoma, Bronchogenic / Q000401:mortality / Q000523:psychology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D007629:Kentucky / Q000453:epidemiology; D008175:Lung Neoplasms / Q000401:mortality / Q000523:psychology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000523:psychology / Q000532:radiotherapy*; D010166:Palliative Care / Q000379:methods* / Q000523:psychology; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome
D007496:Iridium Radioisotopes