The treatment results of 40 patients with localized endobronchial cancer with external beam irradiation and intraluminal irradiation using low dose rate Ir-192 thin wires with a new catheter

Background and purpose: While bronchial intraluminal irradiation is valued highly as a useful palliative treatment for lung cancer, its role as a cura tive treatment is unclear. The treatment results of 40 localized enbobronch ial tumors (including tracheal cancer) who underwent external beam irradiat ion (EBR) and intraluminal irradiation (IR) as a curative treatment is repo rted, and the role of combined EBR and IR as a curative potential treatment is examined. Materials and methods: Forty patients, including 22 with roentgenographical ly occult lung cancer (ROLC), 14 (18 lesions) with postoperative recurrent lung cancer (PORLC) and four with tracheal cancer, who underwent EBR and IR from February 1987 to August 1996, were studied. IR was conducted using lo w dose rate (1.48 GBq) Ir-192 thin wires at a bronchial mucosal dose of 4-6 Gy per fraction, with a total dose of 10-57 Gy (median 28 Gy). All patient s were also given combined external Linac X-ray irradiation for a total dos e of 30-77 Gy (median 52 Gy). Results: As for the primary effect, complete response (CR) was obtained in all 22 ROLC cases; CR was obtained in 12 (16 lesions), partial response (PR ) in one and minor response (MR) in one of the PORLC cases; and CR was obta ined in three and PR in one of the tracheal cancer cases. The 3-year and 5- year local control rate by Kaplan-Meier method was 75 and 65%, respectively . Twenty-two patients survived for 3 years or longer. Complications include d one ease each of fatal tracheal hemorrhage, bronchial mucosal ulcer and b ronchial stenosis. Conclusions: Combined EBR and IR is useful as a curative potential treatmen t, and long-term survival can be expected in ROLC, tracheal cancer and a po rtion of PORLC cases. (C) 2000 Elsevier Science Ireland Ltd. All rights res erved.