Chest
Clinical InvestigationsEffect of Endobronchial Radiation Therapy on Malignant Bronchial Obstruction
Section snippets
MATERIALS AND METHODS
Between October 1986 and March 1989, 52 patients underwent 55 endobronchial procedures. The technical and dosimetric details have been published previously.5, 6 Median age at presentation was 67 years with a male to female ratio of 42 to 10. Forty-six patients had primary lung malignant neoplasms and six had nonpulmonary tumors. Twenty-three patients had metastatic disease at implantation. Eleven patients had received prior chemotherapy and 31 had undergone external radiation prior to
RESULTS
Thirty-three patients showed at least a one-level improvement in PS, 17 remained unchanged, and five showed at least a one-level deterioration one month following EBRT (Table 1A). A total of 166 symptoms were present prior to therapy; 131 of these resolved or improved, 20 remained unchanged, and 15 worsened (Table 1C). When measured as an average parameter, approximately 70 percent of a patients lifetime was rendered symptom free or symptom improved (Fig 1). Fourteen patients were
DISCUSSION
Several therapeutic modalities are currently available for malignant airway occlusion. These include external beam radiation,9, 10, 11 laser therapy,12, 13 and endobronchial radiation.14, 15 To our knowledge, no randomized study has evaluated these modalities prospectively. Although laser therapy achieves immediate airway recanalization, the duration of response is unlikely to be long, as considerable endobronchial as well as extrabronchial tumor is likely to be left untreated. A recent study9
ACKNOWLEDGMENTS
The authors wish to thank Susan Higgins for manuscript preparation.
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Manuscript received May 25; revision accepted August 24.