[Endobronchial brachytherapy with high dose rate 192Ir afterloading technique using a new applicator].

Recently, high dose rate endobronchial brachytherapy has been carried out for the treatment of lung cancer. We devised a new applicator for Ir-192 high dose rate brachytherapy that can position the source in the center of the bronchial lumen, and tried to set up reference points according to bronchial diameter, for optimal dose distribution. Treatment consisted of external beam radiotherapy (40-60 Gy in 4-6 weeks) and endobronchial brachytherapy (6 Gy x 3 fractions for curative intent, 10 Gy x 1 fraction for palliative intent). Reference dose points were 3, 5, 7 and 10 mm from the center of the source according to bronchial diameter. We treated 19 patients with endobronchial brachytherapy and used the new applicator in 13 of them. We could place the applicator in all 13 patients, and no remarkable side effects were observed during the observation period. Our newly designed applicator will help to reduce radiation side effects caused by irradiation overdose due to adherence of the source to the bronchial wall. The reference point should be set according to bronchial diameter not only for curative intent but also palliative intent.