The role of high-dose-rate brachytherapy in the palliation of symptoms in patients with non–small-cell lung cancer: A systematic review

Ung, Yee C.; Yu, Edward; Falkson, Conrad; Haynes, Adam E.; Stys-Norman, Denise; Evans, William K.; Lung Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-based Care,

doi:10.1016/j.brachy.2006.05.001

« PreviousBrachytherapy
Volume 5, Issue 3 , Pages 189-202, July 2006

The role of high-dose-rate brachytherapy in the palliation of symptoms in patients with non–small-cell lung cancer: A systematic review

Yee C. Ung
- Toronto-Sunnybrook Regional Cancer Centre, Toronto, ON, Canada
- Corresponding author. Cancer Care Ontario Program in Evidence-based Care, McMaster University, Downtown Campus, 1280 Main St W, Hamilton, ON, Canada L8S 4L8. