Endobronchial Brachytherapy of Advanced Non-small Cell Lung Carcinoma

Yoon, Won Sup; Choi, Myung Sun; Yang, Dae Sik; Kim, Tae Hyun; Kim, Chul Yong

Abstract

PURPOSE: To evaluate the effect of high-dose-rate endobronchial brachytherapy for symptomatic relief, tumor response and overall survival of advanced non-small cell lung carcinoma (NSCLC).
MATERIALS AND METHODS
Between July 1992 and July 2001, 37 patients with advanced NSCLC were analysed retrospectively. Group A patients (palliative aim, n=25) were treated using brachytherapy alone due to relapse after external beam radiation therapy (EBRT). Group B patients (curative aim, n=12) were treated using brachytherapy alone or combined EBRT due to untreated inoperable NSCLC or positive resection margin after radical resection. The dose per fraction was 3~6 Gy at a radius of 1cm from the center of the source and each patient received 2~3 fractions. The total dose of brachytherapy was 9~18 Gy (median 15 Gy). Each fraction separated by 1 week interval.
RESULTS
Symptomatic relief was obtained for cough (58.3% & 72.7%), dyspnea (56.3% & 75%) and hemoptysis (86.7% & 100%) in group A and B, respectively. The tumor improvement on bronchoscopy was obtained for complete response (28% & 60%) and partial response (64% & 40%) in group A and B, respectively. Median overall survival was 7 and 17.2 months for Group A and B, respectively. In group A, mediastinal node metastasis (p=0.039) and Karnofsky performance scale (p=0.062) was independent prognostic factor by univariate analysis. After radical therapy, 7 symptomatic radiation pneumonitis, 4 hemoptysis and 1 pneumothorax were observed.
CONCLUSION
Endobronchial brachytherapy was effective for symptomatic relief of hemoptysis. In curative aim, we think that survival improvement may be expected in some selected patients