[198Au brachytherapy and external radiation compared with external radiation only in non-small cell lung cancer.]

In this study the effect of a combination of radioactive gold (198Au) grain implantation and external radiation on survival and quality of life in patients with non-small cell lung cancer (NSCLC) and endobronchial lesions was compared to treatment with external radiation only.

Patients with NSCLC who were inoperable because of intrathoracic tumor spread or poor functional status, were randomized to receive either brachytherapy with 198Au implantation followed by external radiation with an intended maximum dosage of 60 Gy (group A), or external radiation only (group B). Time spent in hospital was used to reflect quality of life.

There was no difference in age or performance status at entry into the study. Five of 10 patients in group A had squamous cell carcinoma as did five of eight patients in group B. The mean dose of external radiation was 46.6+/-4.0 Gy in group A and 54.8+/-2.8 Gy in group B (NS). Median survival among group A patients was 29 weeks and 30 weeks in group B. Patients in group A spent 7.4+/-2.8 weeks in hospital whereas patients in group B spent 18.5+/-9.0 weeks in hospital. This difference was not statistically significant (p=0.21).

We conclude that the addition of brachy-therapy using 198Au gold grains did not improve significantly the results of standard radiotherapy in this randomized trial of patients with inoperable NSCLC.