High-Dose-Rate Brachytherapy for Non–Small-Cell Lung Carcinoma: A Retrospective Study of 226 Patients

详细信息    查看全文

• 作者：Maud Aumont– ; le Guilcher M.D.^* ; Bernard Prevost M.D.^† ; ; Marie Pierre Sunyach M.D.^‡ ; ; Didier Peiffert M.D. ; Ph.D.^§ ; ; Philippe Maingon M.D. ; PhD.^¶ ; ; Laurence Thomas M.D. ; Daniè ; le Williaume M.D.^** ; Mickael Begue M.D.^† ; † ; ; Delphine Lerouge M.D.^‡ ; ‡ ; ; Lo&#xef ; c Campion M.D.^* ; Marc-André ; Mahe M ; D. ; Ph.D.^* ; ^{ma-mahe@nantes.fnclcc.fr}
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2011
• 出版时间：15 March 2011
• 年：2011
• 卷：79
• 期：4
• 页码：1112-1116
• 全文大小：162 K

文摘

Purpose

To evaluate the efficacy and toxicity of high-dose-rate (HDR) brachytherapy in patients with inoperable endobronchial carcinoma.

Methods and Materials

We retrospectively reviewed the records (April 1991—May 2004) of patients with non–small-cell carcinoma, with no extrabronchial spread on computed tomography scans, who underwent HDR brachytherapy because of contraindications to surgery and external beam radiation therapy. Kaplan-Meier survival curves were compared by the log-rank test. Prognostic factors were analyzed by multivariate analysis.

Results

226 patients (223 men, 3 women, mean age: 62.2 years (range, 40–84)) were included. Of those, 217 (97 % ) had squamous cell carcinoma (Tis/T1/T2/Tx: 60/153/9/4). Dose was prescribed at 1 cm from the radius (24–35 Gy in 4–6 fractions). Mean follow-up was 30.4 months (range, 9–116). Complete endoscopic response rate was 93.6 % at 3 months. One hundred twenty-eight patients (56 % ) died of intercurrent disease (n = 45), local failure (n = 36), metastasis (n = 10), local failure and metastasis (n = 11), complications (n = 13), and other causes (n = 12). The 2-year and 5-year survival rates were, respectively, 57 % and 29 % (overall) (median, 28.6 months), 81 % and 56 % (cancer-specific), and 68 % and 50 % (local disease-free). Acute toxicity included pneumothorax (1.5 % ) and mucosal inflammation (10 % ). Late complications were hemoptysis (6.6 % with 5 % of fatalities), bronchitis (19.5 % ), and necrosis (3.5 % ). In multivariate analysis, a distal tumor location and the use of two catheters were associated with improved local disease-free survival (p = 0.003 and p = 0.007, respectively) and a distal tumor location with improved overall survival (p = 0.0001).

Conclusions

This large retrospective study confirms that HDR brachytherapy is an efficient and safe treatment in patients with inoperable endobronchial carcinoma.