HDR endobronchial brachytherapy (HDRBT) in the management of advanced lung cancer--comparison of two different dose schedules.

PURPOSE

The aim of this work is to compare the results of various treatment protocols used in palliative HDRBT with the view of analyzing differences in survival and diminishing breathing difficulties.

MATERIAL AND METHODS

A total of 648 patients with advanced lung cancer were divided into two groups according to their clinical stage and the Zubrod-ECOG-WHO score. 303 (46.8%) patients received a total dose of 22.5 Gy in 3 fractions once a week, and 345 (53.2%) patients received a single fraction of 10 Gy. They were under clinical and endobronchial observation taking into consideration survival rates, local remission and duration of symptom relief such as dyspnoea, breathing, cough and haemoptysis.

RESULTS

There was no difference in the length of survival time between the two groups of patients (log-rank test, p=0.055). Patients showing improvement (objective response) survived longer than those who showed no change or progression (F Cox, p=0.000001). In multivariate analysis the other statistically important prognostic factors were: clinical stage of primary tumor (F Cox, p=0.000002), Zubrod-ECOG-WHO score (F Cox, p=0.002) and age of patients (F Cox, p=0.004).

CONCLUSIONS

The two treatment protocols showed similar efficiency in overcoming difficulties in breathing. Prognostic factors that significantly correlated with survival length were: grade of remission after treatment, clinical stage and performance status.