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Volume 9, Number S2, 2004

Palliative effectiveness and tolerance of endobronchial HDR brachytherapy in patients with lung cancer -the preliminary experience of Oncology Centre in Gliwice, Department of Brachytherapy

M. Gawkowska-Suwińska, B. Białas, M. Fijałkowski, R. Gawlik, A. Zajusz, R. Suwiński, K. Behrent, T. Rutkowski, D. Syguła, G. Plewicki


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 optimal radiation and the rate of complications. The aim of the work is to evaluate early effectiveness and tolerance of E-HDR-BT in palliative treatment of patients with lung cancer treated in Oncology Centrein Gliwice.
Material and methods: Since 2000 in Oncology Centre in Gliwice HDR (Ir192) E-HDR-BT is used in palliative treatment
of patients with bronchial obturation due to lung cancer. Regression of bronchial obturation and improvement in dyspnoea, cough and haemoptysis after therapy was analyzed for the first thirty patients. The total dose was 18 Gy, calculated at 1 cm from the source, in 3 fraction (of 6 Gy) given every week.
Results: Twenty-five patients finished therapy as planned. Five patients didn't complete treatment: two of them (6.6%) died because of massive haemoptysis; one patients suffered from exaggeration of angina pectoris, one patients developed high hectic fever not responding for antibacterial treatment, one suffered from exaggeration of their symptoms prohibiting continuation of the treatment. Changes in obturation of the bronchi and in patient's symptoms are shown in Table 1.
Table 1. Changes in obturation of the bronchi and in patient’s symptom.
Symptoms Improvement No changes Exaggeration
Obturation #/% 22/88 % 3/12 % 0
Dyspnoea #/% 15/54 % 11/40 % 2/7 %
Cough #/% 4/27 % 10/67 % 2/7 %
Haemoptysis #/% 2/14 % 10/72 % 2/14 %

More detailed analysis of improvements in symptoms has been carried out according to own scoring system for dyspnoea, cough and haemoptysis. Mean duration of palliative response was 55 days (1-405). Mean survival time was 114 days (2-406).
Conclusion: E-HDR-BT is an effective method of palliation of symptoms related to bronchial obturation in course of lung cancer. The most frequent serious treatment complication of E-HDR-BT was massive haemoptysis.

Signature: Rep Pract Oncol Radiother, 2004; 9(S2) : 274-275


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