PURPOSE:In a prospective study we explored the feasibilty and safety of brachytherapy of inoperable perpheral lung cancer. The technology was confirmed in a second center.
METHODS:Peripheral lung cancers were approached by electromagnetic navigation and the position was confirmed by endobronchial ultrasound. In Heidelberg a brachytherapy catheter was inserted and left in place for up to one week. In Texas two insertions were performed within two weeks. In the radioptherapy department an IR192 source was iserted and 15 to 30 Gy were applied under geometric optimization. Follow up is more than two years under fluoroscopy and ultrasound guided transbronchial biopsy.
RESULTS:10 patients were treated in Heidelberg and 8 in Texas. No significant complications were observed. In one patient placement of the catheter was impossible. One patient experienced a pneumothorax that did not need intervention. In 5/9 patients in Heidelberg and 4/8 patients in Texas we observed a histologically confirmed complete remission. The ultrasound images changed correspondingly.
CONCLUSION:Navigated and ultrasound controlled brachytherapy of inoperable peripheral lung cancer is safe and efficient. Inclusion of the bronchovascular bundle and of the hilum are more similar to radical surgery and offer potential cure. The data have to be confirmed in a prospective study on a larger population.
CLINICAL IMPLICATIONS:Navigated endobronchial brachytherapy is an efficient treatment method for inoperable peripheral lung cancer.
DISCLOSURE:Heinrich Becker, None.