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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

Kaplan-Meier survival curves of local recurrence free survival (LRFS), progression free survival (PFS), and overall survival (OS)
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Figure 0002: Kaplan-Meier survival curves of local recurrence free survival (LRFS), progression free survival (PFS), and overall survival (OS)

Mentions: The median follow-up length of living patients was 24.8 months (10.1-77.9). There was one local recurrence and two regional lymph node recurrences observed. The patient with local recurrence received an additional 50 Gy in 25 fractions of EBRT but the disease could not be controlled and this patient eventually died of present disease. First patient with regional lymph node metastasis developed chronic myeloid leukemia (CML) and best supportive care was chosen, and finally died 9 months after lymph node metastasis. Another patient with regional lymph node metastasis received an additional 60 Gy in 30 fractions of EBRT. Although tumor was controlled after the additional EBRT, this patient died of respiratory failure and was counted as having grade 5 late radiation bronchial obstruction. The 2-year OS, PFS, and LRFS was 82.1%, 77.9%, and 91.7%, respectively (Figure 2).


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)

Kaplan-Meier survival curves of local recurrence free survival (LRFS), progression free survival (PFS), and overall survival (OS)
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 0002: Kaplan-Meier survival curves of local recurrence free survival (LRFS), progression free survival (PFS), and overall survival (OS)
Mentions: The median follow-up length of living patients was 24.8 months (10.1-77.9). There was one local recurrence and two regional lymph node recurrences observed. The patient with local recurrence received an additional 50 Gy in 25 fractions of EBRT but the disease could not be controlled and this patient eventually died of present disease. First patient with regional lymph node metastasis developed chronic myeloid leukemia (CML) and best supportive care was chosen, and finally died 9 months after lymph node metastasis. Another patient with regional lymph node metastasis received an additional 60 Gy in 30 fractions of EBRT. Although tumor was controlled after the additional EBRT, this patient died of respiratory failure and was counted as having grade 5 late radiation bronchial obstruction. The 2-year OS, PFS, and LRFS was 82.1%, 77.9%, and 91.7%, respectively (Figure 2).

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