Image-guided interstitial high-dose-rate brachytherapy for dose escalation in the radiotherapy treatment of locally advanced lung cancer: A single-institute experience.

PURPOSE

To evaluate the clinical outcome after CT-guided interstitial high-dose-rate (HDR) brachytherapy for dose escalation in the radiotherapy treatment of inoperable locally advanced non-small-cell lung cancer (NSCLC).

METHODS AND MATERIALS

From 2005 to 2015, 16 patients with unresectable NSCLC were treated. Median age was 65.7 years (range, 52-86). The median tumor volume was 95.3 cm (range, 20.0-2000.0). The median prescribed HDR was 15.0 Gy (range, 7.0-32.0) delivered in twice-daily fractions of 6.0-8.0 Gy in 4 patients and in once-daily fractions of 7.0-15.0 Gy in 12 patients, respectively.

RESULTS

After a median followup of 12.5 months, median overall survival and local control was 12.9 and 24.9 months, respectively. The corresponding median overall survival and local control rates at 1, 2, and 3 years were 56.2%, 37.5%, and 12.5% as well as 68.9%, 57.4%, and 43%, respectively. Apart from one Grade 1 cough episode persisting for 1 week and one patient developing a minor hemopneumothorax requiring no postprocedural drainage, no other adverse events were recorded.

CONCLUSIONS

CT-guided interstitial HDR brachytherapy is a safe modality for radiation dose escalation which may play a role in the definitive radiotherapy treatment of locally advanced NSCLC.