Intraluminal irradiation in the treatment of malignant airway obstruction

A group of 79 patients with non-resectable lung carcinomas (T1, 1; T2, 13; T3, 34; T4, 19; recurrence, 12) underwent endobronchial iridium-192 high-dose rate afterloading therapy (5 Gy/session total dose: 5-25 Gy, mean 11.6 Gy). In 39 cases the fair general condition and absence of metastases allowed external-beam irradiation (EBR) to be administered (50-70 Gy total dose; 2gy/day), starting 1 week after the brachytherapy session. In nine cases with superior vena cava syndrome, EBR (30 Gy total dose; 3 Gy/day) was administered concomitantly. Improvement in symptoms of respiratory obstruction was noted in 87% of our patients. The mean duration of palliation was 17.1 weeks in the group without and 34.7 weeks in that with additional EBR. The median survival time was 6 months without and 13 months with additional EBR. In T4 cases EBR had no impact on the 1-year survival (30.8% vs 24.4%, P > 0.05). The rate of severe complications was 7%, without significant differences between cases with or without EBR.