Primary Radiotherapy with Endobronchial High-Dose-Rate Brachytherapy Boost for Inoperable Lung Cancer: Long-Term Results. Issue 2 (March 2013)

• Record Type: Journal Article
• Authors: Rochet, Nathalie; Hauswald, Henrik; Stoiber, Eva Maria; Hensley, Frank W; Becker, Heinrich D; Debus, Juergen; Lindel, Katja
• Is Part Of: Tumori. Volume 99:Issue 2(2013)
• Page Start: 183
• Page End: 190
• Publication Date: 2013-03
• Subjects: external beam radiotherapy -- high-dose rate endobronchial brachytherapy -- irradiation -- non-small-cell lung cancer; Cancer -- Periodicals; 616.994
• DOI: 10.1177/030089161309900211
• Languages: English
• ISSNs: 0300-8916

Abstract

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.