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Published in: Radiation Oncology 1/2012

Open Access 01-12-2012 | Research

Long-term results of curative intraluminal high dose rate brachytherapy for endobronchial carcinoma

Authors: Hidemasa Kawamura, Takeshi Ebara, Hiroyuki Katoh, Tomoaki Tamaki, Hitoshi Ishikawa, Hideyuki Sakurai, Takashi Nakano

Published in: Radiation Oncology | Issue 1/2012

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Abstract

Background

The treatment strategy of central lung tumors is not established. Intraluminal brachytherapy (ILBT) is widely used for palliative treatment of endobronchial tumors, however, it is also a promising option for curative treatment with limited data. This study evaluates the results after ILBT for endobronchial carcinoma.

Method

Sixteen-endobronchial carcinoma of 13 patients treated with ILBT in curative intent for 2000 to 2008 were retrospectively reviewed. ILBT using high dose rate 192 iridium thin wire system was performed with 5 Gy/fraction at mucosal surface. The patient age ranged from 57 to 82 years old with median 75 years old. The 16 lesions consisted of 13 central endobronchial cancers including 7 roentgenographically occult lung cancers and 3 of tracheal cancers. Of them, 10 lesions were treated with ILBT of median 20 Gy combined with external beam radiation therapy of median 45 Gy and 6 lesions were treated with ILBT alone of median 25 Gy.

Results

Median follow-up time was 32.5 months. Two-year survival rate and local control rate were 92.3% and 86.2%, respectively. Local recurrences were observed in 2 lesions. Three patients died due to lung cancer (1 patient) and intercurrent disease (2 patients). Complications greater than grade 2 were not observed except for one grade 3 dyspnea.

