PERCUTANEOUS COMPUTED TOMOGRAPHY-GUIDED FINE-NEEDLE BRACHYTHERAPY OF PULMONARY MALIGNANCIES

Small caliber needle aspiration of lung lesions has been successfully and safely used for diagnostic purposes. We report our initial experie nce using computed tomography-guided fine needle percutaneous implanta tion for direct intralesional high-dose rate brachytherapy for maligna nt pulmonary lesions. Twenty patients with primary lung cancer or meta static cancer which involved the lung or chest wall were treated with a high-dose rate remote afterloader. Eighteen of the 20 patients also received external beam radiation in conjunction with intralesional rad iation therapy. Fourteen patients had primary lung cancer. A complete response was obtained in 5 of the 14 patients. Ten of the 14 patients with primary non-small-cell carcinoma of the lung showed a significant response to treatment (greater than 50 percent reduction in tumor mea surement). Six patients with metastatic lesions also were treated. Fiv e of the six showed a significant tumor response measured as either 50 percent reduction in tumor measurement or complete pain relief. The o nly significant complication was pneumothorax (6 of the 20), which did not prevent completion of any treatment plan.