Document Detail

Massive haemoptysis after radiotherapy in inoperable non-small cell lung carcinoma: is endobronchial brachytherapy really a risk factor?
MedLine Citation:
PMID:  10052884     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND PURPOSE: This retrospective study was conducted to investigate whether endobronchial brachytherapy (EBB) is a risk factor for massive haemoptysis in patients primarily treated by a combination of EBB and external irradiation (XRT) for NSCLC. MATERIALS AND METHODS: The records of 938 patients with inoperable NSCLC who were treated with XRT and/or EBB were reviewed. The patients were divided into five groups as follows: group XRT, treated by XRT alone (n = 421); group XRTelig, treated by XRT but eligible for EBB (n = 419); group XRTEBB, primarily treated with EBB+XRT (n = 62); group EBBrec, treated by EBB for recurrence after XRT (n = 23); and group EBB, treated by EBB alone (n = 13). EBB was delivered using HDR. Patients with bronchoscopy-proven endobronchial tumour in the proximal airways, i.e. the trachea, the main bronchus or lobar bronchus were considered eligible for EBB. RESULTS: One hundred one out of 938 patients (10.8%) died from massive haemoptysis. The incidence was 4.3% in group XRT, 13.1% in group XRTelig and 25.4% in group XRTEBB. The differences between groups XRT and XRTelig as well as between groups XRTelig and XRTEBB were statistically significant (P<0.01). The incidence of massive haemoptysis depended significantly on the fraction size of brachytherapy. When two fractions of 7.5 Gy or a single fraction of 10 Gy were used, 11.1% of the patients died from massive haemoptysis. However, when a single dose of 15 Gy was used, 47.8% died from massive haemoptysis. In the multivariate analysis, a single dose of 15 Gy EBB was the most important prognostic factor for massive haemoptysis. CONCLUSION: XRT+EBB as primary treatment for NSCLC does not lead to a higher risk of massive haemoptysis as compared to XRT alone when fraction sizes for EBB of 7.5 or 10 Gy are used. However, the risk of massive haemoptysis increases dramatically when a fraction size of 15 Gy is used.
J A Langendijk; M K Tjwa; J M de Jong; G P ten Velde; E F Wouters
Related Documents :
6256264 - Trophoblastic disease: analysis of 342 patients.
6399984 - Clinical experience with long-term bendroflumethiazide treatment in calcium oxalate sto...
20848404 - Ultrasound-guided mechanical fragmentation of sialoliths (sonoguide forceps).
17263604 - Extracorporeal shockwave lithotripsy versus ureteroscopy for 5- to 10-mm stones in the ...
22167304 - Palliative treatment of rectal carcinoma recurrence using radiofrequency ablation.
11531864 - Randomized clinical trial comparing totally extraperitoneal inguinal hernia repair with...
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology     Volume:  49     ISSN:  0167-8140     ISO Abbreviation:  Radiother Oncol     Publication Date:  1998 Nov 
Date Detail:
Created Date:  1999-04-19     Completed Date:  1999-04-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8407192     Medline TA:  Radiother Oncol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  175-83     Citation Subset:  IM    
Radiotherapeutisch Instituut Limburg, Heerlen, The Netherlands.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Brachytherapy / adverse effects*
Carcinoma, Non-Small-Cell Lung / radiotherapy*
Child, Preschool
Follow-Up Studies
Hemoptysis / epidemiology,  etiology*
Infant, Newborn
Lung / radiation effects*
Lung Neoplasms / radiotherapy*
Middle Aged
Palliative Care
Radiation Injuries / epidemiology,  etiology*
Retrospective Studies
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Moderate dose intraoperative and external beam radiotherapy for locally recurrent rectal carcinoma.
Next Document:  Audiological assessment before and after fractionated stereotactic irradiation for vestibular schwan...