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Strahlentherapie und Onkologie

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Open Access 20-10-2022 | Tuberculosis | Original Article

Stereotactic body radiotherapy for recurrent hemoptysis due to chronic pulmonary aspergillosis: a case report and systematic review of the literature

Authors: Alexander Koch, Daniel H. Schanne, Gunar Günther, Daniel M. Aebersold, Olgun Elicin

Published in: Strahlentherapie und Onkologie | Issue 2/2023

Abstract

Purpose

Chronic pulmonary aspergillosis (CPA) can manifest as fungus balls in preexisting cavities of lung parenchyma and recurrent hemoptysis is among the most frequent complications. Radiotherapy can be considered for treatment-refractory aspergilloma and severe hemoptysis. To the best of our knowledge, we present the first application of stereotactic body radiotherapy (SBRT) for a pulmonary aspergilloma in a patient with limited functional lung capacity. The topic was further expanded on with a systematic review of the literature addressing the implementation of radiotherapy in CPA patients.

Case report

A 52-year-old man presented with recurring and treatment-refractory hemoptysis caused by chronic cavitary aspergillosis localized in the left lower lobe. We applied SBRT on two consecutive days with a total dose of 16 Gy. Hemoptysis frequency decreased to a clinically insignificant level.

Systematic review

We performed a systematic search of the literature in line with the PRISMA statement. The initial PubMed search resulted in 230 articles, of which 9 were included.

Results

The available literature contained 35 patients with CPA who received radiotherapy. Dose fractionation usually ranged from 2 to 4 Gy per fraction, applied almost exclusively in conventional two-dimensional (2D) techniques. There is no report of SBRT usage in such a scenario. Most cases report a positive treatment response after irradiation.

Conclusion

The presented case demonstrates long-term clinical stability after SBRT for recurrent hemoptysis due to pulmonary aspergilloma. The systematic literature search revealed that concept definition is still uncertain, and further work is necessary to establish radiotherapy in clinical practice.

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Title: Stereotactic body radiotherapy for recurrent hemoptysis due to chronic pulmonary aspergillosis: a case report and systematic review of the literature
Authors: Alexander Koch
Daniel H. Schanne
Gunar Günther
Daniel M. Aebersold
Olgun Elicin
Publication date: 20-10-2022
Publisher: Springer Berlin Heidelberg
Keywords: Tuberculosis
Hemoptysis
Aspergillosis
Tuberculosis
Radiotherapy
Hemoptysis
Published in: Strahlentherapie und Onkologie / Issue 2/2023
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-022-02013-1

At a glance: The STEP trials

Springer Medicine

Stereotactic body radiotherapy for recurrent hemoptysis due to chronic pulmonary aspergillosis: a case report and systematic review of the literature

Abstract

Purpose

Case report

Systematic review

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Case report

Systematic review

Results

Conclusion

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