Management of malignant airway compromise with laser and low dose rate brachytherapy. The Mayo Clinic experience

Journal Article · Mon Feb 01 00:00:00 EST 1988 · Chest; (United States)

OSTI ID:5355494

Schray, M F; McDougall, J C; Martinez, A; Cortese, D A; Brutinel, W M

Between January 1983 and October 1985, 65 patients with malignant airway compromise have had 93 flexible bronchoscopic placements of a nylon afterloading catheter for low dose rate iridium-192 temporary intraluminal brachytherapy. All patients received prior (59 patients) and/or concurrent (13 patients) external beam irradiation to tolerance and were not candidates for surgery. Forty of these patients also received neodymium-YAG laser treatment prior to brachytherapy in a planned combined approach to provide immediate symptomatic relief and facilitate catheter placement. A dose of 3000 cGy is prescribed to 5 mm and 10 mm radii over 20-40 hours in the bronchus and trachea, respectively. Of 59 patients treated with palliative intent, 40 patients (68%) have had follow-up bronchoscopy, 18 patients have had clinical follow-up only, and one patient was lost to follow-up. Of 40 patients examined by bronchoscope in follow-up, 24 (60%) responded, eight were stable, and eight progressed. Lack of progression after prior external beam radiation for periods of greater than 12 months, six-12 months and less than six months yielded response rates to brachytherapy in 83, 50 and 31%, respectively. Most patients with clinical follow-up only expired at early intervals with airway palliation from extra-airway disease progression. Four of five patients treated with curative intent are disease-free at a median of 16 months. Eleven patients have experienced fistula and/or hemorrhage, of which seven instances (11% of all patients) appear to be treatment-induced. This brachytherapy technique is simple, well tolerated, and convenient for the patient providing airway palliation in the significant majority of patients with acceptable risk.

• Research Organization: Mayo Clinic, Rochester, MN (USA)
• OSTI ID: 5355494
• Journal Information: Chest; (United States), Vol. 93:2
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
LASER RADIATION
BIOLOGICAL EFFECTS
NEOPLASMS
RADIOTHERAPY
RESPIRATORY SYSTEM
IRIDIUM 192
NEODYMIUM LASERS
PATIENTS
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTROMAGNETIC RADIATION
ELECTRON CAPTURE RADIOISOTOPES
HEAVY NUCLEI
INTERNAL CONVERSION RADIOISOTOPES
IRIDIUM ISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LASERS
MEDICINE
MINUTES LIVING RADIOISOTOPES
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
RADIATIONS
RADIOISOTOPES
RADIOLOGY
SOLID STATE LASERS
THERAPY
YEARS LIVING RADIOISOTOPES
550600* - Medicine
550604 - Medicine- Unsealed Radionuclides in Therapy- (1980-)
560400 - Other Environmental Pollutant Effects