Treatment of recurrent bronchial carcinoma: the role of high-dose-rate endoluminal brachytherapy.

Abstract

PURPOSE:

This study's aim was to assess outcome and toxicity of high-dose-rate endoluminal brachytherapy (HDREB) for recurrent bronchial carcinoma.

METHODS AND MATERIALS:

From 1987 to 2005, 41 patients were treated with HDREB for symptomatic recurrent bronchial carcinoma. All patients had previously undergone external beam radiotherapy (EBRT) with a median dose of 56 Gy (range, 30-70 Gy). The median HDREB dose applied was 15 Gy (range, 5-29 Gy). The median time interval between primary EBRT and reirradiation was 9 months (range, 2-54 months).

RESULTS:

After a median follow-up of 6.7 months, the 6-, 12-, and 24-month overall survival rates were 58%, 18%, and 7%, respectively. The median overall survival time was 6.7 months. Local remission was achieved in 73% of patients (n = 30). A total of 24% of patients (n = 10) showed no response or progressive disease within 8 weeks after treatment. In 1 patient, treatment response was not documented. The 6-, 12-, and 24-month local control rates were 38%, 17%, and 3%, respectively. The median local progression-free survival time was 4 months (range, 1-23 months). Prognostic factors were a total dose of >or=15 Gy of HDREB (p = 0.029) and a Karnofsky performance score of >or=80% (p = 0.0012). The cause of death was locoregional progression in 27% of patients (n = 11), distant metastases in 24% of patients (n = 10), fatal hemorrhage in 15% of patients (n = 6), and other causes in 29% of patients (n = 12). None of the patients with locally controlled disease showed grade 3 or 4 late effects.

CONCLUSIONS:

Palliative treatment of symptomatic, locally recurrent bronchial carcinoma with HDREB can effectively relieve symptoms in the majority of patients while causing only few complications. Still, time to progression is short.

• Authors: Henrik Hauswald, Eva Stoiber, Nathalie Rochet, Katja Lindel, Christian Grehn, Heinrich D Becker, Juergen Debus, Wolfgang Harms
• Journal: International journal of radiation oncology, biology, physics (Int J Radiat Oncol Biol Phys) Vol. 77 Issue 2 Pg. 373-7 (Jun 01 2010) ISSN: 1879-355X [Electronic] United States
• PMID: 19836162 (Publication Type: Journal Article)
• Copyright: Copyright 2010 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Brachytherapy (adverse effects, methods)
• Carcinoma, Bronchogenic (mortality, radiotherapy)
• Cause of Death
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Lung Neoplasms (mortality, radiotherapy)
• Male
• Middle Aged
• Neoplasm Recurrence, Local (mortality, radiotherapy)
• Palliative Care
• Radiation Injuries (complications, pathology)
• Radiotherapy Dosage
• Retreatment
• Retrospective Studies
• Treatment Outcome