• Title/Summary/Keyword: Endobronchial Brachytherapy

Search Result 6, Processing Time 0.066 seconds

Short-term Results of Endobronchial Brachytherapy for Malignant Airway Obstructions (악성 기도 폐쇄에 대한 기관내 근접 조사 방사선치료의 단기 임상 경험)

  • Ahn Yong Chan;Lim Do Hoon;Choi Dong Rak;Kim Moon Kyung;Kim Dae Yong;Huh Seung Jae;Kim Ho Joong;Chung Man Pyo;Kwon O Jung;Rhee Chong Heon
    • Radiation Oncology Journal
    • /
    • v.14 no.4
    • /
    • pp.299-306
    • /
    • 1996
  • Purpose : Respiratory symptoms related with malignant airway disease have been the main causes of lowered qualify of life and also sometimes may be life-threatening if not properly managed. The authors report the short-term experiences of endobronchial brachytherapy for symptomatic malignant airway obstruction using high dose rate after-loading brachytherapy unit. Materials and Methdos : Twenty-five Patients with symptomatic malignant airway obstruction were treated with endobronchial brachytherapy between the period of December 1994 and March 1996 at Department of Radiation Oncology of Samsung Medical Center Twenty-one ($84\%$) were patients with non-small cell lung cancer, three with tracheal malignancies, and one with recurrence of esophageal cancer. Twenty Patients were given elective external beam radiation therapy, while six were given endobronchial laser evaporation therapy on emergency bases in addition to endobronchial brachytherapy. Three procedures for each patient were planned and total of 70 procedures were completed. Results : Improvement rates of major respiratory symptoms after endobronchial brachytherapy procedures were $88\%$(22/25). $96\%$(22/23), $100\%$ (15/15), and $100\%$(9/9) for cough, dyspnea, hemoptysis and obstructive pneumonia, respectively. ECOG performance scores were improved in $56\%$ of total patients group, while there was no case with worsened ECOG score. Fifteen patients died and the median interval from the start of treatment to death was 4 months (range: $1\~17$ months), while that of ten survivors was 9 months (range $5\~19$ months). There were five patients with controlled intrathoracic disease, who have survived over one rear. All deaths were associated with uncontrolled local and/or distant disease. Four Patients died of massive fatal hemoptysis, three of who received emergency endobronchial laser evaporation therapy before the start of endobronchial brachytherapy. Conclusion : Endobronchial brachytherapy has been confirmed as an excellent palliative treatment modality improving respiratory symptoms as well as patients' general performance status. Based on the current observations, use of endobronchial brachytherapy in curative setting as a boost technique may be warranted.

  • PDF

Endobronchial Brachytherapy for Malignant Airway Obstruction: Low Dose Rate Versus High Dose Rate (악성 종양에 의한 기도폐쇄시 내기관지 근접치료 : 저선량 치료 대 고선량 치료의 비교)

  • Cho, Young-Kap
    • Radiation Oncology Journal
    • /
    • v.14 no.2
    • /
    • pp.123-128
    • /
    • 1996
  • Purpose : This is a retrospective study to compare the Palliation rates, survival rates and complications of low dose rate and high dose rate endobronchial brachytherapy in the management of malignant airway obstruction. Materials and methods : Forty three consecutive patients with malignant airway compromise from primary or metastatic lung tumors were treated with low dose rate(LDR) endobronchial Iridium-192 insertion(21 patients) between October 1988 and June 1992, and high dose rate(HDR) endobronchial brachytherapy(22 patients) between August 1992 and April 1994 with palliative aim Flexible fiberoptic bronchoscopy under fluoroscopic control was utilized in all 91 procedures. Twenty seven LDR Procedures delivered a dose of 5-7.5 Gy to a 1.0 cm radius respectively. Results : Subjective and objective responses to treatments were evaluated on follow-up examinations by clinical examination, chest x-rays and CT scan of the chest on some patients. Fifteen of 21 LDR patients and 19 of 22 HDR Patients showed subjective improvement in terms of better breathing and less Productive cough as well as complete disappearance of hemoptysis. Objective improvement on chest x-rays and CT scan of the chest had been demonstrated on 8 LDR Patients and 10 HDR patients. Conclusion : The technique of LDR and HDR endobronchial brachytherapy is simple and well tolerated procedure with minimal morbidity It Provides excellent palliation by keeping airway Patent in these short life-spanned patients.

  • PDF

Evaluation of Dosimetric Effect and Treatment Time by Plan Parameters for Endobronchial Brachytherapy

  • Choi, Chang Heon;Park, Jong Min;Park, So-Yeon;Kang, SungHee;Cho, Jin Dong;Kim, Jung-in
    • Progress in Medical Physics
    • /
    • v.28 no.2
    • /
    • pp.39-44
    • /
    • 2017
  • This study aims to analyze dose distribution and treatment time of endobronchial brachytherapy (EBBT) by changing the position step size of the dwell position. A solid water phantom and an intraluminal catheter were used in the treatment plan. The treatment plans were generated for 3, 5, 7, and 10 cm treatment lengths, respectively. For each treatment length, the source position step sizes were set as 2.5, 5, and 10 mm. Three reference points were set 1 cm away from the central axis of the catheter, along the axis, for uniform dose distribution. Volumetric dose distribution was calculated to evaluate the dosimetric effect. The total radiation delivery time and total dwell time were estimated for treatment efficiency, which were increased with position step sizes. At half-life time, the differences between the position step sizes in the total radiation delivery time were 18.1, 15.4, 18.0, and 24.0 s for 3, 5, 7, and 10 cm treatment lengths, respectively. The dose distributions were more homogenous by increasing the position step sizes. The dose difference of the reference point was less than 10%. In brachytherapy, this difference can be negligible. For EBBT, the treatment time is the key factor while considering the patient status. To reduce the total treatment time, EBBT can be performed with 2.5 mm position step size.

