Anesthesia for the application of endotracheal and endobronchial radiation therapy

High-activity remote afterloading was recently adapted at Memorial Sloan-Kettering Cancer Center for the treatment of carcinoma of the lung recurrent to the major airways. An anesthesia approach is presented which aids in the performance of this beneficial procedure. The remote afterloader is a device containing a high-intensity radioactive source which is applied intraluminally to control both endobronchial and endotracheal tumors. The patient is intubated with an endobronchial or endotracheal tube which facilitates passage and measurement of the Gamma Med catheter. The potential usage for airway maintenance is a secondary benefit. After bronchoscopic placement is verified radiographically, computerized treatment is initiated. The several advantages of this technique are presented.