Cancer Res Treat.  2015 Apr;47(2):189-196. 10.4143/crt.2013.261.

The Efficacy of External Beam Radiotherapy for Airway Obstruction in Lung Cancer Patients

• Lee JW
• Lee JH
• Kim HK
• Shim BY
• An HJ
• Kim SH

• KMID: 2132797
• DOI: http://doi.org/10.4143/crt.2013.261

Abstract

PURPOSE
The objective of this study was to evaluate external beam radiotherapy (EBRT) in lung cancer patients who suffer from airway obstruction.
MATERIALS AND METHODS
Medical data of 95 patients with a lung mass that obstructed the airway and received EBRT for it were analyzed. Fifty-nine patients (62.1%) had non-small cell lung cancer and 36 patients (37.9%) had small cell lung cancer. Radiotherapy was given at 8 to 45 Gy (median, 30 Gy) in 1 to 15 fractions (median, 10 fractions). The response to EBRT was assessed through changes in radiographic findings and/or subjective symptoms between before and after EBRT. The median follow-up duration was 124 days. The primary end point was the airway-obstruction resolving rate after EBRT. The secondary end points were patient survival and toxic effects of EBRT.
RESULTS
Improvement of airway obstruction after EBRT on chest X-ray was achieved in 75 of 95 patients (78.9%). The median time for resolving the radiologic findings and/or symptoms of airway obstruction after EBRT was 7 days (range, 1 to 76 days). The 1-year survival rate was significantly higher in responders than non-responders (12.5% vs. 0.0%, p < 0.001). The biologically effective dose of > or = 39 Gyalpha/beta=10 (p < 0.01) and the longest obstructive lesion of < 6 cm (p=0.04) were significantly associated with a good response to EBRT in resolving the airway obstruction. No one had grade 3 or higher acute and chronic toxicities.
CONCLUSION
EBRT is an effective treatment in relieving airway obstruction without severe toxicities in lung cancer patients.

Keyword

Lung neoplasm; Radiotherapy; Airway obstruction

MeSH Terms

Airway Obstruction*
Carcinoma, Non-Small-Cell Lung
Follow-Up Studies
Humans
Lung
Lung Neoplasms*
Radiotherapy*
Small Cell Lung Carcinoma
Survival Rate
Thorax

Figure

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  Fig. 1. The 1-year survival rate for all patients with a bronchial obstruction was 9.9%.

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  Fig. 2. The 1-year survival rate for responders to the irradiation was significantly higher than non-responders (12.5% vs. 0%, p < 0.001).

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  Fig. 3. A patient with small cell carcinoma had obstructive pneumopathy in right upper lobe and received a radiation dose of 30 Gy in 10 fractions. (A) There was an obstructive lesion in right upper lobe at the initial chest X-ray and computed tomography (CT). (B) Radiation-dose distributions in axial and coronal planning CT image. (C) Follow-up chest X-ray and CT showed an improvement of obstruction in right upper lobe 7 days after external beam radiotherapy.

Reference

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