RT Journal Article
SR Electronic
T1 Radiotherapy: a novel treatment for pneumothorax
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 427
OP 429
DO 10.1183/09031936.06.00020905
VO 27
IS 2
A1 Y. E. Ong
A1 A. Sheth
A1 N. J. Simmonds
A1 S. Heenan
A1 R. Allan
A1 J. P. Glees
A1 B. P. Madden
YR 2006
UL http://erj.ersjournals.com/content/27/2/427.abstract
AB Pneumothorax is a relatively common condition that is usually managed either conservatively, by chest tube drainage or, if a refractory air leak persists, then with cardiothoracic intervention. However, there is a small group of patients with a persistent air leak in whom surgical intervention is felt to be inappropriate. This study looks at a novel management strategy in a patient presenting with this scenario. A male with underlying bullous lung disease presented with a right pneumothorax. Complete re-expansion was not achieved, despite chest tube drainage and suction. Cardiothoracic intervention was felt to be inappropriate and the air leak persisted despite prolonged conservative management. Ventilation scintigraphy was therefore used to localise the air leak prior to targeted radiotherapy in an attempt to seal the leak via radiation-induced fibrosis. Three weeks after the first fraction of radiotherapy, the air leak ceased. In complex cases of pneumothorax with persistent air leak where cardiothoracic intervention is deemed inappropriate, identification of the air leak site and localised radiotherapy could be considered.