Emilia Timotin

A prospective analysis of high-dose-rate endobronchial brachytherapy in the palliation of obstructive symptoms in lung cancer patients: A single-institution experience.

PURPOSEnObstructive symptoms that affect quality of life (QOL) are commonly caused by endobronchial disease in many patients with locally advanced, inoperable lung cancer. High-dose-rate endobronchial brachytherapy (HDREBBT) has been used to palliate these symptoms, yet its role is not well defined in the literature.nnnMETHODS AND MATERIALSnNinety-eight patients with locally advanced, inoperable lung cancer received HDREBBT. They were prospectively followed for survival, QOL, and toxicity endpoints. QOL measures were captured using the Quality of Life Questionnaire-Lung Cancer 30 and -Lung Cancerxa013.nnnRESULTSnAt 1-year follow-up, no significant toxicities were seen. Overall survival was 13.4% at 12xa0months (mean 192xa0days). Performance status, additional treatment after HDREBBT and treatment intent affected overall survival on univariate analysis (p < 0.05). Mean hemoptysis-free survival for all patients was 232.3xa0days, cough-free survival was 140.3xa0days, and dyspnea-free survival was 173.5xa0days. There was no impact of any treatment- or patient-related factors of these outcomes on multivariate analysis, including additional treatment modalities and HDREBBT dose.nnnCONCLUSIONSnHDREBBT is a safe and effective way to palliate endobronchial symptoms. Additional external-beam radiation therapy, chemotherapy, or chemoradiation after HDREBBT improves survival, but does not affect QOL measures.

Endotracheal brachytherapy alone: An effective palliative treatment for tracheal tumors

BACKGROUNDnTracheal tumors are rare. They are usually unresectable and treated primarily with external beam radiation. The use of palliative endotracheal brachytherapy (ETBT) alone in treating patients with tracheal tumors has not been reported.nnnMETHODSnUsing a prospective database, demographic, treatment, and outcome data of patients with tracheal tumors treated palliatively with ETBT from 2006 to 2014 were analyzed. Tumor and symptom responses were evaluated based on response evaluation criteria in solid tumors criteria. Survival, in-field disease control, symptom response, and duration of symptom responses were evaluated using descriptive analyses.nnnRESULTSnSixteen ETBT (median, 2) treatments were delivered to 8 patients. Median age was 63.4 years old. Common symptoms were hemoptysis, cough, and dyspnea. Tracheal lengths of 3.5-11 cm were treated with 5-7 Gy/fraction, using 1-3 fractions. The mean overall survival was 5 months and symptom-free survival was 6.8 months, respectively. After ETBT, 88% of patients experienced symptomatic improvement (hemoptysis [n = 3/3], cough [n = 6/7], and dyspnea [n = 4/4]). One patient developed Grade 1 stenosis that did not require intervention.nnnCONCLUSIONSnThis is among the largest series of tracheal tumors treated palliatively with ETBT alone. ETBT provided effective palliation with symptom improvement and minimal toxicity.

202: Brachytherapy for Endobronchial Metastasis: An Effective Method of Achieving Palliative Relief of Cough, Hemoptysis, Chest Pain and Dyspnea

CARO 2016 _________________________________________________________________________________________________________ The position of the catheters relative to the tumour bed was measured in CT. Results: With sole US guidance, seven out of 10 catheters passed through the tumour bed. The catheter spacing was inconsistent and the desired goal of two rows of five equally-spaced catheters was not precisely achieved, with a mean spacing of 1.0 cm with 0.7 1.9 cm range. Under combined EMT-US guidance, nine out of 10 catheters passed through the tumour bed, yielding two rows of five catheters with more consistent spacing, with a mean spacing of 1.0 cm with 0.8-1.2 cm range. Conclusions: This phantom experiment suggests that combined EMT-US guidance can help achieve consistent catheter spacing over the tumour bed. These results are preliminary, and a trial of the method is now being conducted to validate our results. Additional research is being conducted to translate the proposed navigation technique to patient trials.