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 15-30Gy 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 were treated. The treatment was tolerated without major side effects or complications. The longest observation period is more than one year. 2pts achieved CR, 7pts PR. In 1pt the probe could not be placed inside a lesion close to the chest wall. The ultrasonic image changed significantly corresponding to the histological response.
CONCLUSION: Navigated brachytherapy of inoperable peripheral lung tumors is feasible and a safe procedure.
CLINICAL IMPLICATIONS: In future, navigated brachytherapy could become a potentially even curative treatment for inoperable peripheral lung tumors, sparing major damage to radiosensitive surrounding structures. Currently a dose finding study is inaugurated.
DISCLOSURE: Heinrich Becker, Product/procedure/technique that is considered research and is NOT yet approved for any purpose. application of the SDBS for tretament of peripheral lesions