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Endobronchial brachytherapy for metastasis from extrapulmonary malignancies as an effective treatment for palliation of symptoms.
- Source :
-
Brachytherapy [Brachytherapy] 2017 May - Jun; Vol. 16 (3), pp. 630-638. Date of Electronic Publication: 2017 Feb 12. - Publication Year :
- 2017
-
Abstract
- Purpose: Endobronchial metastasis (EBM) originating from primary cancers outside the lung is rare. External beam radiotherapy is often attempted for control of symptoms with variable effectiveness and retreatment is challenging if symptoms recur. There is limited documentation of high-dose-rate brachytherapy for EBM in the literature.<br />Methods and Materials: A prospective database was created from 2006 to 2015. Patients with EBM who received high-dose-rate brachytherapy were included. Cough, dyspnea, chest pain, and hemoptysis were assessed and graded (0-4) at the time of initial consult and in followup. Symptom-free survival and re-expansion were assessed.<br />Results: Thirty-five patients with EBM were identified. Most patients received three fractions of 700 cGy, and 17 patients had prior external beam radiotherapy. Median symptom-free and overall survival were 67 and 117 days. After brachytherapy, improvement in cough was documented in 75.0%, hemoptysis in 76.4%, dyspnea in 60.0% for a median of 3-6 months. Of the 22 patients who had subsequent chest imaging, re-expansion was documented in 32%. There were no significant toxicities reported.<br />Conclusions: Brachytherapy appears effective in achieving durable symptom control of cough hemoptysis, and dyspnea in patients with EBM and should be considered routinely for palliation where available. Further studies are required to better characterize expected symptom improvement, lung re-expansion rates, and efficacy in comparison with other local treatments.<br /> (Copyright © 2017 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Bronchial Neoplasms secondary
Chest Pain etiology
Cough etiology
Disease-Free Survival
Dose Fractionation, Radiation
Dyspnea etiology
Female
Hemoptysis etiology
Humans
Male
Prospective Studies
Survival Rate
Symptom Assessment
Treatment Outcome
Brachytherapy methods
Bronchial Neoplasms complications
Bronchial Neoplasms radiotherapy
Palliative Care methods
Subjects
Details
- Language :
- English
- ISSN :
- 1873-1449
- Volume :
- 16
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Brachytherapy
- Publication Type :
- Academic Journal
- Accession number :
- 28202343
- Full Text :
- https://doi.org/10.1016/j.brachy.2017.01.003