Conclusions

ILBT combined with or without EBRT might be a curative treatment option in inoperable endobronchial carcinoma patients with tolerable complication.
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Literature
1.
go back to reference Adebonojo SA, Moritz DM, Danby CA: The results of modern surgical therapy for multiple primary lung cancers. Chest 1997, 112: 693-701. 10.1378/chest.112.3.693CrossRefPubMed Adebonojo SA, Moritz DM, Danby CA: The results of modern surgical therapy for multiple primary lung cancers. Chest 1997, 112: 693-701. 10.1378/chest.112.3.693CrossRefPubMed
2.
go back to reference Okada M, Tsubota N, Yoshimura M, Miyamoto Y: Operative approach for multiple primary lung carcinomas. J Thorac Cardiovasc Surg 1998, 115: 836-840. 10.1016/S0022-5223(98)70364-2CrossRefPubMed Okada M, Tsubota N, Yoshimura M, Miyamoto Y: Operative approach for multiple primary lung carcinomas. J Thorac Cardiovasc Surg 1998, 115: 836-840. 10.1016/S0022-5223(98)70364-2CrossRefPubMed
3.
go back to reference Harms W, Becker HD, Krempien R, Wannenmacher M: Contemporary role of modern brachytherapy techniques in the management of malignant thoracic tumors. Semin Surg Oncol 2001, 20: 57-65. 10.1002/ssu.1017CrossRefPubMed Harms W, Becker HD, Krempien R, Wannenmacher M: Contemporary role of modern brachytherapy techniques in the management of malignant thoracic tumors. Semin Surg Oncol 2001, 20: 57-65. 10.1002/ssu.1017CrossRefPubMed
4.
go back to reference Kubaszewska M, Skowronek J, Chicheł A, Kanikowski M: The use of high dose rate endobronchial brachytherapy to palliate symptomatic recurrence of previously irriadiated lung cancer. Neoplasma 2008, 55: 239-245.PubMed Kubaszewska M, Skowronek J, Chicheł A, Kanikowski M: The use of high dose rate endobronchial brachytherapy to palliate symptomatic recurrence of previously irriadiated lung cancer. Neoplasma 2008, 55: 239-245.PubMed
5.
go back to reference Ozkok S, Karakoyun-Celik O, Goksel T, Mogulkoc N, Yalman D, Gok G, Bolukbasi Y: High dose rate endobronchial brachytherapy in the management of lung cancer: response and toxicity evaluation in 158 patients. Lung Cancer 2008, 62: 326-333. 10.1016/j.lungcan.2008.03.018CrossRefPubMed Ozkok S, Karakoyun-Celik O, Goksel T, Mogulkoc N, Yalman D, Gok G, Bolukbasi Y: High dose rate endobronchial brachytherapy in the management of lung cancer: response and toxicity evaluation in 158 patients. Lung Cancer 2008, 62: 326-333. 10.1016/j.lungcan.2008.03.018CrossRefPubMed
6.
go back to reference Zorlu AF, Selek U, Emri S, Gurkaynak M, Akyol FH: Second line palliative endobronchial radiotherapy with HDR Ir 192 in recurrent lung carcinoma. Yonsei Med J 2008, 49: 620-624. 10.3349/ymj.2008.49.4.620PubMedCentralCrossRefPubMed Zorlu AF, Selek U, Emri S, Gurkaynak M, Akyol FH: Second line palliative endobronchial radiotherapy with HDR Ir 192 in recurrent lung carcinoma. Yonsei Med J 2008, 49: 620-624. 10.3349/ymj.2008.49.4.620PubMedCentralCrossRefPubMed
7.
go back to reference Fuwa N, Matsumoto A, Kamata M, Kodaira T, Furutani K, Ito Y: External irradiation and intraluminal irradiation using middle-dose-rate iridium in patients with roentgenographically occult lung cancer. Int J Radiat Oncol Biol Phys 2001, 49: 965-971. 10.1016/S0360-3016(00)01447-4CrossRefPubMed Fuwa N, Matsumoto A, Kamata M, Kodaira T, Furutani K, Ito Y: External irradiation and intraluminal irradiation using middle-dose-rate iridium in patients with roentgenographically occult lung cancer. Int J Radiat Oncol Biol Phys 2001, 49: 965-971. 10.1016/S0360-3016(00)01447-4CrossRefPubMed
8.
go back to reference Saito M, Yokoyama A, Kurita Y, Uematsu T, Tsukada H, Yamanoi T: Treatment of roentgenographically occult endobronchial carcinoma with external beam radiotherapy and intraluminal low-dose-rate brachytherapy: second report. Int J Radiat Oncol Biol Phys 2000, 47: 673-680. 10.1016/S0360-3016(00)00489-2CrossRefPubMed Saito M, Yokoyama A, Kurita Y, Uematsu T, Tsukada H, Yamanoi T: Treatment of roentgenographically occult endobronchial carcinoma with external beam radiotherapy and intraluminal low-dose-rate brachytherapy: second report. Int J Radiat Oncol Biol Phys 2000, 47: 673-680. 10.1016/S0360-3016(00)00489-2CrossRefPubMed
9.
go back to reference Hennequin C, Bleichner O, Tréaniel J, Quero L, Sergent G, Zalcman G, Maylin C: Long-term results of endobronchial brachytherapy: a curative treatment? Radiat Oncol Biol 2007, 67: 425-430. 10.1016/j.ijrobp.2006.08.068CrossRef Hennequin C, Bleichner O, Tréaniel J, Quero L, Sergent G, Zalcman G, Maylin C: Long-term results of endobronchial brachytherapy: a curative treatment? Radiat Oncol Biol 2007, 67: 425-430. 10.1016/j.ijrobp.2006.08.068CrossRef
10.
go back to reference Marsiglia H, Baldeyrou P, Lartigau E, Briot E, Haie-Meder C, Le Chevalier T, Sasso G, Gerbaulet A: High-dose-rate brachytherapy as sole modality for early-stage endobronchial carcinoma. Int J Radiat Oncol Biol Phys 2000, 47: 665-672. 10.1016/S0360-3016(00)00486-7CrossRefPubMed Marsiglia H, Baldeyrou P, Lartigau E, Briot E, Haie-Meder C, Le Chevalier T, Sasso G, Gerbaulet A: High-dose-rate brachytherapy as sole modality for early-stage endobronchial carcinoma. Int J Radiat Oncol Biol Phys 2000, 47: 665-672. 10.1016/S0360-3016(00)00486-7CrossRefPubMed
11.
