Format

Send to

Choose Destination
See comment in PubMed Commons below
Brachytherapy. 2012 Jul-Aug;11(4):322-6. doi: 10.1016/j.brachy.2012.01.007. Epub 2012 Feb 28.

Endobronchial brachytherapy provides excellent long-term control of recurrent granulation tissue after tracheal stenosis.

Author information

1
Institute of Oncology, Radiation Therapy Unit Davidoff Center, Rabin Medical Center, Petach Tikvah, Israel. aarona2@clalit.org.il

Abstract

PURPOSE:

To review the experience of using endobronchial brachytherapy (EBB) as a treatment for recurrent tracheal granulation tissue.

METHODS AND MATERIALS:

Patients referred for EBB at the Rabin Medical Center for benign stenosis were reviewed with institutional review board approval. Patients underwent bronchoscopic resection of granulation tissue followed by insertion of self-expanding metallic stents. After stenting, repeat laser resection was done at least 1 week before brachytherapy. After CT simulation, patients had three-dimensional brachytherapy treatment planning. A single 10-Gy dose was prescribed to 1.0cm from the source and treatment was delivered using high-dose-rate afterloader with (192)Ir source. Patients were followedup with bronchoscopy every 3 months after the completion of therapy.

RESULTS:

From November 2001 to January 2009, 29 patients were treated with EBB to prevent granulation tissue reformation. Median age was 70 years and 55% of patients were male. Ninety percent of patients were treated to the trachea and the remaining patients had stenoses in the main stem bronchi. The primary cause of stenosis was prolonged mechanical ventilation (76%). The median time from stent placement to brachytherapy was 69 days. Median active length of treatment was 7cm. With a median followup of 36 months, 66% (19 of 29) of patients remained free of granulation tissue. Forty-eight percent of patients have died, with all except 1 patient dying of their underlying condition. A single patient experienced death from tracheoesophageal fistula.

CONCLUSION:

EBB is an effective and safe treatment to prevent recurrent granulation tissue formation after endobronchial resection and should be considered in patients who are unable to undergo surgical resection.

PMID:
22381651
DOI:
10.1016/j.brachy.2012.01.007
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center