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  • Title: Treatment of recurrent bronchial carcinoma: the role of high-dose-rate endoluminal brachytherapy.
    Author: Hauswald H, Stoiber E, Rochet N, Lindel K, Grehn C, Becker HD, Debus J, Harms W.
    Journal: Int J Radiat Oncol Biol Phys; 2010 Jun 01; 77(2):373-7. PubMed ID: 19836162.
    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.
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