Early effectiveness and toxicity of intraluminal HDR brachytherapy in patients with lung cancer: preliminary experience of the Center of Oncology in Gliwice, Department of Brachytherapy

Aim: Endobronchial HDR brachytherapy (E-HDR-BT) is a well-established method of palliative treatment in patients with lung cancer. There is, however, no consensus on the optimal radiation and the rate of complications. The aim of the work is to evaluate the effectiveness and tolerance of E-HDR-BT in palliative treatment of patients with lung cancer treated in the Center of Oncology in Gliwice.
Material and methods: Since 2001 in the Center of Oncology in Gliwice (Ir192) E-HDR-BT has been used in palliative treatment of patients with bronchial obturation due to lung cancer. Regression of bronchial obturation and improvement in dyspnea, cough and hemoptysis after therapy were analyzed for the first thirty patients. The total dose was 18 Gy, calculated at 1 cm from the source, in 3 fractions (of 6 Gy) given every week.
A detailed analysis of changes in obturation and improvements in symptoms has been carried out according to own scoring system for dyspnea, cough and hemoptysis.
Results: Five patients did not complete treatment: two of them (6.6%) died because of massive hemoptysis; two patients suffered from the worsening of angina pectoris, one patient developed high hectic fever not responding to antibacterial treatment and another one suffered from the worsening of the symptoms prohibiting continuation of the treatment.
Mean duration of palliative response was 98 days (3-175).
Median survival time was 84 days.
Conclusion: E-HDR-BT is an effective method of palliation of symptoms related to bronchial obturation in the course of lung cancer. The most frequent serious treatment complication of E-HDR-BT was massive hemoptysis.