Corsa P, Parisi S S, Raguso A, el Jaouni M, Fusco V, Maiorana A, Lauriola P, Di Corcia A, Di Cosmo V, Albano A
Servizio di Radioterapia, Ospedale I.R.C.C.S. Casa Sollievo della Sofferenza, San Giovanni Rotondo, FG.
Radiol Med. 1997 Jul-Aug;94(1-2):94-9.
Form March, 1991, to September, 1995, twenty-nine patients with endobronchial neoplastic stenosis were treated with high dose rate (HDR) brachytherapy at the Casa Sollievo della Sofferenza Hospital in San Giovanni Rotondo (Foggia, Italy). Fifteen patients had hemoptysis, 10 dyspnea, 6 constant cough and 6 lung atelectasis. The total dose, specified at 1 cm from the source, ranged 5 to 21 Gy and the fraction doses 5 to 15 Gy. Fourteen of 29 patients (48%) died. The mean survival is 7 months, with the follow-up ranging 1 to 22 months. Subjective responses were achieved in 78.4% of cases, with 67.6% complete and 10.8% partial remission rates. Complete remission of hemoptysis was observed in 100% of patients. Dyspnea improved in 70%, cough in 46.4% and atelectasis in 83.2%. Endoscopic findings, 1 month after the end of brachytherapy, showed a response in 79.4% of patients. The complication rate was 13.8% (1 tracheoesophageal fistula, 2 pulmonary hemorrhages and 1 cavitary necrosis). Even though the number of treated patients is small, our experience confirms the efficacy of HDR endobronchial brachytherapy in the palliation of lung cancer-related symptoms. Literature data show that brachytherapy improves the quality of life in the patients with poor prognosis who are otherwise untreatable. The HDR technique is more accurate than the LDR technique and therapy is better tolerated also because execution time is shorter. Prospective clinical trials are needed to investigate the most effective total doses and fractionations and to better define the role of brachytherapy in the curative treatment of lung cancer.
1991年3月至1995年9月期间，位于意大利福贾省圣乔瓦尼-罗通多的索列沃-德拉-索费伦扎医院对29例支气管内肿瘤性狭窄患者进行了高剂量率近距离放射治疗。15例患者有咯血症状，10例有呼吸困难，6例有持续性咳嗽，6例有肺不张。距放射源1厘米处规定的总剂量为5至21 Gy，分次剂量为5至15 Gy。29例患者中有14例（48%）死亡。平均生存期为7个月，随访时间为1至22个月。78.4%的病例有主观反应，完全缓解率为67.6%，部分缓解率为10.8%。100%的咯血患者完全缓解。70%的呼吸困难患者症状改善，46.4%的咳嗽患者症状改善，83.2%的肺不张患者症状改善。近距离放射治疗结束1个月后的内镜检查结果显示，79.4%的患者有反应。并发症发生率为13.8%（1例气管食管瘘、2例肺出血和1例空洞性坏死）。尽管治疗的患者数量较少，但我们的经验证实了高剂量率支气管内近距离放射治疗在缓解肺癌相关症状方面的有效性。文献数据表明，近距离放射治疗可改善预后较差且无法采用其他治疗方法的患者的生活质量。高剂量率技术比低剂量率技术更精确，而且由于治疗执行时间较短，患者对治疗的耐受性也更好。需要进行前瞻性临床试验，以研究最有效的总剂量和分割方式，并更好地确定近距离放射治疗在肺癌根治性治疗中的作用。