go back to reference Fuwa N, Ito Y, Matsumoto A, Morita K: The treatment results of 40 patients with localized endobronchial cancer with external beam irradiation and intraluminal irradiation using low dose rate (192)Ir thin wires with a new catheter. Radiother Oncol 2000, 56: 189-195. 10.1016/S0167-8140(00)00217-6CrossRefPubMed Fuwa N, Ito Y, Matsumoto A, Morita K: The treatment results of 40 patients with localized endobronchial cancer with external beam irradiation and intraluminal irradiation using low dose rate (192)Ir thin wires with a new catheter. Radiother Oncol 2000, 56: 189-195. 10.1016/S0167-8140(00)00217-6CrossRefPubMed
12.
go back to reference Sutedja TG, van Boxem AJ, Postmus PE: The curative potential of intraluminal bronchoscopic treatment for early-stage non-small-cell lung cancer. Clin Lung Canc 2001, 2: 264-270. discussion 271–2 10.3816/CLC.2001.n.009CrossRef Sutedja TG, van Boxem AJ, Postmus PE: The curative potential of intraluminal bronchoscopic treatment for early-stage non-small-cell lung cancer. Clin Lung Canc 2001, 2: 264-270. discussion 271–2 10.3816/CLC.2001.n.009CrossRef
13.
go back to reference Taulelle M, Chauvet B, Vincent P, Féix-Faure C, Buciarelli B, Garcia R, Brewer Y, Reboul F: High dose rate endobronchial brachytherapy: results and complications in 189 patients. Eur Respir J 1998, 11: 162-168. 10.1183/09031936.98.11010162CrossRefPubMed Taulelle M, Chauvet B, Vincent P, Féix-Faure C, Buciarelli B, Garcia R, Brewer Y, Reboul F: High dose rate endobronchial brachytherapy: results and complications in 189 patients. Eur Respir J 1998, 11: 162-168. 10.1183/09031936.98.11010162CrossRefPubMed
14.
go back to reference The Japan Lung Cancer Society: Classification of Lung Cancer 1st English ed. Tokyo: Kanehara & Co., LTD.; 2000. The Japan Lung Cancer Society: Classification of Lung Cancer 1st English ed. Tokyo: Kanehara & Co., LTD.; 2000.
15.
go back to reference Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958, 53: 457-481. 10.1080/01621459.1958.10501452CrossRef Kaplan EL, Meier P: Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958, 53: 457-481. 10.1080/01621459.1958.10501452CrossRef
16.
go back to reference Kato S, Tran DN, Ohno T, Nakano T, Kiyohara H, Ohkubo Y, Kamada T: CT-based 3D dose-volume parameter of the rectum and late rectal complication in patients with cervical cancer treated with high-dose-rate intracavitary brachytherapy. J Radiat Res (Tokyo) 2010, 51: 215-221. 10.1269/jrr.09118CrossRef Kato S, Tran DN, Ohno T, Nakano T, Kiyohara H, Ohkubo Y, Kamada T: CT-based 3D dose-volume parameter of the rectum and late rectal complication in patients with cervical cancer treated with high-dose-rate intracavitary brachytherapy. J Radiat Res (Tokyo) 2010, 51: 215-221. 10.1269/jrr.09118CrossRef
17.
go back to reference Gay HA, Allison RR, Downie GH, Mota HC, Austerlitz C, Jenkins T, Sibata CH: Toward endobronchial Ir-192 high-dose-rate brachytherapy therapeutic optimization. Phys Med Biol 2007, 52: 2987-2999. 10.1088/0031-9155/52/11/004CrossRefPubMed Gay HA, Allison RR, Downie GH, Mota HC, Austerlitz C, Jenkins T, Sibata CH: Toward endobronchial Ir-192 high-dose-rate brachytherapy therapeutic optimization. Phys Med Biol 2007, 52: 2987-2999. 10.1088/0031-9155/52/11/004CrossRefPubMed
18.
go back to reference Lagerwaard FJ, Murrer LH, de Pan C, Roos M, Senan S: Mucosal dose prescription in endobronchial brachytherapy: a study based on CT-dosimetry. Radiat Oncol Biol 2000, 46: 1051-1059. 10.1016/S0360-3016(99)00483-6CrossRef Lagerwaard FJ, Murrer LH, de Pan C, Roos M, Senan S: Mucosal dose prescription in endobronchial brachytherapy: a study based on CT-dosimetry. Radiat Oncol Biol 2000, 46: 1051-1059. 10.1016/S0360-3016(99)00483-6CrossRef
19.
go back to reference Senan S, Lagerwaard FJ, de Pan C, Sipkema D, Burgers SA, Murrer LH: A CT-assisted method of dosimetry in brachytherapy of lung cancer. Rotterdam Oncological Thoracic Study Group. Radiother Oncol 2000, 55: 75-80.CrossRefPubMed Senan S, Lagerwaard FJ, de Pan C, Sipkema D, Burgers SA, Murrer LH: A CT-assisted method of dosimetry in brachytherapy of lung cancer. Rotterdam Oncological Thoracic Study Group. Radiother Oncol 2000, 55: 75-80.CrossRefPubMed
20.
go back to reference Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, Ewing M, Abdulrahman R, DesRosiers C, Williams M, Fletcher J: Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol 2006, 24: 4833-4839. 10.1200/JCO.2006.07.5937CrossRefPubMed Timmerman R, McGarry R, Yiannoutsos C, Papiez L, Tudor K, DeLuca J, Ewing M, Abdulrahman R, DesRosiers C, Williams M, Fletcher J: Excessive toxicity when treating central tumors in a phase II study of stereotactic body radiation therapy for medically inoperable early-stage lung cancer. J Clin Oncol 2006, 24: 4833-4839. 10.1200/JCO.2006.07.5937CrossRefPubMed
Metadata
Title
Long-term results of curative intraluminal high dose rate brachytherapy for endobronchial carcinoma
Authors
Hidemasa Kawamura
Takeshi Ebara
Hiroyuki Katoh
Tomoaki Tamaki
Hitoshi Ishikawa
Hideyuki Sakurai
Takashi Nakano
Publication date
01-12-2012
Publisher
BioMed Central
Published in
Radiation Oncology / Issue 1/2012
Electronic ISSN: 1748-717X
DOI
https://doi.org/10.1186/1748-717X-7-112

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