A Case of Radiation Bronchitis Induced Massive Hemoptysis after High-Dose-Rate Endobronchial Brachytherapy

  • Lee, Seok Jeong;Lee, Jong-Young;Jung, Soon Hee;Lee, Shun Nyung;Lee, Ji-Ho;Kim, Chong Whan;Jung, Saehyun;Jung, Ye-Ryung;Lee, Won-Yeon
    • Tuberculosis and Respiratory Diseases
    • /
    • v.73 no.6
    • /
    • pp.325-330
    • /
    • 2012
  • High-dose-rate endobronchial brachytherapy (HDREB) have been used as the treatment of early endobronchial cancer, as well as for palliation of advanced cancer. However, fatal hemoptysis can occur after HDREB at the rate of 7~32%. We report a case of massive hemoptysis due to radiation bronchitis developed after HDREB. A 67-year-old man was treated with HDREB for early endobronchial cancer on the left upper lobe bronchus. He complained of persistent cough from 4 weeks after completion of HDREB. Radiation bronchitis was observed on the bronchoscopy at 34 weeks, and it was progressed from mucosal swelling and exudate formation to necrosis and ulceration without local relapse. In addition, he died of massive hemoptysis after 15 months. The patient had no sign or radiologic evidences to predict the hemoptysis. This case implies that HDREB directly contributes to an occurrence of a fatal hemoptysis, and follow-up bronchoscopy is important to predict a progression of radiation bronchitis and fatal hemoptysis.

The Palliative Effect of Endobronchial Brachytherapy for Previously Irradiated Patients with Lung Cancer (이전에 외부방사선치료를 받은 폐암 환자에서 기관지내 근접치료의 고식적 효과)

  • Park, Young-Je;Kim, Kwang-Taik;Yang, Dae-Sik;Lee, Suk;Kim, Chul-Yang
    • Radiation Oncology Journal
    • /
    • v.25 no.3
    • /
    • pp.177-184
    • /
    • 2007
  • Purpose: To evaluate the palliative effect of endobronchial brachytherapy (EBB) for patients with lung cancer that previously received external beam radiotherapy (EBRT). Materials and Methods: From July 1992 to May 2003, 29 patients with a recurrent or persistent lung cancer were treated with palliative EBB at our institute. EBB consisted of three fractions (once a week) of a dose of 5 Gy using the high dose-rate remote afterloader. Symptomatic improvement was assessed subjectively, and patients were divided into two groups according to whether symptoms were improved or not. Factors such as age, performance status, duration from EBRT to EBB and the location of the tumor were compared between the improved and unimproved groups of patients. Results: Overall symptomatic improvement was found in 27 out of 52 symptoms (52%). Improvement as to the type of symptoms was seen in 41 %, 50%, 82% and 33% of patients with cough, dyspnea, hemoptysis, and obstructive pneumonia respectively. The rate of improvement of hemoptysis was more than that of cough (p<0.05). The median time to symptom relapse was 5 months. The improved patient group (n=17, 59%) had a better performance status and longer duration from EBRT to EBB than the unimproved patient group (p<0.05). Lesions located in the distal trachea and/or main bronchus were found more frequently in the improved group of patients than in the unimproved group of patients, but the difference was not statistically significant (p=0.06). Fatal complications developed in two patients (7%), which were a hemoptysis and bronchopleural fistula respectively. Conclusion: Symptom improvement was found in 60% of patients after EBB and improvement was maintained for 5 months. Palliative EBB, even when EBRT was given previously, can be effective for a patient that has an endobronchial symptom, such as hemoptysis, and for a patient with good performance and a long duration from previous EBRT to EBB.

Remote Afterloading Hish Dose Rate (HDR) Endobronchia1 Brachytherapy (원격조정 고선량 기관지내 근접 치료)

  • Chang Hyesook;Choi Eun Kyung;Yi Byong Yong;Kim Won Dong;Kim Woo Sung;Koh Youn Suck
    • Radiation Oncology Journal
    • /
    • v.9 no.2
    • /
    • pp.227-232
    • /
    • 1991
  • Authors described the remote afterloading endobronchial brachytherapy (EBBT technique using the microSelectron HDR Ir-192 and the Asan Medical Center experience. Total 28 EBBT in 9 patients were performed since November 1989 and 24 EBBT in 8 patients were emploiyed for palliation and 3 EBBT in 1 patient was treated curatively. Authors observed a significant relief of obstructive symptom with tumor regression in 7 patients out of 8 who were treated palliatively but one of them died of pulmonary congestion in 3 weeks after EBBT One patient with prior therapy of extensive electrocautery expired within 1 day after 2nd EBBT procedure with massive hemorrhage from the lesion. EBBT procedure has been tolerable and can be performed as an outpatient.

  • PDF