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Lung Brachytherapy

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Handbook of Image-Guided Brachytherapy

Abstract

Lung brachytherapy allows for the delivery of a highly conformal radiation dose for recurrent disease while sparing surrounding structures. Endobronchial brachytherapy enables delivery of radiation to sites of previously irradiated tissue in the lung, allowing for palliation of obstructive symptoms. Interstitial brachytherapy may be done at the time of surgery if there is concern for incomplete tumor resection or positive margins. Lung brachytherapy has been demonstrated in numerous studies to reduce local recurrence and improve disease-free survival. While toxicities are generally low (around 5 %), the most critical late toxicity is fatal hemoptysis.

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References

  1. American Cancer Society. Cancer facts & figures 2015. Atlanta: American Cancer Society; 2015.

    Google Scholar 

  2. Niemoeller OM, Pöllinger B, Niyazi M, et al. Mature results of a randomized trial comparing two fractionation schedules of high dose rate endoluminal brachytherapy for the treatment of endobronchial tumors. Radiat Oncol. 2013;7:8.

    Article  Google Scholar 

  3. Huber RM, Fischer R, Hautmann H, et al. Palliative endobronchial brachytherapy for central lung tumors. A prospective, randomized comparison of two fractionation schedules. Chest. 1995;107:463–70.

    Article  CAS  PubMed  Google Scholar 

  4. Huber RM, Fischer R, Hautmann H, et al. Does additional brachytherapy improve the effect of external irradiation? A prospective, randomized study in central lung tumors. Int J Radiat Oncol Biol Phys. 1997;38:533–40.

    Article  CAS  PubMed  Google Scholar 

  5. Mallick I, Sharma SC, Behera D. Endobronchial brachytherapy for symptom palliation in non-small cell lung cancer—analysis of symptom response, endoscopic improvement and quality of life. Lung Cancer. 2007;55:313–8.

    Article  PubMed  Google Scholar 

  6. Langendijk H, de Jong J, Tjwa M, et al. External irradiation versus external irradiation plus endobronchial brachytherapy in inoperable non-small cell lung cancer: a prospective randomized study. Radiother Oncol. 2001;58:257–68.

    Article  CAS  PubMed  Google Scholar 

  7. Sur R, Donde B, Mohuiddin M, et al. Randomized prospective study on the role of high dose rate intraluminal brachytherapy (HDRILBT) in palliation of symptoms in advanced non-small cell lung cancer (NSCLC) treated with radiation alone [abstract]. Int J Radiat Oncol Biol Phys. 2004;60:S205.

    Google Scholar 

  8. Stout R, Barber P, Burt P, et al. Clinical and quality of life outcomes in the first United Kingdom randomized trial of endobronchial brachytherapy (intraluminal radiotherapy) vs. external beam radiotherapy in the palliative treatment of inoperable non-small cell lung cancer. Radiother Oncol. 2000;56:323.

    Article  CAS  PubMed  Google Scholar 

  9. Chella A, Ambrogi MC, Ribechini A, et al. Combined Nd-YAG laser/HDR brachytherapy versus Nd-YAG laser only in malignant central airway involvement: a prospective randomized study. Lung Cancer. 2000;27:169–75.

    Article  CAS  PubMed  Google Scholar 

  10. Fernando HC, Landreneau RJ, Mandrekar SJ, et al. Impact of brachytherapy on local recurrence rates after sublobar resection: results from ACOSOG Z4032 (Alliance), a phase III randomized trial for high-risk operable non-small-cell lung cancer. J Clin Oncol. 2014;32(23):2456–62.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Santos R, Colonias A, Parda D, et al. Comparison between sublobar resection and 125Iodine brachytherapy after sublobar resection in high-risk patients with Stage I non-small-cell lung cancer. Surgery. 2003;134(4):691–7.

    Article  PubMed  Google Scholar 

  12. Lee W, Daly BD, Dipetrillo TA, et al. Limited resection for non-small cell lung cancer: observed local control with implantation of I-125 brachytherapy seeds. Ann Thorac Surg. 2003;75(1):237–42.

    Article  PubMed  Google Scholar 

  13. Parashar B, Port J, Arora S, et al. Analysis of stereotactic radiation vs. wedge resection vs. wedge resection plus Cesium-131 brachytherapy in early stage lung cancer. Brachytherapy. 2015;14(5):648–54.

    Article  PubMed  Google Scholar 

  14. Nag S, Kelly JF, Horton JL, Komaki R, Nori D. Brachytherapy for carcinoma of the lung. Oncology (Williston Park). 2001;15(3):371–81.

    CAS  Google Scholar 

  15. Stewart A, Parashar B, Patel M, et al. American Brachytherapy Society consensus guidelines for thoracic brachytherapy for lung cancer. Brachytherapy. 2016;15(1):1–11.

    Article  CAS  PubMed  Google Scholar 

  16. Ernst A. Principles and practice of interventional pulmonology. New York: Springer; 2013.

    Book  Google Scholar 

  17. Sharma DN, Rath GK, Thulkar S, et al. Computerized tomography guided percutaneous high-dose-rate interstitial brachytherapy for malignant lung lesions. J Cancer Res Ther. 2011;7:174–9.

    Article  PubMed  Google Scholar 

  18. King CG, Stockstill TF, BLoomer WD, et al. Point dose variations with time in brachytherapy for cervical carcinoma. Abstr Med Phys. 1993;19:777.

    Google Scholar 

  19. Thomadsen BR, Shahabi S, Stitt JA, et al. High dose rate intracavitary brachytherapy for carcinoma of the cervix: the Madison System: II. Procedural and physical considerations. Int J Radiat Oncol Biol Phys. 1992;24:349–57.

