2 research outputs found
Optimization of dose and fractionation of endobronchial brachytherapy with or without external radiation in the palliative management of non-small cell lung cancer: A prospective randomized study
Aims: Endobronchial brachytherapy (EBBT) is an established modality
for the palliation in advanced non-small cell lung cancer. We compared
three different schedules using EBBT with or without external radiation
(XRT) in this setting. Materials and Methods: Forty-five patients were
randomized to three treatment arms. Arm A received XRT to a dose of 30
Gy/ 10 fr/ 2 weeks and two sessions of EBBT 8 Gy each. Arm B received
the same XRT and a single session of EBBT 10 Gy at 1 cm. Arm C received
only a single fraction of brachytherapy to a dose of 15 Gy at 1 cm
without XRT. Symptomatic response rates, duration of symptom
palliation, obstruction scores, quality of life outcomes and
complications were assessed and compared. Results: The overall
symptomatic response rates were 91% for dyspnea, 84% for cough, 94% for
hemoptysis and 83% for obstructive pneumonia. There was no significant
difference between the arms. The median time to symptom relapse was 4-8
months for all symptoms and the median time to symptom progression was
6-11 months. The results were comparable between groups except for
hemoptysis, where a shorter palliation was seen in Arm C that achieved
statistical significance ( P < 0.01). Quality of life showed
significant improvement, with maximum benefit in Arm A. Complication
rates were low. Only one patient died of fatal hemoptysis. Conclusion:
EBBT is thus a safe and effective palliative tool in advanced non-small
cell lung cancer, either alone or in conjunction with XRT. The
difference between the treatment arms were not statistically
significant in most categories, but patients treated with XRT and two
endobronchial sessions of 8 Gy had the most consistent benefit in terms
of all the parameters studied