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Titolo:
External irradiation versus external irradiation plus endobronchial brachytherapy in inoperable non-small cell lung cancer: a prospective randomized study
Autore:
Langendijk, H; de Jong, J; Tjwa, M; Muller, M; ten Velde, G; Aaronson, N; Lamers, R; Slotman, B; Wouters, M;
Indirizzi:
Radiotherapeut Inst Limburg, Heerlen, Netherlands Radiotherapeut Inst Limburg Heerlen Netherlands g, Heerlen, Netherlands Vrije Univ Amsterdam, Univ Hosp, Dept Radiat Oncol, Amsterdam, NetherlandsVrije Univ Amsterdam Amsterdam Netherlands ncol, Amsterdam, Netherlands De Wever Ziekenhuis, Dept Resp Dis, Heerlen, Netherlands De Wever Ziekenhuis Heerlen Netherlands Resp Dis, Heerlen, Netherlands Netherlands Canc Inst, Div Psychosocial Res & Epidemiol, Amsterdam, Netherlands Netherlands Canc Inst Amsterdam Netherlands iol, Amsterdam, Netherlands Univ Hosp Maastricht, Dept Resp Dis, Maastricht, Netherlands Univ Hosp Maastricht Maastricht Netherlands is, Maastricht, Netherlands Univ Hosp Maastricht, Dept Radiol, Maastricht, Netherlands Univ Hosp Maastricht Maastricht Netherlands ol, Maastricht, Netherlands
Titolo Testata:
RADIOTHERAPY AND ONCOLOGY
fascicolo: 3, volume: 58, anno: 2001,
pagine: 257 - 268
SICI:
0167-8140(200103)58:3<257:EIVEIP>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
MALIGNANT AIRWAY-OBSTRUCTION; QUALITY-OF-LIFE; RATE INTRALUMINAL IRRADIATION; DOSE-RATE BRACHYTHERAPY; BRONCHOGENIC-CARCINOMA; RADIATION-THERAPY; PALLIATIVE RADIOTHERAPY; CLINICAL-TRIALS; LOCAL-CONTROL; DOSIMETRY;
Keywords:
external irradiation; endobronchial brachytherapy; non-small cell lung cancer;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
33
Recensione:
Indirizzi per estratti:
Indirizzo: Langendijk, H Radiotherapeut Inst Limburg, Heerlen, Netherlands Radiotherapeut Inst Limburg Heerlen Netherlands therlands
Citazione:
H. Langendijk et al., "External irradiation versus external irradiation plus endobronchial brachytherapy in inoperable non-small cell lung cancer: a prospective randomized study", RADIOTH ONC, 58(3), 2001, pp. 257-268

Abstract

Purpose: No randomized studies are available on the additional value of endobronchial brachytherapy (EBB) to external irradiation (XRT) regarding palliation of respiratory symptoms (RS). A prospective randomized study was initiated to test the hypothesis that the addition of EBB to XRT provides higher levels of palliation of dyspnea and other RS and improvement of qualityof life (QoL) in patients with non-small cell lung cancer (NSCLC) with endobronchial tumour. Materials and methods: Patients with previously untreated NSCLC, stages I-IIIb, WHO-performance status of 0-3 and with biopsy proven endobronchial tumour in the proximal airways were eligible. EBB consisted of two fractions of 7.5 Gy at 1 cm on day 1 and 8. XRT started at day 2. The XRT dose was 30Gy (2 weeks) or 60 Gy (6 weeks). The EORTC QLQ-C30 and QLQ-LC13 were assessed before treatment and 2 weeks, 6 weeks, 3, 6 and 12 months after treatment. Re-expansion of collapsed lung was tested by the inspiratory vital capacity (IVC) and CT scan of the chest. Results: Ninety-five patients were randomized between arm 1 (XRT alone) (n= 48) or arm 2 (XRT + EBB) (n = 47). The arms were well balanced regardingpre-treatment characteristics and QoL scores. The compliance for QoL-assessment was >90% at all times. No significant difference between the trial arms was observed with respect to response of dyspnea. However, a beneficial effect of EBB was noted concerning the mean scores of dyspnea over time (P = 0.02), which lasted for 3 months. This benefit was only observed among patients with an obstructing tumour of the main bronchus. A higher rate of re-expansion of collapsed lung was observed in arm 2 (57%) compared to arm 1 (35%) (P = 0.01). The inspiratory vital capacity (IVC) assessed 2 weeks after radiotherapy improved with 493 cm(3) in arm 2 and decreased 50 cm(3) in arm 1 (P = 0.03). No difference was noted regarding the incidence of massive haemoptysis (13 vs. 15%). Conclusion: The addition of EBB to XRT in NSCLC is safe and provides higher rates of re-expansion of collapsed lung resulting in a transient lower levels of dyspnea. This beneficial effect was only observed among patients with obstructing tumours in the main bronchus. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 06/04/20 alle ore 08:14:00