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A total EQD2 greater than 85 Gy for trachea and main bronchus D2cc being associated with severe late complications after definitive endobronchial brachytherapy.

Murakami N, Kobayashi K, Nakamura S, Wakita A, Okamoto H, Tsuchida K, Kashihara T, Harada K, Yamada M, Sekii S, Takahashi K, Umezawa R, Inaba K, Ito Y, Igaki H, Itami J - J Contemp Brachytherapy (2015)

Bottom Line: The mean EQD2 of LRT D2cc, TMB D2cc, D1cc, and D0.5cc of patients with or without late severe respiratory complications was significantly different between two groups (p = 0.018, 0.008, 0.009, and 0.013, respectively).The 2-year incidence rates of late severe complications in patients with TMB D2cc ≤ 85 Gy in EQD2 and > 85 Gy were 0% and 83.3%, respectively with a statistically significance (p = 0.014).It was discovered that TMB D2cc > 85 Gy in EQD2 is a strong risk factor for severe late respiratory complication after EBBT.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.

ABSTRACT

Purpose: The endobronchial brachytherapy (EBBT) is an established treatment method for tumors of the tracheobronchial system, however, little is known about the tolerance dose for organ at risk (OAR) in EBBT. The purpose of this study is to analyze patients with superficial bronchial carcinoma treated with definitive EBBT, and to investigate a relationship between late complications and dose for OAR.

Material and methods: Endobronchial brachytherapy was performed 6 Gy per fraction for three to four fractions with or without external beam radiation therapy (EBRT). For the purpose of dosimetric analysis, the wall of the lower respiratory tract (LRT: trachea, main bronchus, and lobar bronchiole), trachea, and main bronchus (TMB) was extracted. D0.5cc, D1cc, and D2cc of LRT and TMB were calculated in each EBBT session and added together. V100, V150, and V200 of LRT were also calculated.

Results: Between March 2008 and April 2014, EBBT was performed in 14 patients for curative intent. The 2-year overall survival (OS), progression-free survival (PFS), and local recurrence free survival (LRFS) was 82.1%, 77.9%, and 91.7%, respectively. There was one patient with grade 5, one grade 4, and three grade 3 obstruction of trachea or bronchus. The mean EQD2 of LRT D2cc, TMB D2cc, D1cc, and D0.5cc of patients with or without late severe respiratory complications was significantly different between two groups (p = 0.018, 0.008, 0.009, and 0.013, respectively). The 2-year incidence rates of late severe complications in patients with TMB D2cc ≤ 85 Gy in EQD2 and > 85 Gy were 0% and 83.3%, respectively with a statistically significance (p = 0.014).

Conclusions: It was discovered that TMB D2cc > 85 Gy in EQD2 is a strong risk factor for severe late respiratory complication after EBBT.

No MeSH data available.


Related in: MedlinePlus

Distribution of tumor sites. The number shown in each circle represents individual patient. Because some patients had disease more than one part of the lower respiratory tract, the total number of the circles exceeded the number of patients analyzed in this study. Gray circle represents patients without grade 3 of greater late complication, black circle with late complication, and shaded circle with local recurrence
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Figure 0001: Distribution of tumor sites. The number shown in each circle represents individual patient. Because some patients had disease more than one part of the lower respiratory tract, the total number of the circles exceeded the number of patients analyzed in this study. Gray circle represents patients without grade 3 of greater late complication, black circle with late complication, and shaded circle with local recurrence

Mentions: Figure 1 shows distribution of the sites of the tumor in all the patients. The number shown in each small circle represents individual patient. Some patients had multiple diseases, so the total number of circles, which represent the location of the tumor exceeded the number of patients. Gray circles represent patients without grade 3 of greater late severe respiratory complications, black circles with complications mentioned above, and shaded circles with local recurrence.


A total EQD2 greater than 85 Gy for trachea and main bronchus D2cc being associated with severe late complications after definitive endobronchial brachytherapy.

Murakami N, Kobayashi K, Nakamura S, Wakita A, Okamoto H, Tsuchida K, Kashihara T, Harada K, Yamada M, Sekii S, Takahashi K, Umezawa R, Inaba K, Ito Y, Igaki H, Itami J - J Contemp Brachytherapy (2015)

Distribution of tumor sites. The number shown in each circle represents individual patient. Because some patients had disease more than one part of the lower respiratory tract, the total number of the circles exceeded the number of patients analyzed in this study. Gray circle represents patients without grade 3 of greater late complication, black circle with late complication, and shaded circle with local recurrence
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663210&req=5

Figure 0001: Distribution of tumor sites. The number shown in each circle represents individual patient. Because some patients had disease more than one part of the lower respiratory tract, the total number of the circles exceeded the number of patients analyzed in this study. Gray circle represents patients without grade 3 of greater late complication, black circle with late complication, and shaded circle with local recurrence
Mentions: Figure 1 shows distribution of the sites of the tumor in all the patients. The number shown in each small circle represents individual patient. Some patients had multiple diseases, so the total number of circles, which represent the location of the tumor exceeded the number of patients. Gray circles represent patients without grade 3 of greater late severe respiratory complications, black circles with complications mentioned above, and shaded circles with local recurrence.

Bottom Line: The mean EQD2 of LRT D2cc, TMB D2cc, D1cc, and D0.5cc of patients with or without late severe respiratory complications was significantly different between two groups (p = 0.018, 0.008, 0.009, and 0.013, respectively).The 2-year incidence rates of late severe complications in patients with TMB D2cc ≤ 85 Gy in EQD2 and > 85 Gy were 0% and 83.3%, respectively with a statistically significance (p = 0.014).It was discovered that TMB D2cc > 85 Gy in EQD2 is a strong risk factor for severe late respiratory complication after EBBT.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.

ABSTRACT

Purpose: The endobronchial brachytherapy (EBBT) is an established treatment method for tumors of the tracheobronchial system, however, little is known about the tolerance dose for organ at risk (OAR) in EBBT. The purpose of this study is to analyze patients with superficial bronchial carcinoma treated with definitive EBBT, and to investigate a relationship between late complications and dose for OAR.

Material and methods: Endobronchial brachytherapy was performed 6 Gy per fraction for three to four fractions with or without external beam radiation therapy (EBRT). For the purpose of dosimetric analysis, the wall of the lower respiratory tract (LRT: trachea, main bronchus, and lobar bronchiole), trachea, and main bronchus (TMB) was extracted. D0.5cc, D1cc, and D2cc of LRT and TMB were calculated in each EBBT session and added together. V100, V150, and V200 of LRT were also calculated.

Results: Between March 2008 and April 2014, EBBT was performed in 14 patients for curative intent. The 2-year overall survival (OS), progression-free survival (PFS), and local recurrence free survival (LRFS) was 82.1%, 77.9%, and 91.7%, respectively. There was one patient with grade 5, one grade 4, and three grade 3 obstruction of trachea or bronchus. The mean EQD2 of LRT D2cc, TMB D2cc, D1cc, and D0.5cc of patients with or without late severe respiratory complications was significantly different between two groups (p = 0.018, 0.008, 0.009, and 0.013, respectively). The 2-year incidence rates of late severe complications in patients with TMB D2cc ≤ 85 Gy in EQD2 and > 85 Gy were 0% and 83.3%, respectively with a statistically significance (p = 0.014).

Conclusions: It was discovered that TMB D2cc > 85 Gy in EQD2 is a strong risk factor for severe late respiratory complication after EBBT.

No MeSH data available.


Related in: MedlinePlus