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

Lee, Jong‐Young; Jung, Soon Hee; Lee, Shun Nyung; Lee, Ji-Ho; Kim, Chong Whan; Jung, Saehyun; Jung, Young-Soo; Lee, Won Yeon

doi:10.4046/trd.2012.73.6.325

Cited by 5 publications

(5 citation statements)

References 15 publications

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“…Endobronchial brachytherapy is a notable approach frequently employed to administer high doses of radiation in proximity to the primary tumor, applying high-dose rates to the tumor while sparing the surrounding normal tissue [ 15 , 22 ]. However, when a catheter is placed near the bronchial wall where a larger vessel exists, there is a considerable risk of bleeding, as well as potential late toxicities such as fistula formation, hemoptysis, tracheomalacia, and bronchial stenosis [ 27 , 28 , 29 , 30 ]. Furthermore, the procedures and outcomes of brachytherapy can vary substantially depending on the operator, and there may be substantial intra- or inter-fraction discrepancies and errors, rendering it less reproducible [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Dose-Escalated Radiotherapy for Primary Tracheobronchial Adenoid Cystic Carcinoma

Lee,

Jang,

Noh

et al. 2024

Cancers

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Primary tracheobronchial adenoid cystic carcinoma (ACC) is a rare malignancy, so the optimal radiotherapy (RT) dose remains unestablished. We aimed to evaluate the effectiveness of dose-escalated RT for primary tracheobronchial ACC. We retrospectively reviewed 48 patients who had undergone definitive or postoperative RT. Patients classified into the low- and high-dose groups received RT doses <70.0 and ≥70.0 Gy in EQD2, respectively. The primary endpoint was freedom from local progression (FFLP) and overall survival (OS). Throughout the follow-up period, seven patients (14.6%) experienced local progression, while 31 (64.6%) exhibited distant metastasis, most commonly in the lungs. In total, the 5-year FFLP and OS rates were 85.7 and 84.7%, respectively. Multivariate analysis revealed that regional lymph node metastasis at diagnosis and receipt of definitive RT were associated with poorer OS. In the subgroup analysis, the definitive RT group had a 5-year FFLP rate of 33.3 and 78.2% in the low- and high-dose groups (p = 0.065), whereas 5-year OS rates were 66.7 and 79.0%, respectively (p = 0.022). Four patients (8.3%) experienced Grade 3 toxicity with tracheal or main bronchus stenosis. Dose-escalated RT with conventional fractionation may be effective in patients with tracheobronchial ACC, especially for a definitive aim.

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Section: Discussionmentioning

confidence: 99%

Dose-Escalated Radiotherapy for Primary Tracheobronchial Adenoid Cystic Carcinoma

Lee,

Jang,

Noh

et al. 2024

Cancers

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“…Radiation‐induced lung injuries mainly include radiation pneumonitis, lung fibrosis, and organizing pneumonia 6,7 . Radiation bronchitis with stenosis or granulation was reported in lung cancer patients, but they had received brachytherapy 3,4 or combined external‐beam and high dose‐rate iridium brachytherapy 8 . Radiation bronchitis was reported in esophageal cancer patients who had a total 68.4 Gy dose 9 …”

Section: Discussionmentioning

confidence: 99%

“…Thoracic radiotherapy may induce lung injuries, mainly radiation-induced pneumonitis, radiation-induced lung fibrosis, radiationinduced bronchiolitis obliterans organizing pneumonia, 1,2 and radiation-induced bronchitis. 3,4 We report two rare cases of radiation-induced pseudomembranous tracheobronchitis with or without bronchial obstruction in lung cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Radiation‐induced pseudomembranous tracheobronchitis: A report of two cases

Choi

2022

Thoracic Cancer

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Radiation therapy can cause radiation pneumonitis, organizing pneumonia, and lung fibrosis. Radiation‐induced pseudomembranous bronchitis is a rare condition. Here, we describe a rare case each of pseudomembranous tracheobronchitis and pseudomembrane with total bronchial obstruction which developed after thoracic radiotherapy. A 50‐year‐old man presented paroxysmal severe cough 1 month after concurrent chemoradiotherapy for small‐cell lung cancer. Bronchoscopy revealed a whitish membrane in the trachea and bronchus, which were the fields of radiation. Another 60‐year‐old man complained of dyspnea 7 months after radiation therapy for metastatic lymph node adenocarcinoma. Bronchoscopy demonstrated a membrane with total obstruction of right lower lobar bronchus, which was the area of radiation. The pathological findings of histological examination in both cases demonstrated radiation‐induced pseudomembranous tracheobronchitis. Patients in both cases responded well to steroids and the pseudomembrane disappeared. If patients who have received thoracic radiation therapy complain of persistent cough, bronchoscopy may be helpful.

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“…Recently, several studies have reported the use of EBBT for radical irradiation to eliminate tumors (Table 1). 6–11 However, adverse events (AEs) such as hemoptysis or severe bronchitis due to overdosing owing to uneven dose distribution in the bronchus have been a problem 12,13 . Thus, we have developed an applicator (Figure 1(a)) to keep the radioactive source in the center of the bronchial lumen (Figure 1(b)) and attempted to improve the dose distribution in the bronchial lumen 14 .…”

Section: Introductionmentioning

confidence: 99%

Endobronchial brachytherapy combined with surgical procedure for synchronous multiple primary lung cancer: A case report

et al. 2021

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The management of synchronous multiple primary lung cancer is a challenge. In this report, we describe our experience in a patient with three synchronous multiple cancers. The first lesion was completely surgically removed, the second lesion received postoperative irradiation, and the third lesion was treated with radiotherapy alone. Radiation therapies were performed using a combination of external irradiation and endobronchial brachytherapy. Endobronchial brachytherapy is an effective radiation therapy for endobronchial tumors owing to its advantage of high‐dose concentration. However, adverse events (AEs) such as hemoptysis or severe bronchitis are a problem. Thus, we have developed an applicator to keep the radioactive source in the center of the bronchial lumen. A total of 28 months after treatment, the patient had not experienced any relapses or AEs. Endobronchial brachytherapy using an applicator can be an alternative treatment for cases in which surgery is expected to lead to pulmonary dysfunction.

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

Cited by 5 publications

References 15 publications

Dose-Escalated Radiotherapy for Primary Tracheobronchial Adenoid Cystic Carcinoma

Dose-Escalated Radiotherapy for Primary Tracheobronchial Adenoid Cystic Carcinoma

Radiation‐induced pseudomembranous tracheobronchitis: A report of two cases

Endobronchial brachytherapy combined with surgical procedure for synchronous multiple primary lung cancer: A case report

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