The effects of high dose rate brachytherapy in recurrent obstructive bronchogenic cancer after external irradiation therapy

Background: Patients with centrally recurred bronchogenic carcinoma make a complaint of many symptoms like hemoptysis, cough and dyspnea. At these conditions, the goal of treatment is only to relieve their symptoms. High dose rate brachytherapy (HDR-BT) is the palliative treatment modality of centrally located endobronchial tumor regardless of previous external irradiation (XRT) on the same site in symptomatic patients. Methods: We studied the effects of HDR-BT in 26 patients with symptomatic recurrent lung cancer. Patients (male: 24, mean age: 54 yrs) were treated with HDR-BT underwent bronchoscopic placement of ¹⁹²Ir HDR after loading unit (Gammamed®, Germany) to deliver 500cGY intraluminal irradiation at a depth of 1cm every 1wk on 3 occasions. Evaluation at base line and 4wks after HDR brachytherapy included chest X-ray, bronchoscopy, symptoms (Standardized Scale for dyspnea cough, hemoptysis), and Karnofsky performance Results: Endobronchial obstruction was improved in 11/26 patients (37%). A telectasis in chest X-ray was improved in 5/15 patients (33%). Hemoptysia, dyspnea and cough were improved in 5/10 patients (50%), 5/8 patients (62%) and 10/18 patients (56%) respectively. Karnofsky performance status was changed from 76.4 scores in pretreatment to 77.6 scores after treatment. During HDR-BT, massive hemoptysis (2 patients) and pneumothorax(1 patient) were occurred as complications. Conclusion: We concluded that HDR-BT gave additional benefits for the control of symptoms and general performance and endobronchial obstruction and atelectasis. And HDR-BT will be an additional treatment for the recurrent and endobronchial obstructive lung cancer.