title: A prospective analysis of high-dose-rate endobronchial brachytherapy in the palliation of obstructive symptoms in lung cancer patients: A single-institution experience.
abstract: OBJECTIVE
  Obstructive symptoms that affect quality of life (QOL) are commonly caused by endobronchial disease in many patients with locally advanced, inoperable lung cancer. High-dose-rate endobronchial brachytherapy (HDREBBT) has been used to palliate these symptoms, yet its role is not well defined in the literature.
  
  
  METHODS
  Ninety-eight patients with locally advanced, inoperable lung cancer received HDREBBT. They were prospectively followed for survival, QOL, and toxicity endpoints. QOL measures were captured using the Quality of Life Questionnaire-Lung Cancer 30 and -Lung Cancer 13.
  
  
  RESULTS
  At 1-year follow-up, no significant toxicities were seen. Overall survival was 13.4% at 12 months (mean 192 days). Performance status, additional treatment after HDREBBT and treatment intent affected overall survival on univariate analysis (p < 0.05). Mean hemoptysis-free survival for all patients was 232.3 days, cough-free survival was 140.3 days, and dyspnea-free survival was 173.5 days. There was no impact of any treatment- or patient-related factors of these outcomes on multivariate analysis, including additional treatment modalities and HDREBBT dose.
  
  
  CONCLUSIONS
  HDREBBT is a safe and effective way to palliate endobronchial symptoms. Additional external-beam radiation therapy, chemotherapy, or chemoradiation after HDREBBT improves survival, but does not affect QOL measures.
authors.affiliation: Department of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, ON, Canada. Electronic address: mirabgoldberg@gmail.com.
authors.forename: Mira
authors.initials: M
authors.lastname: Goldberg
authors.affiliation: Department of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, ON, Canada.
authors.forename: Emilia
authors.initials: E
authors.lastname: Timotin
authors.affiliation: Department of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, ON, Canada.
authors.forename: Tom
authors.initials: T
authors.lastname: Farrell
authors.affiliation: Department of Medicine, McMaster University, Juravinski Cancer Centre, Hamilton, ON, Canada.
authors.forename: Serge
authors.initials: S
authors.lastname: Puksa
authors.affiliation: Department of Radiation Oncology, Sandton Oncology Centre, Johannesburg, South Africa.
authors.forename: Bernard
authors.initials: B
authors.lastname: Donde
authors.affiliation: Department of Radiation Oncology, McMaster University, Juravinski Cancer Centre, Hamilton, ON, Canada.
authors.forename: Ranjan
authors.initials: R
authors.lastname: Sur
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000209:etiology / Q000532:radiotherapy*; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications / Q000532:radiotherapy*; D003371:Cough / Q000209:etiology; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000379:methods*; D011446:Prospective Studies; D011788:Quality of Life; D011879:Radiotherapy Dosage; D015996:Survival Rate
keywords: Brachytherapy; External radiation; High dose rate; Lung cancer; Palliation; Symptom-free survival