Combined laser therapy and endobronchial radiotherapy for unresectable lung carcinoma with bronchial obstruction

Journal Article · Mon Jul 01 04:00:00 EDT 1985 · Am. J. Surg.; (United States)

DOI:https://doi.org/10.1016/0002-9610(85)90012-1· OSTI ID:5244655

Allen, M D; Baldwin, J C; Fish, V J; Goffinet, D R; Cannon, W B; Mark, J B

Over a 4 year period, the authors refined a protocol for treatment of airway obstruction due to recurrent lung carcinoma. Patients undergo bronchoscopy with the Nd:YAG laser available on standby. If bronchial obstruction is found to be due to extrinsic compression, an endobronchial catheter is inserted for iridium 192 brachytherapy, treating a cylindrical volume 7.5 to 15 mm in radius. If an endobronchial lesion is found, the presence of complete versus partial bronchial obstruction determines the course of treatment. Total airway obstruction is treated with the laser until a channel is created and then an endobronchial catheter is placed for adjuvant endobronchial radiotherapy to treat a cylindrical volume 5 mm in radius. Partial airway obstruction is treated with an endobronchial catheter and radiotherapy alone. Segmental obstruction is also treated with a distally placed endobronchial catheter instead of the laser. Using this protocol, the authors hope to minimize risk to the patient by restricting the use of the laser with its inherent higher potential rate of complications to cases of total obstruction. In addition, they expect to prolong the duration of palliation with endobronchial radiotherapy. The laser is an excellent tool to reopen occluded bronchi, but it is relatively ineffective in producing long-term tumor control. Instead, the authors have found that placement of a temporary transtracheal endobronchial catheter for radiotherapy is a simple, low-risk procedure that can be safely performed even in critically ill patients. The endobronchial catheter can provide good to excellent long-term palliation for patients with both partially and totally obstructed endobronchial lesions or malignant extrinsic compression of major airways.

• Research Organization: Stanford Univ. School of Medicine, CA
• OSTI ID: 5244655
• Journal Information: Am. J. Surg.; (United States), Journal Name: Am. J. Surg.; (United States) Vol. 1; ISSN AJSUA
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BODY
CARBON COMPOUNDS
CARBON DIOXIDE
CARBON OXIDES
CARCINOMAS
CHALCOGENIDES
DAYS LIVING RADIOISOTOPES
DISEASES
ELECTRON CAPTURE RADIOISOTOPES
ELEMENTS
HEAVY NUCLEI
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IRIDIUM 192
IRIDIUM ISOTOPES
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
LASERS
LUNGS
MEDICINE
MINUTES LIVING RADIOISOTOPES
NEOPLASMS
NONMETALS
NUCLEAR MEDICINE
NUCLEI
ODD-ODD NUCLEI
ORGANS
OXIDES
OXYGEN
OXYGEN COMPOUNDS
PATIENTS
RADIOISOTOPES
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
RISK ASSESSMENT
SYNERGISM
THERAPY
USES
YEARS LIVING RADIOISOTOPES