[The results of the endoluminal high-dose-rate irradiation of central non-small cell bronchial carcinomas]. 1993

P Schraube, and P Fritz, and H D Becker, and M Wannenmacher
Radiologische Klinik, Universität Heidelberg.

Between November 1987 and July 1991 34 patients with a non-small-cell lung cancer were treated with an endobronchial iridium-192 high-dose-rate afterloading therapy. In 13 patients with relapses after percutaneous irradiation brachytherapy was the sole radiotherapy modality with 20 (5 to 29) Gy within 14 (one to 42) days in four (one to six) fractions in a palliative sense. Endoscopically controlled, seven remissions (four complete, three partial) could be achieved. The median duration to local progression was two months, the median survival of this group was nine months. In 21 patients with a medically or surgically unresectable tumor a combined percutaneous (51 [46 to 60] Gy within 4.5 to six weeks) and endobronchial irradiation was done. This patient group consisted of one stage IV, eight stage IIIb, 8 stage IIIa, 1 stage II, 1 stage I patients and two patients with tumor relapses after surgery. Patients were selected for combined therapy by a mostly endo/peribronchial tumor volume. The brachytherapy was applied after an interval of 16 (one to 48) days with 17.5 (9 to 20) Gy in three to four fractions. In 13 patients six to eight weeks after treatment a complete remission by endoscopy was found. Patients with a complete remission had a statistically better survival than the remaining patients. The median estimated survival of this group until local progression was 16 months, the median survival 20 months. In all patients there were two occurrences of hemorrhage (one group I, one group II) and one tracheo-mediastinal fistula (group II), but in no case of these fatal events a local tumor control had been reached. In three patients radiogenic bronchitis occurred up to a degree, which demanded endoscopic interventions. This study suggests, that there might be a subgroup of centrally located lung cancer with endo/peribronchial tumor mass, which gains by a combined radiation treatment with an acceptable risk of side effects. The results should be evaluated in further randomized studies.

UI MeSH Term Description Entries
D007496 Iridium Radioisotopes Unstable isotopes of iridium that decay or disintegrate emitting radiation. Ir atoms with atomic weights 182-190, 192, and 194-198 are radioactive iridium isotopes. Radioisotopes, Iridium
D008175 Lung Neoplasms Tumors or cancer of the LUNG. Cancer of Lung,Lung Cancer,Pulmonary Cancer,Pulmonary Neoplasms,Cancer of the Lung,Neoplasms, Lung,Neoplasms, Pulmonary,Cancer, Lung,Cancer, Pulmonary,Cancers, Lung,Cancers, Pulmonary,Lung Cancers,Lung Neoplasm,Neoplasm, Lung,Neoplasm, Pulmonary,Pulmonary Cancers,Pulmonary Neoplasm
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D009367 Neoplasm Staging Methods which attempt to express in replicable terms the extent of the neoplasm in the patient. Cancer Staging,Staging, Neoplasm,Tumor Staging,TNM Classification,TNM Staging,TNM Staging System,Classification, TNM,Classifications, TNM,Staging System, TNM,Staging Systems, TNM,Staging, Cancer,Staging, TNM,Staging, Tumor,System, TNM Staging,Systems, TNM Staging,TNM Classifications,TNM Staging Systems
D011879 Radiotherapy Dosage The total amount of radiation absorbed by tissues as a result of radiotherapy. Dosage, Radiotherapy,Dosages, Radiotherapy,Radiotherapy Dosages
D012074 Remission Induction Therapeutic act or process that initiates a response to a complete or partial remission level. Induction of Remission,Induction, Remission,Inductions, Remission,Remission Inductions
D001918 Brachytherapy A collective term for interstitial, intracavity, and surface radiotherapy. It uses small sealed or partly-sealed sources that may be placed on or near the body surface or within a natural body cavity or implanted directly into the tissues. Curietherapy,Implant Radiotherapy,Plaque Therapy, Radioisotope,Radioisotope Brachytherapy,Radiotherapy, Interstitial,Radiotherapy, Intracavity,Radiotherapy, Surface,Brachytherapy, Radioisotope,Interstitial Radiotherapy,Intracavity Radiotherapy,Radioisotope Plaque Therapy,Radiotherapy, Implant,Surface Radiotherapy,Therapy, Radioisotope Plaque
D001980 Bronchi The larger air passages of the lungs arising from the terminal bifurcation of the TRACHEA. They include the largest two primary bronchi which branch out into secondary bronchi, and tertiary bronchi which extend into BRONCHIOLES and PULMONARY ALVEOLI. Primary Bronchi,Primary Bronchus,Secondary Bronchi,Secondary Bronchus,Tertiary Bronchi,Tertiary Bronchus,Bronchi, Primary,Bronchi, Secondary,Bronchi, Tertiary,Bronchus,Bronchus, Primary,Bronchus, Secondary,Bronchus, Tertiary

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