In a prospective study we investigated the feasibility and safety of brachytherapy for inoperable peripheral lung cancer. The concept was confirmed by a prospective study for potentially curative treatment.
Inoperable peripheral malignant lung lesions were approached by electromagnetic navigation and the position was confirmed by endobronchial ultrasound. In the pilot study the brachytherapy catheter was left in place for up to one week. In Texas two insertions were performed within two weeks. In the radiotherapy departments IR192 sources were inserted and 15 to 30Gy were applied under geometric optimization. Folow up is up to three years including fluoroscopy and ultrasound guided bronchoscopic biopsy.
10 patients were treated in the feasibility study in Heidelberg. In one patient placement was impossible and one patient experienced a pneumothorax that did not need treatment. 5/9 achieved histologically proven complete remission. In all ll patients with curative intent in stage I to IIa complete remission (CR) was achieved. One died from MI. The otheres are in stable CR for up to 42 months.
Brachytherapy of inoperable peripheral lung cancer is safe and efficient. Inclusion of the bronchovascular bundle and the hilum is more similar to radical surgery and offers potential cure.
Navigated endobronchial brachytherapy is an efficient method for treatment of inoperable peripheral lung cancer and could add to or even replace external radiation in selected partients.
Heinrich Becker, No Financial Disclosure Information; No Product/Research Disclosure Information