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.
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.
Six patients have been treated so far. The treatment has been tolerated without major side effects or complications. The longest observation period is more than one year with only minor cytological residuals. The ultrasonic image of the tumor changed significantly corresponding to the histological response.
Brachytherapy of inoperable peripheral lung tumors is feasible and is a safe procedure.
Brachytherapy could become a promising approach for potentially even curative treatment of inoperable peripheral tumors of the lung sparing major damage to radiosentitive surrounding tissue.
Heinrich Becker, Grant monies (from industry related sources); Technical support by SuperDimension Co., Herzliya, Israel.