Endobronchial brachytherapy in combination with external beam irradiation in obstructing malignant bronchial tumors

Endobronchial brachytherapy is commonly used in the palliative management of malignant airway obstructions. In the present study, we describe the results of brachytherapy (mean dose of 18 Gy), used in combination with external beam irradiation (mean dose of 50 Gy) in 30 patients who had primary bronchogenic carcinoma of the lung. The extent of airway obstruction was determined according to symptoms and by bronchoscopy. We found symptoms improved in nearly 37% of patients and 21 of 30 patients (70%), evaluated with bronchoscopy, showed a response when evaluated 3 to 6 months after brachytherapy. This endobronchial technique appeared to be a well-tolerated procedure with a low rate of acute toxicity. The immediate complication rate was 13%, during the follow-up 3 deaths were related to treatment, of which 2 were fatal haemoptysis (12 and 18 months after irradiation). We conclude that the combination of endobronchial brachytherapy with external beam irradiation may be useful and needs further comparisons with other irradiation procedures.