Interstitial single fraction brachytherapy for malignant pulmonary tumours
| Autor: | Michael Pinkawa, Hathal Haddad, Susanne Temming, Andreas Schäfer, Ali Rashid, Attila Kovács, Peter Bischoff, Horst Hermani |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Organs at Risk medicine.medical_specialty Lung Neoplasms medicine.medical_treatment Brachytherapy Hemorrhage Kaplan-Meier Estimate Adenocarcinoma 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Esophagus Interquartile range Carcinoma Non-Small-Cell Lung Medicine Brachytherapies Humans Radiology Nuclear Medicine and imaging Lung cancer Radiation Injuries Thoracic Wall Aged Aged 80 and over Lung business.industry Pneumothorax Dose-Response Relationship Radiation Heart Radiotherapy Dosage Sarcoma Middle Aged medicine.disease Radiation therapy medicine.anatomical_structure Oncology Spinal Cord 030220 oncology & carcinogenesis Female Radiology business Colorectal Neoplasms Thoracic wall Radiotherapy Image-Guided |
| Zdroj: | Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. 197(5) |
| ISSN: | 1439-099X |
| Popis: | Interstitial brachytherapy for pulmonary tumours is an alternative to stereotactic radiotherapy, allowing high conformity despite it being an invasive technique. The aim of the study was the analysis of dose distribution, toxicity and tumour response rates. In the years 2014–2019, 27 patients with pulmonary tumours received 36 interstitial brachytherapies with Ir-192: 11 patients with non-small cell lung cancer, 16 patients with pulmonary metastases of other entities. Patients were treated with a median (interquartile range) prescription dose of 20 (20–26) Gy in a single fraction. Mean lung dose to the ipsilateral lung was 2.8 (1.6–4.7) Gy. Maximum doses to the heart, oesophagus, thoracic wall and spinal cord were 2.4 (1.8–4.6) Gy, 2.0 (1.2–6.2) Gy, 12.6 (8.0–18.2) Gy and 1.5 (0.6–3.9) Gy. Median survival after treatment was 15 months, with a 1- and 2‑year local control of 84% and 60%. Median overall survival after initial cancer diagnosis was 94 months; 2 years following brachytherapy, 75% of patients with colorectal cancer vs. 37% with other histologies were alive; p = 0.14. In 69% (n = 25), brachytherapy could be performed without acute complications. A self-limiting bleeding occurred in 8% (n = 3), fever in 3% (n = 1), pneumothorax in 17% (n = 6), and pulmonary failure in 3% (n = 1). Patients with > 20 Gy in 95% of planning target volume had higher pneumothorax rates needing intervention (31% vs. 5%, p = 0.04). Interstitial brachytherapy for pulmonary tumours is a highly conformal therapy with minimal doses to the organs at risk. For the majority of patients, treatment can be performed without relevant complications in a single fraction with a satisfactory local control. |
| Databáze: | OpenAIRE |
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