PURPOSE: To prove the feasibility and the safety of endobronchial high dose radiation of inoperable peripheral tumors of the lung by catheter placement based on electromagnetic navigation and endobronchial ultrasound.
METHODS: After localization of the lesion by electromagnetic navigation, confirmation of the position by endobronchial ultrasound and assessment of histology a brachytherapy catheter is placed via an extended working channnel, fixed at the nose and left in place for one week. The patient is transferred to the radiotherapy department. A total dose of 15Gy is applied by introducing an Ir192 source three times a week based on geometrical optimization to the target volume. Follow-up includes ultrasound guided biopsies and chest CT.
RESULTS: 10 patients have been treated. The treatment was tolerated without major side effects or complications (1 asymptomatic pneuthorax). Placement was impossible in one patient. Maximal follow up is more than two years. 5/9 patients had a complete remission. The ultrasonic image of the tumor changed significantly corresponding to the histological response.
CONCLUSION: Brachytherapy of inoperable peripheral lung tumors seems to be a safe procedure and could be a promising approach for potentially even curative treatment, sparing major damage to radiosensitive surrounding structures.
CLINICAL IMPLICATIONS: Brachytherapy of peripheral lung tumors could become a treatment option with results comparable to surgery in patients at high risk. More data are needed for dose finding and long term follow up.
DISCLOSURE: Heinrich Becker, None.