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KMID : 0982820030020020110
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Journal of Lung Cancer
2003 Volume.2 No. 2 p.110 ~ p.115
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Endobronchial Brachytherapy of Advanced Non-small Cell Lung Carcinoma
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Yoon Won-Sup
Choi Myung-Sun
Yang Dae-Sik
Kim Tae-Hyun
Kim Chul-Yong
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Abstract
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Purpose: To evaluate the effect of high-dose-rate endobronchial brachytherapy for symptomatic relief, tumor response and overall survival of advanced non-small cell lung carcinoma (NSCLC).
Materials and Methods: Between July 1992 and July 2001, 37 patients with advanced NSCLC were analysed retrospectively. Group A patients (palliative aim, n=25) were treated using brachytherapy alone due to relapse after external beam radiation therapy (EBRT). Group B patients (curative aim, n=12) were treated using brachytherapy alone or combined EBRT due to untreated inoperable NSCLC or positive resection margin after radical resection. The dose per fraction was 3∼6 Gy at a radius of 1cm from the center of the source and each patient received 2∼3 fractions. The total dose of brachytherapy was 9∼18 Gy (median 15 Gy). Each fraction separated by 1 week interval.
Results: Symptomatic relief was obtained for cough (58.3% & 72.7%), dyspnea (56.3% & 75%) and hemoptysis (86.7% & 100%) in group A and B, respectively. The tumor improvement on bronchoscopy was obtained for complete response (28% & 60%) and partial response (64% & 40%) in group A and B, respectively. Median overall survival was 7 and 17.2 months for Group A and B, respectively. In group A, mediastinal node metastasis (p=0.039) and Karnofsky performance scale (p=0.062) was independent prognostic factor by univariate analysis. After radical therapy, 7 symptomatic radiation pneumonitis, 4 hemoptysis and 1 pneumothorax were observed.
Conclusion: Endobronchial brachytherapy was effective for symptomatic relief of hemoptysis. In curative aim, we think that survival improvement may be expected in some selected patients.
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KEYWORD
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Non-small cell lung carcinoma, Endobronchial brachytherapy
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