Lung Brachytherapy: Experience from Germany

Abstract

Lung cancer is one of the most common types of cancer and is also a leading cause of cancer mortality. Surgery, considered the gold standard of therapy for early-stage lung cancer, is often not feasible, or desirable, because of comorbidities or the patient’s low-performance status. At the same time, lung metastases from various cancers are very common. With the emerging concept of oligometastasis as an intermediary state of disease, local therapy has frequently come into focus. Previous treatment modalities were often unable to meet the requirements made by local treatment of metastases. Fortunately, new local therapies such as interventional brachytherapy and stereotactic body radiation therapy (SBRT) have been developed, addressing these issues, and have been found successful in a variety of settings. CT-guided interstitial brachytherapy for the treatment of early-stage lung cancer and lung metastases has proven to be effective, safe, and well-tolerated, with promising results from a variety of centers (mostly in Germany); it represents an elegant addition to existing treatment modalities. At present, further insights must be gained regarding the choice of local therapy and the combination of focal with systemic approaches in a multimodal therapy setting. A wider implementation of the method would be expedient and desirable.