Abstract
BackgroundThe treatment strategy of central lung tumors is not established. Intraluminal brachytherapy (ILBT) is widely used for palliative treatment of endobronchial tumors, however, it is also a promising option for curative treatment with limited data. This study evaluates the results after ILBT for endobronchial carcinoma.MethodSixteen-endobronchial carcinoma of 13 patients treated with ILBT in curative intent for 2000 to 2008 were retrospectively reviewed. ILBT using high dose rate 192 iridium thin wire system was performed with 5 Gy/fraction at mucosal surface. The patient age ranged from 57 to 82 years old with median 75 years old. The 16 lesions consisted of 13 central endobronchial cancers including 7 roentgenographically occult lung cancers and 3 of tracheal cancers. Of them, 10 lesions were treated with ILBT of median 20 Gy combined with external beam radiation therapy of median 45 Gy and 6 lesions were treated with ILBT alone of median 25 Gy.ResultsMedian follow-up time was 32.5 months. Two-year survival rate and local control rate were 92.3% and 86.2%, respectively. Local recurrences were observed in 2 lesions. Three patients died due to lung cancer (1 patient) and intercurrent disease (2 patients). Complications greater than grade 2 were not observed except for one grade 3 dyspnea.ConclusionsILBT combined with or without EBRT might be a curative treatment option in inoperable endobronchial carcinoma patients with tolerable complication.
Highlights
The treatment strategy of central lung tumors is not established
The charts of 16 lesions with 13 endobronchial carcinoma patients treated with Intraluminal brachytherapy (ILBT) in 2000 to 2008 were retrospectively reviewed
Roentgenographically occult early endbronchial cancer (ROEC) is defined as follows; The tumor can not be detected with X-ray and computed tomography (CT) scans, located in sub segmental or more proximal bronchi, size is less than 2 cm, peripheral margin is visible bronchoscopically, and is identified as squamous cell carcinoma histologically
Summary
The treatment strategy of central lung tumors is not established. Intraluminal brachytherapy (ILBT) is widely used for palliative treatment of endobronchial tumors, it is a promising option for curative treatment with limited data. This study evaluates the results after ILBT for endobronchial carcinoma. With the recent advance in diagnostic techniques, increasing number of small lung tumors has been detected. Widespread use of bronchoscopy and sputum cytology detects tumors localized in the bronchial lumen. Surgery is regarded as the first choice of treatment for endobronchial carcinoma. Endobronchial carcinoma is usually detected in high-risk patient and it is not rare that the patient has poor pulmonary function. 10% of patients have synchronous or non-synchronous multiple lesions [1,2]. Because of the poor pulmonary function and multiple
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