CT-guided interstitial brachytherapy of primary and secondary lung malignancies: results of a prospective phase II trial.

Abstract

BACKGROUND AND PURPOSE:

CT-guided interstitial brachytherapy of primary lung malignancies and pulmonary metastases represents a novel interventional technique, combining conventional high-dose-rate (HDR) iridium-192 ((192)Ir) brachytherapy with modern CT guidance for applicator positioning and computer-aided 3-D radiation treatment planning. The purpose of this study was to assess safety and efficacy of this technique.

PATIENTS AND METHODS:

30 patients with 83 primary or secondary lung malignancies were recruited in a prospective nonrandomized trial (Table 1). After catheter positioning under CT fluoroscopy, a spiral CT was acquired for treatment planning (Figure 1). All but two patients received a defined single dose (coverage > 99%) of at least 20 Gy from a (192)Ir source in HDR technique.

RESULTS:

Adverse effects were nausea (n = 3, 6%), minor (n = 6, 12%) and one major pneumothorax (2%). Post intervention, no changes of vital capacity and forced expiratory volume could be detected. The median follow-up period was 9 months (1-21 months) with a local tumor control of 91% at 12 months (Figure 2).

CONCLUSION:

CT-guided interstitial brachytherapy proved to be safe and effective for the treatment of primary and secondary lung malignancies.

• Authors: Nils Peters, Gero Wieners, Maciej Pech, Susanne Hengst, Ricarda Rühl, Florian Streitparth, Enrique Lopez Hänninen, Roland Felix, Peter Wust, Jens Ricke
• Journal: Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] (Strahlenther Onkol) Vol. 184 Issue 6 Pg. 296-301 (Jun 2008) ISSN: 0179-7158 [Print] Germany
• PMID: 18535804 (Publication Type: Clinical Trial, Phase II, Journal Article)

Chemical References

• Radioisotopes
• Iridium

Topics

• Adult
• Aged
• Brachytherapy (methods)
• Carcinoma, Non-Small-Cell Lung (radiotherapy)
• Colorectal Neoplasms (radiotherapy)
• Female
• Fluoroscopy (methods)
• Forced Expiratory Volume (radiation effects)
• Humans
• Image Processing, Computer-Assisted (methods)
• Iridium (therapeutic use)
• Lung Neoplasms (radiotherapy, secondary)
• Male
• Middle Aged
• Nausea (etiology)
• Pneumothorax (etiology)
• Prospective Studies
• Radioisotopes (therapeutic use)
• Radiotherapy Dosage
• Radiotherapy Planning, Computer-Assisted (methods)
• Radiotherapy, Computer-Assisted (instrumentation)
• Tomography, Spiral Computed (methods)
• Vital Capacity (radiation effects)