Primary Radiotherapy with Endobronchial High-Dose-Rate Brachytherapy Boost for Inoperable Lung Cancer: Long-Term Results
| Autor: | Nathalie, Rochet, Henrik, Hauswald, Eva Maria, Stoiber, Frank W, Hensley, Heinrich D, Becker, Juergen, Debus, Katja, Lindel |
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| Rok vydání: | 2013 |
| Předmět: |
Male
Hemoptysis Cancer Research Lung Neoplasms Brachytherapy Bronchi Constriction Pathologic Kaplan-Meier Estimate Disease-Free Survival 030218 nuclear medicine & medical imaging Necrosis 03 medical and health sciences 0302 clinical medicine Carcinoma Non-Small-Cell Lung Humans Bronchitis Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Radiotherapy Dosage General Medicine Middle Aged Iridium Radioisotopes Trachea Treatment Outcome Oncology 030220 oncology & carcinogenesis Female Dose Fractionation Radiation |
| Zdroj: | Tumori Journal. 99:183-190 |
| ISSN: | 2038-2529 0300-8916 |
| DOI: | 10.1177/030089161309900211 |
| Popis: | Background To retrospectively evaluate the outcome of patients with inoperable non-small-cell lung cancer treated with primary external beam radiotherapy combined with high-dose-rate endobronchial brachytherapy boost. Patients and methods Between 1988 and 2005, 35 patients with non-small-cell lung cancer (stage I-III) ineligible for surgical resection and/or chemotherapy, were primarily treated with external beam radiotherapy with a median total dose of 50 Gy (range, 46–60). A median of 3 fractions high-dose-rate endobronchial brachytherapy was applied as a boost after external beam radiotherapy, the median total dose was 15 Gy (range, 8–20). High-dose-rate endobronchial brachytherapy was carried out with iridium-192 sources (370 GBq) and prescribed to 1 cm distance from the source axis. Results With a median follow-up of 26 months from the first fraction of high-dose-rate endobronchial brachytherapy, the 1-, 2- and 5-year overall (local progression-free) survival rates were 76% (76%), 61% (57%) and 28% (42%), respectively. Complete or partial remission rates 6 to 8 weeks after treatment were 57% and 17%, respectively. Significant prognostic favorable factors were a complete remission 6–8 weeks after treatment and a negative nodal status. In patients without mediastinal node involvement, a long-term local control could be achieved with 56% 5-year local progression-free survival. Common Toxicity Criteria grade 3 toxicities were hemoptysis (n = 2) and necrosis (n = 1). One fatal hemoptysis occurred in combination with a local tumor recurrence. Conclusions The combination of external beam radiotherapy with high-dose-rate endobronchial brachytherapy boost is an effective primary treatment with acceptable toxicity in patients with non-small-cell lung cancer ineligible for surgical resection and/or chemotherapy. |
| Databáze: | OpenAIRE |
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