Abstract |
Endobronchial brachytherapy (EBB) is an effective treatment for endobronchial tumors. However, bronchial toxicity caused by over-irradiation remains problematic. To decrease bronchial toxicity, we developed a source-centralizing applicator for EBB. The purpose of the present study was to assess the efficacy and safety of EBB with varying reference dose points according to the bronchial diameter, using a source-centralizing applicator. We reviewed 15 patients with endobronchial carcinoma who were treated with curative intent using a combination of external beam radiotherapy (EBRT) and high-dose-rate EBB between 2005 and 2014. During each EBB session, we used a source-centralizing applicator that maintained the source-delivering catheter in the center of the bronchial lumen. Reference dose points were 5-7 mm from the source axis, depending on the bronchial diameter. The median radiation doses of EBRT and EBB were 40 Gy in 20 fractions and 18 Gy in 3 fractions, respectively. The median observation period was 36 months. The 3-year overall survival, progression-free survival and local control rates were 79%, 77% and 100%, respectively. Grade 2 radiation pneumonitis was observed in two cases. Bronchial toxicities, such as hemoptysis or the symptoms of chronic bronchitis, were not observed. EBB with varying reference dose points according to bronchial diameter, using a source-centralizing applicator, is a promising procedure that may be effective for tumor elimination and reducing toxicity to the bronchial wall.
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Authors | Yoshihito Nomoto, Noriko Ii, Shuichi Murashima, Yasufumi Yamashita, Satoru Ochiai, Akinori Takada, Yutaka Toyomasu, Tomoko Kawamura, Hajime Sakuma |
Journal | Journal of radiation research
(J Radiat Res)
Vol. 58
Issue 6
Pg. 849-853
(Nov 01 2017)
ISSN: 1349-9157 [Electronic] England |
PMID | 29106573
(Publication Type: Journal Article)
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Copyright | © The Author 2017. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology. |
Topics |
- Aged
- Aged, 80 and over
- Brachytherapy
- Bronchi
(pathology, radiation effects)
- Disease-Free Survival
- Dose-Response Relationship, Radiation
- Female
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Reference Standards
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