    Article  CAS  PubMed  Google Scholar 

  20. Kennedy MP, Jimenez CA, Chang J, et al. Optimisation of bronchial brachytherapy catheter placement with a modified airway stent. Eur Respir J. 2008;31:902–3.

    Article  CAS  PubMed  Google Scholar 

  21. Marsiglia H, Baldeyrou P, Lartigau E, et al. High-dose-rate brachytherapy as sole modality for early-stage endobronchial carcinoma. Int J Radiat Oncol Biol Phys. 2000;47:665–72.

    Article  CAS  PubMed  Google Scholar 

  22. Liu L, Bassano DA, Prasad SC, et al. On the use of C-arm fluoroscopy for treatment planning in high dose rate brachytherapy. Med Phys. 2003;30:2297–302.

    Article  PubMed  Google Scholar 

  23. Hara R, Itami J, Aruga T, et al. Risk factors for massive hemoptysis after endobronchial brachytherapy in patients with tracheobronchial malignancies. Cancer. 2001;92(10):2623–7.

    Article  CAS  PubMed  Google Scholar 

  24. Sawicki M, Kazalski D, Lyczek J, et al. The evaluation of treatment plans in high-dose-rate endobronchial brachytherapy by utilizing 2D and 3D computed tomography imaging methods. J Contemp Brachytherapy. 2014;6:289–92.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Lycek J, Kazalski D, Kowali K, et al. Comparison of the GTV coverage by PTV and isodose of 90% in 2D and 3D planning during endobronchial brachytherapy in the palliative treatment of patients with advanced lung cancer. Pilot study. J Contemp Brachytherapy. 2012;4:113–5.

    Article  Google Scholar 

  26. Kishi K, Yoshimasu T, Shirai S, et al. Usefulness of minitrachoesotmy and torque controlled insertion of applicator in fractionated endobronchial brachytherapy. Br J Radiol. 2006;79:522–5.

    Article  CAS  PubMed  Google Scholar 

  27. Gay HA, Allison RR, Downie GH, et al. Toward endobronchial Ir-192 high-dose-rate brachytherapy therapeutic optimization. Phys Med Biol. 2007;52:2987–99.

    Article  CAS  PubMed  Google Scholar 

  28. Ferstl A, Fischer R, Hautmann H, et al. Simultaneous chemotherapy and high dose rate brachytherapy (HDRBT) in the treatment of locally advanced non-small cell lung cancer. Eur Respir J. 1997;10 Suppl 25:198.

    Google Scholar 

  29. D’Amato TA, Galloway M, Syzdlowski G, et al. Intraoperative brachytherapy following thoracoscopic wedge resection of stage I lung cancer. Chest. 1998;114:1112–5.

    Article  PubMed  Google Scholar 

  30. Fleischman EH, Kagan AR, Streeter OE, et al. Iodine 125 interstitial brachytherapy in the treatment of carcinoma of the lung. J Surg Oncol. 1992;49:25–8.

    Article  CAS  PubMed  Google Scholar 

  31. Trombetta MG, Colonias A, Malishi D, et al. Tolerance of the proximal aorta using intraoperative iodine-125 interstitial brachytherapy in cancer of the lung. Brachytherapy. 2008;7:50–4.

    Article  PubMed  Google Scholar 

  32. Cormack RA, Holloway CL, O’Farrell D, et al. Permanent planar iodine-125 implants: the dosimetric effect of geometric parameters for idealized source configurations. Int J Radiat Oncol Biol Phys. 2007;69:1310–5.

    Article  CAS  PubMed  Google Scholar 

  33. Skowronek J, Piorunek T, Kanikowski M, et al. Definitive high-dose-rate endobronchial brachytherapy of bronchial stump for lung cancer after surgery. Brachytherapy. 2013;12:560–6.

    Article  PubMed  Google Scholar 

  34. Zaric B, Perin B, Jovelic A, et al. Clinical risk factors for early complications after high-dose-rate endobronchial brachytherapy in the palliative treatment of lung cancer. Clin Lung Cancer. 2010;11:182.

    Article  PubMed  Google Scholar 

  35. Perez CA, Brady LW, editors. Principles and practice of radiation oncology. 2nd ed. Philadelphia: JB Lippincott Co; 1992:50–63. pp. 114–23.

    Google Scholar 

  36. Ung YC, Yu E, Falkson C, et al. The role of high-dose-rate brachytherapy in the palliation of symptoms in patients with non-small-cell lung cancer: a systematic review. Brachytherapy. 2006;5(3):189–202.

    Article  PubMed  Google Scholar 

  37. Gollins SW, Ryder WD, Burt PA, et al. Massive haemoptysis death and other morbidity associated with high dose rate intraluminal radiotherapy for carcinoma of the bronchus. Radiother Oncol. 1996;39:105–16.

    Article  CAS  PubMed  Google Scholar 

  38. Ozkok S, Karakoyun-celik O, Goksel T, et al. High dose rate endobronchial brachytherapy in the management of lung cancer: response and toxicity evaluation in 158 patients. Lung Cancer. 2008;62(3):326–33.

    Article  PubMed  Google Scholar 

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Correspondence to Justin Mann MD or Bhupesh Parashar MD .

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Mann, J., Herskovic, A., Chen, J., Wernicke, A.G., Parashar, B. (2017). Lung Brachytherapy. In: Mayadev, J., Benedict, S., Kamrava, M. (eds) Handbook of Image-Guided Brachytherapy. Springer, Cham. https://doi.org/10.1007/978-3-319-44827-5_19

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  • DOI: https://doi.org/10.1007/978-3-319-44827-5_19

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