Abstract
Purpose. The purpose of this study was to assess the efficacy of endobronchial radiation therapy (EBRT) for the local control of endobronchial carcinoma by the tumor-regression-rate, and survival. Methods. The EBRT using ^<192>Ir-HDR was performed on 34 cases with primary lung cancer. The histological types were: 28 squamous cell carcinoma, four small cell carcinoma, one large cell carcinoma, and one adenoid cystic carcinoma. Assessment of efficacy was performed on each ordinary therapeutic group, early cancer group, surgery-combined group, and symptom control group. EBRT was administered by a dosage of either 15-18 Gy/3 Fr. or 10 Gy/1 Fr. and was combined with external beam radiotherapy of 40-70 Gy, in 31 cases (91%). Results. Bronchoscopic response rate (CR + PR) was 84% in over-all groups. This rate means that EBRT has a good potential to improve local tumor control. Survival rate of the ordinary therapeutic group (27 cases) was estimated at 44.3% in one year, 23.6% in two years, and 5.9% in three years. Mean survival time was 10.8 months. Long cancer-free survival was obtained in an early cancer group (3 cases). This proved the good efficacy of EBRT for the treatment of hilar early squamous cell carcinoma. In two cases of the symptom control group, the hemosputa could not be controlled sufficiently. In another two cases of surgery-combined group, bronchial or tracheal reconstruction procedures, which is troublesome even after the ordinary radiation therapy, was performed successfully. No serious problems were encountered surrounding the wound healing and patients recovered well. They survived a long time without recurrence. Conclusion. EBRT, including the combination of external beam radiation therapy, was useful to control a local growth of the endobronchial carcinoma. EBRT was also effective for the treatment of early squamous cell carcinoma. Surgical resection after the EBRT was well tolerated and contributed to the long survival.
