High-dose-rate brachytherapy as sole modality for early-stage endobronchial carcinoma

Purpose: To evaluate exclusive high-dose-rate brachytherapy for localized e arly-stage non-small-cell bronchial carcinoma; to develop new insights in t reatment-catheter positioning and tumor-volume assessment by computed tomog raphy (CT) scan. Methods and Materials: Between 1992 and 1996, 34 patients with non-small-ce ll bronchial carcinoma were treated by brachytherapy alone. All patients we re medically inoperable and had contraindications for external beam irradia tion, The treatment protocol was six sessions of 5 Gy over 6 weeks, The tre atment catheter was placed under fiberoscopy and was positioned with the he lp of spacer catheters or with a surrounding plastic tube; CT scan was perf ormed in 50% of the cases to measure the spacing between the applicator and the bronchial wall. Dose prescription was individually based on clinical a nd radiologic evaluation of tumor volume. Results: Local disease failure occurred in 5 patients (15%), With a median follow-up of 2 years, the local control rate was 85% and the survival rate 78%, No acute toxicity was found, except one pneumothorax. Conclusion: Brachytherapy alone can give an optimal therapeutic ratio in sm all endobronchial carcinomas without radiation-induced morbidity, Such resu lts are achieved after careful tumor volume evaluation and individualized t reatment catheter positioning. (C) 2000 Elsevier Science Inc.