Braquiterapia endobronquial de alta tasa de dosis en pacientes con obstrucción de la vía aérea central: experiencia en el Instituto Nacional del Cáncer y revisión de la literatura / High dose rate endobronchial brachytherapy in patients with central airway obstruction

Introduction: The main indication of modern high dose rate end bronchial brachyherapy (HDR EBBT) is the palliation of symptoms related to the growth of the endobronchial lung cancer. Methods: EBBT was performed to 27 patients who suffered symptomatic tumoral endobronchial or tracheal pathology, due to primary bronchial disease or secondary metastasis cancer, evaluating the rate of clinical benefit. The tumors were located at tracheal, carinal or proximal bronchial level. Fibrobronchoscopy was performed to all the patients to measure the degree of airway obstruction and to install brachytherapy endobronchial catheters. Between 1 to 4 fractions of 7 to 7.5 Gy were administered. Dyspnea, cough and hemoptysis were subjectively registered before and after treatment, according to an international validated scale. Results: After treatment, all symptoms considerably decreased, disappearing all of the severe categories. Hemoptysis and dyspnea resolved in a 100 percent and 40 percent of patients, respectively; and cough disappeared or was reduced to a minimum grade in 90 percent of cases.

Introducción: La indicación principal de la braquiterapia endobronquial moderna (BTEB) de alta tasa de dosis (HDR), es la paliación de síntomas por crecimiento endobronquial de cánceres pulmonares. Métodos: Se realizó BTEB HDR a 27 pacientes sintomáticos de patología tumoral endobronquial o traqueal, debido a patologías primarias bronquiales o secundarias metastásicas. Los tumores se ubicaban en tráquea, carina o a nivel bronquialproximal. Para observar mejorías en la sintomatología clínica, a todos se les realizó una fibrobroncoscopía (FBC) para medir el grado de obstrucción bronquial e instalar catéteres endobronquiales de braquiterapia. Se administraron entre 1 y 4 fracciones de 7 a 7,5 Gy. Se registró subjetivamente la disnea, tos y hemoptisis antes y después del tratamiento, de acuerdo a una escala internacionalmente validada. Resultados: Tras el tratamiento todos los síntomas disminuyeron considerablemente, desapareciendo toda sintomatología severa. La hemoptisis y disnea desaparecieron en el 100 por ciento y 40 por ciento de los pacientes respectivamente, y la tos desapareció o disminuyó a grado leve en el 90 por ciento de los pacientes.

Resultados e complicações da braquiterapia de alta taxa de dose endobrônquica e traqueal / Results and complications of tracheal and endobronchial high dose-rats brachytherapy

Para avaliar a eficácia da braquiterapia de alta taxa de dose endobrônquica e endotraqueal nas neoplasias obstrutivas das vias aéreas, suas complicações e sobrevida, foram analisados 84 pacientes tratados de Janeiro de 1991 a Junho de 2002. Foram avaliados parâmetros clínicos e técnicos e sua correlação com a mortalidade. Melhora sintomática foi obtida em / In order to evaluate symptoms palliation, survival and complications in patients with malignant airway obstruction treated with high-dose rate endobronchial brachytherapy, 84 patients treated from January 1991 to June 2002 with a prospective brachytherapy protocol were analyzed. Clinical and technical parameters were evaluated and correlated with mortality. Symptomatic relief was obtained for hemoptysis...

Endobronchial Metastasis of Uterine Cervix Cancer: A Two Case Reports and a Review of the Literature

Endobronchial metastasis from uterine cervix cancer defines a bronchoscopically visible nonpulmonary neoplasm metastatic to the bronchus and histologically identical to cervix cancer. Endobronchial metastasis of uterine cervix cancer is rare, therefore, it is difficult to diagnose without pulmonary symptoms or abnormal radiological findings. Moreover, endobronchial metastasis of a nonpulmonary neoplasm is difficult to differentiate from a primary pulmonary neoplasm. The incidence of endobronchial metastasis is increasing because of the regular use of fiberoptic bronchoscopy and the longer survival of cancer patients. This study describes our experience of two patients with pulmonary symptoms and abnormal radiologic findings during the follow up of uterine cervix cancer, who were diagnosed as having endobronchial metastasis from uterine cervix cancer, and includes a brief review of related articles.

Evaluation of split course and continuous radiation therapy in inoperable non small cell bronchial carcinoma

This study included 192 patients with inoperable non small cell bronchial carcinoma treated radically by irradiation at Faculty of Medicine, University of Alexandria between 1980 to 1989. Two treatment protocols were used in group A, a split- course in 71 patients and 121 patients in group B, continuous course radiation therapy. NSD and BED values were calculated for both treatment groups and were correlated with response and treatment morbidities. The overall [CR+PR] were 34/55 [34/55 [62%] in group A versus 50.75 [67%] in group B. The difference was not statistically significant [P > 0.05]. The two years survival rate was 13/31 [42%] relatively higher in group A compared to 17/47 [36%] in group B, but the difference was not statistically significant. The morbidities were nearly equal in both treatment groups