Treatment of unresectable lung cancer with brachytherapy

Endobronchial brachytherapy is an evolving treatment modality. Although standard clinical indications and dosage schedules have not yet been established, the wide range of individual experience overwhelmingly demonstrates its efficacy in palliating lung cancer patients who generally have limited treatment options. Although the exact complication rate is not known, it appears to be low and the potential benefits far outweigh the risks. The role of endobronchial brachytherapy for cure is less clear. For most instances "prolonged palliation" would be a more suitable term than "cure." Further data is needed to clarify the proper place of endobronchial brachytherapy as a boost to external beam radiation therapy. The dose, fractionation scheme, and timing relative to external beam radiation therapy are based on institutional preference at this time. The historical evolution, treatment technique, results, and complications of endobronchial brachytherapy are reviewed here.