High-Dose-Rate Brachytherapy for Non-Small-Cell Lung Carcinoma: A Retrospective Study of 226 Patients

Journal Article · Tue Mar 15 04:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.12.041· OSTI ID:21491663

Aumont-le Guilcher, Maud ^[1]; Prevost, Bernard ^[2]; Sunyach, Marie Pierre ^[3]; Peiffert, Didier ^[4]; Maingon, Philippe ^[5]; Thomas, Laurence ^[6]; Williaume, Daniele ^[7]; Begue, Mickael ^[8]; Lerouge, Delphine ^[9]; Campion, Loic ^[1]; Mahe, Marc-Andre ^[1]

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1. Centre Rene Gauducheau, Nantes (France)
2. Centre Oscar Lambret, Lille (France)
3. Centre Leon Berard, Lyon (France)
4. Centre Alexis Vautrin, Nancy (France)
5. Centre Georges-Francois Leclerc, Dijon (France)
6. Institut Bergonie, Bordeaux (France)
7. Centre Eugene Marquis, Rennes (France)
8. Institut Claudius Regaud, Toulouse (France)
9. Centre Francois Baclesse, Caen (France)

Purpose: To evaluate the efficacy and toxicity of high-dose-rate (HDR) brachytherapy in patients with inoperable endobronchial carcinoma. Methods and Materials: We retrospectively reviewed the records (April 1991-May 2004) of patients with non-small-cell carcinoma, with no extrabronchial spread on computed tomography scans, who underwent HDR brachytherapy because of contraindications to surgery and external beam radiation therapy. Kaplan-Meier survival curves were compared by the log-rank test. Prognostic factors were analyzed by multivariate analysis. Results: 226 patients (223 men, 3 women, mean age: 62.2 years (range, 40-84)) were included. Of those, 217 (97%) had squamous cell carcinoma (Tis/T1/T2/Tx: 60/153/9/4). Dose was prescribed at 1 cm from the radius (24-35 Gy in 4-6 fractions). Mean follow-up was 30.4 months (range, 9-116). Complete endoscopic response rate was 93.6% at 3 months. One hundred twenty-eight patients (56%) died of intercurrent disease (n = 45), local failure (n = 36), metastasis (n = 10), local failure and metastasis (n = 11), complications (n = 13), and other causes (n = 12). The 2-year and 5-year survival rates were, respectively, 57% and 29% (overall) (median, 28.6 months), 81% and 56% (cancer-specific), and 68% and 50% (local disease-free). Acute toxicity included pneumothorax (1.5%) and mucosal inflammation (10%). Late complications were hemoptysis (6.6% with 5% of fatalities), bronchitis (19.5%), and necrosis (3.5%). In multivariate analysis, a distal tumor location and the use of two catheters were associated with improved local disease-free survival (p = 0.003 and p = 0.007, respectively) and a distal tumor location with improved overall survival (p = 0.0001). Conclusions: This large retrospective study confirms that HDR brachytherapy is an efficient and safe treatment in patients with inoperable endobronchial carcinoma.

• OSTI ID: 21491663
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 79; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
BRACHYTHERAPY
BRONCHITIS
CARCINOMAS
COMPUTERIZED TOMOGRAPHY
DIAGNOSTIC TECHNIQUES
DISEASES
EFFICIENCY
FAILURES
INFLAMMATION
LUNGS
MATHEMATICS
MEDICINE
METASTASES
MULTIVARIATE ANALYSIS
NECROSIS
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PATHOLOGICAL CHANGES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
RESPIRATORY SYSTEM DISEASES
STATISTICS
SURVIVAL CURVES
SYMPTOMS
THERAPY
TOMOGRAPHY
TOXICITY