Effect of endobronchial radiation therapy on malignant bronchial obstruction

We evaluated the effect of endobronchial radiation therapy in 52 patients with malignant airway occlusion. Fifty-five endobronchial applications of the radioisotope iridium 192 were carried out. Response was assessed by change in performance status, symptom resolution, duration of symptom relief, roentgenographic reaeration, pulmonary function tests, and postimplant bronchoscopy. Thirty-three patients showed at least a one-level improvement in performance status. Of a total of 166 symptoms present prior to therapy, 131 resolved or improved. Approximately 70 percent of a patient's lifetime was rendered symptom improved or symptom free. A roentgenographic reaeration response of 30/41 (73 percent) was achieved. The average FEV1 and FVC improved from 1.5 to 2.1 L and from 2.3 to 2.9 L, respectively. Posttherapy bronchoscopy was performed between one and two months following the implant in 15 patients who agreed to undergo the procedure. Eleven (73 percent) of 15 had complete tumor regression. Major long-term complications were noted in seven patients. Endobronchial radiation, therefore, appears to be a safe and effective technique to palliate malignant airway occlusion.