Title

The Role of High-dose-rate Brachytherapy in the Palliation of Symptoms in Patients with Non-small-cell Lung Cancer: A Systematic Review

Authors

Yee C. Ung, Toronto-Sunnybrook Regional Cancer Centre, Toronto, ON
Edward Yu, University of Western OntarioFollow
Conrad Falkson, Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, ON
Adam E. Haynes, McMaster University
Denise Stys-Norman, McMaster University
William K. Evans, McMaster University
Cancer Care Ontario's Program in Evidence-based Care, McMaster University

Document Type

Article

Publication Date

7-2006

Journal

Brachytherapy

Volume

5

Issue

3

First Page

189

Last Page

202

Abstract

Purpose: This review addresses the role of high-dose-rate endobronchial brachytherapy (HDREB) for symptom palliation in patients with non-small-cell lung cancer.

Methods and materials: Relevant trials were identified through a systematic search of the literature.

Results: Twenty-nine trials were eligible. Six randomized trials involved HDREB alone or with external beam radiation therapy (EBR) or laser therapy. Median and 1-year survival ranged from 4 to 10 months and from 11% to 38%, respectively. Symptoms controlled by HDREB were dyspnea, cough, chest pain, and hemoptysis. Fatal hemoptysis ranged from 7% to 22%. Better overall symptom palliation and fewer retreatments were required in previously untreated patients using EBR alone or EBR with HDREB.

Conclusions: EBR alone is more effective than HDREB for symptom palliation in previously untreated patients with endobronchial non-small-cell lung cancer. HDREB with EBR seems to provide better symptom relief than EBR alone. HDREB is recommended for symptomatic patients with recurrent endobronchial obstruction previously treated by EBR, providing it is technically feasible.

Notes

Published in: Brachytherapy, Volume 5, Issue 3, July-September 2006, Pages 189-202. doi: http://dx.doi.org/10.1016/j.brachy.2006.05.001