Ung Yee C, Yu Edward, Falkson Conrad, Haynes Adam E, Stys-Norman Denise, Evans William K
Toronto-Sunnybrook Regional Cancer Centre, Toronto, ON, Canada.
Brachytherapy. 2006 Jul-Sep;5(3):189-202. doi: 10.1016/j.brachy.2006.05.001.
This review addresses the role of high-dose-rate endobronchial brachytherapy (HDREB) for symptom palliation in patients with non-small-cell lung cancer.
Relevant trials were identified through a systematic search of the literature.
Twenty-nine trials were eligible. Six randomized trials involved HDREB alone or with external beam radiation therapy (EBR) or laser therapy. Median and 1-year survival ranged from 4 to 10 months and from 11% to 38%, respectively. Symptoms controlled by HDREB were dyspnea, cough, chest pain, and hemoptysis. Fatal hemoptysis ranged from 7% to 22%. Better overall symptom palliation and fewer retreatments were required in previously untreated patients using EBR alone or EBR with HDREB.
EBR alone is more effective than HDREB for symptom palliation in previously untreated patients with endobronchial non-small-cell lung cancer. HDREB with EBR seems to provide better symptom relief than EBR alone. HDREB is recommended for symptomatic patients with recurrent endobronchial obstruction previously treated by EBR, providing it is technically feasible.
本综述探讨高剂量率支气管内近距离放射治疗（HDREB）在非小细胞肺癌患者症状缓解中的作用。
通过系统检索文献确定相关试验。
29项试验符合条件。6项随机试验涉及单独使用HDREB或联合外照射放疗（EBR）或激光治疗。中位生存期和1年生存率分别为4至10个月和11%至38%。HDREB控制的症状有呼吸困难、咳嗽、胸痛和咯血。致命性咯血发生率为7%至22%。单独使用EBR或EBR联合HDREB治疗的既往未治疗患者总体症状缓解更好，且需要再次治疗的情况更少。
对于既往未治疗的支气管内非小细胞肺癌患者，单独使用EBR在症状缓解方面比HDREB更有效。HDREB联合EBR似乎比单独使用EBR能提供更好的症状缓解。对于既往接受EBR治疗后出现复发性支气管内阻塞的有症状患者，若技术上可行，推荐使用HDREB。
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