PALLIATIVE ENDOBRONCHIAL RADIOTHERAPY IN LUNG CANCER

Between February 1993-October 1996, 68 lung cancer patients were treated with endobronchial radiotherapy (ERT) for palliation. The median age of the cases was 60 (35-82); 64 were male (94.1 %) and 4 were female (5.9%). Histopathological diagnosis was epidermoid carcinoma in 35 (51.5%), small cell carcinoma in 13 (19.2%), adenocarcinoma in 3 (4.4%) and adeno cystic carcinoma in 2 (2.9%) cases. Remaining 15 patients were diagnosed as non-small cell carcinoma. There were two groups of patients. In the first group there were 48 de novo cases, and they were treated with external beam radiotherapy (10x3 Gy) followed by endobronchial radiotherapy 2 x 7.5 Gy. In the second group there were 20 patients with recurrence; these were treated with 3 x 7.5 Gy endobronchial radiotherapy alone with 7-10 days of interval between fraction. Palliation in the whole group was as follows: cough 59.3%, dyspnea 88.9%, haemoptysia 100%, obstructive pneumonia 88.3%. Overall symptomatic response was 83.6% in the first group and 77.7% for second group. Follow up bronchoscopy was available in 30 cases, total bronchoscopic response was 36.7%, partial response was 43.3%, so overall response was 80%. A total of 149 applications were performed where procedure was disconfirmed due to bronchospasm in one patient and deplacement of the catheters in 2 patients. During follow-up 4 patients (5.9%) died of fatal haemoptysia, of the patients in whom follow up bronchoscopy were performed 2 (6.6%) were developed grade III-IV radiation bronchitis and stenosis. Survival at 6, 12, and 24 months was 48.4%, 31.1 %, 11.6% and 53.8%, 18.89, 0.0% for group 1 and 2 respectively. Median survival was 5 months in the first group and 6 months in the second. Overall survival was 50.4%, 27.5%, 8.9% at 6, 12 and 24 months respectively for whole group. Median survival of the whole group was 6 months. It is concluded that ERT is a good method for the palliation of the symptoms of lung cancer such as haemoptysia, dyspnea, cough, obstructive pneumonia where rapid palliation is of importance.