Management of malignant airway compromise with laser and low dose rate brachytherapy: The Mayo Clinic experience

M. F. Schray, J. C. McDougall, A. Martinez, Denis Cortese, W. M. Brutinel

Research output: Contribution to journalArticle

79 Citations (Scopus)

Abstract

Between January 1983 and October 1985, 65 patients with malignant airway compromise have had 93 flexible bronchoscopic placements of a nylon afterloading catheter for low dose rate iridium-192 temporary intraluminal brachytherapy. All patients received prior (59 patients) and/or concurrent (13 patients) external beam irradiation to 'tolerance' and were not candidates for surgery. Forty of these patients also received neodymium-YAG laser treatment prior to brachytherapy in a planned combined approach to provide immediate symptomatic relief and facilitate catheter placement. A dose of 3,000 cGy is prescribed to 5 mm and 10 mm radii over 20-40 hours in the bronchus and trachea, respectively. Of 59 patients treated with palliative intent, 40 patients (68 percent) have had follow-up bonchoscopy, 18 patients have had clinical follow-up only, and one patient was lost to follow-up. Of 40 patients examined by bronchoscope in follow-up, 24 (60 percent) responded, eight were stable, and eight progressed. Lack of progression after prior external beam radiation for periods of >12 months, six-12 months and <six months yielded response rates to brachytherapy in 83 percent, 50 percent and 31 percent, respectively. Most patients with clinical follow-up only expired at early intervals with airway palliation from extra-airway disease progression. Four of five patients treated with curative intent are disease-free at a median of 16 months. Eleven patients have experienced fistula and/or hemorrhage, of which seven instances (11 percent of all patients) appear to be treatment-induced. This brachytherapy technique is simple, well tolerated, and convenient for the patient providing airway palliation in the significant majority of patients with acceptable risk.

Original languageEnglish (US)
Pages (from-to)264-269
Number of pages6
JournalChest
Volume93
Issue number2
StatePublished - 1988
Externally publishedYes

Fingerprint

Airway Management
Brachytherapy
Lasers
Catheters
Neodymium
Bronchoscopes
Iridium
Lost to Follow-Up
Nylons
Solid-State Lasers
Bronchi
Trachea

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Schray, M. F., McDougall, J. C., Martinez, A., Cortese, D., & Brutinel, W. M. (1988). Management of malignant airway compromise with laser and low dose rate brachytherapy: The Mayo Clinic experience. Chest, 93(2), 264-269.

Management of malignant airway compromise with laser and low dose rate brachytherapy : The Mayo Clinic experience. / Schray, M. F.; McDougall, J. C.; Martinez, A.; Cortese, Denis; Brutinel, W. M.

In: Chest, Vol. 93, No. 2, 1988, p. 264-269.

Research output: Contribution to journalArticle

Schray, MF, McDougall, JC, Martinez, A, Cortese, D & Brutinel, WM 1988, 'Management of malignant airway compromise with laser and low dose rate brachytherapy: The Mayo Clinic experience', Chest, vol. 93, no. 2, pp. 264-269.
Schray, M. F. ; McDougall, J. C. ; Martinez, A. ; Cortese, Denis ; Brutinel, W. M. / Management of malignant airway compromise with laser and low dose rate brachytherapy : The Mayo Clinic experience. In: Chest. 1988 ; Vol. 93, No. 2. pp. 264-269.
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