0
Lung Cancer |

High Dose Rate (HDR) Dual Intraluminal Brachytherapy Catheter in Treatment of Bilateral Endobronchial Tumor Progression: A Case Report

Larry Ladi, MD; John Grecula, MD; Eric Allen, MD; Shaheen Islam, MD
Author and Funding Information

The Ohio State University-Wexner Medical Center, Grandview Heights, OH


Chest. 2015;148(4_MeetingAbstracts):536A. doi:10.1378/chest.2276888
Text Size: A A A
Published online

Abstract

SESSION TITLE: Lung Cancer Cases

SESSION TYPE: Affiliate Case Report Slide

PRESENTED ON: Sunday, October 25, 2015 at 10:45 AM - 12:00 PM

INTRODUCTION: The use of brachytherapy is one method of delivering a higher radiation dose to endobronchial tumor while sparing the surrounding normal tissues. Although commonly done with a single catheter we report on the simultaneous use of dual HDR-intraluminal brachytherapy catheters.

CASE PRESENTATION: We report of a 71-year-old man with left mainstem recurrence of squamous cell carcinoma who was treated with chemoradiation (63 Gy/ 35 tx) previously. Three months ago, bronchoscopy revealed extension of tumor involving carina and proximal 2 cm of both left and right mainstem bronchi. Biopsy confirmed squamous cell carcinoma. He underwent tumor debulking using Nd:YAG laser first and then referred for HDR-brachytherapy to treat any submucosal extension. Since both main stem bronchi were involved, a decision was made to place two catheters to radiate both sides simultaneously. A pediatric bronchoscope was inserted next to the catheter to verify positioning (Fig. 1). The position of the catheters was confirmed with digital orthogonal x-rays and conebeam CT. Eclipse software was used to plan the treatment of the proximal 5 cm of both the right and left mainstem bronchi and carina with 750cGy prescribed to 1 cm from the source at the carina. The target volume is shown above (Fig.2). 750 cGy was delivered over actual time of 466.2 seconds with the high activity (4.33 Ci) Ir-192 source (nominal treatment time = 201.6 seconds). Two additional weekly treatments of 750 cGy to the above area were planned.

DISCUSSION: HDR-brachytherapy is effective in palliating dyspnea. In our patient, given the bilaterality of tumor progression, routine HDR-intraluminal brachytherapy would have required our patient to undergo unilateral treatment separately in multiple sessions and may have resulted in overlap of the brachytherapy isodoses. By planning the bilateral HDR-intraluminal brachytherapy catheters simultaneous, the risk of future overlap is avoided, and the overall treatment interval is reduced in half

CONCLUSIONS: HDR-intraluminal brachytherapy has demonstrated improvement of overall quality of life with single luminal therapies. We demonstrate the concomitant use of two intraluminal brachytherapy catheters placed in separate bronchi decreased the overall treatment interval. Future studies need to be conducted to evaluate efficacy.

Reference #1: Hennequin C, et al. Long-term results of endobronchial brachytherapy. Int J Radiat Oncol Biol Phys. 2007;67(2):425.

DISCLOSURE: The following authors have nothing to disclose: Larry Ladi, John Grecula, Eric Allen, Shaheen Islam

No Product/Research Disclosure Information


Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Figures

Tables

References

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

MEMBER & INDIVIDUAL SUBSCRIBER

Want Access?

NEW TO CHEST?

Become a CHEST member and receive a FREE subscription as a benefit of membership.

Individuals can purchase this article on ScienceDirect.

Individuals can purchase a subscription to the journal.

Individuals can purchase a subscription to the journal or buy individual articles.

Learn more about membership or Purchase a Full Subscription.

INSTITUTIONAL ACCESS

Institutional access is now available through ScienceDirect and can be purchased at myelsevier.com.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Find Similar Articles
CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543