High-dose-rate endobronchial brachytherapy in the management of advanced lung cancer - comparison according to the presence of lung atelectasis

Abstract

Introduction/Objective. Locally advanced lung cancer (LC) is often accompanied with atelectasis of either a part or the entire lung. The aim of this study was to establish the benefits of brachytherapy on the patients? quality of life (QoL), the length of the progression free survival (PFS), and the overall survival (OS) as related to the presence or absence of atelectasis after the applied treatment. Methods. The total of 100 patients with locally advanced LC or endobronchial metastasis of other malignancy were treated with the high dose rate endobronchial brachytherapy (HDR-EBB) in 2017. For observing the patients? clinical characteristics, the PFS and OS, the patients were classified into four groups according to the presence of atelectasis before and after HDR-EBB. Results. After HDR-EBB alone or combined with other treatment modalities, a statistically significant symptom alleviation was registered for all the symptoms except cough (p<0.05). The significantly highest PFS value was registered among the patients with atelectasis prior but not after HDR-EBB. The longest survival was registered in the patients who had atelectasis prior to, but not after HDR-EBB, as well as among the patients without of atelectasis either before or after EBB. Conclusion. HDR-EBB is an efficient method that improved the QoL of most patients. There were improved rates of re-aeration after HDR-EBB treatment alone and as a part of combined treatment. Re-aeration after EBB is a positive prognostic factor with respect to PFS and OS of these patients.

Effective Differences between 2D and 3D Planned Brachytherapy in Lung Cancer: An Institutional Retrospective Study

“…Brachytherapy represents a palliative procedure in LC where there is obstruction of the main airways by a tumor and is often used with other interventional therapeutic procedures, all to rapidly improve the Quality of Life (QoL) [ 38 ]. The effects of brachytherapy are significant because patients can have an improvement in QoL in a few hours or days after the applied procedure, and in most cases, brachytherapy has a palliative therapeutic goal in the advanced stage of the disease [ 13 , 39 ]. In our study, an improvement in the patient’s ECOG status was demonstrated for both types of applied brachytherapy.…”

“…In curative brachytherapy, the radiation field is defined as a three-step process: the macroscopic tumor lesion is defined by diagnostic methods and is designated as the gross tumor volume (GTV), the clinical radiation field is designated as the clinical target volume (CTV), and finally, the planning target volume (PTV) is estimated 1 cm over and 1 cm under the CTV due to the accuracy of localization and the possible movement of the patient during transport. In this way, the tumor, the bronchial catheter position, and the OAR are visualized [ 12 , 13 , 14 ]. The most frequently applied dose regimens are 2 × 7 Gy; 2 × 7.2 Gy and 1 × 15 Gy.…”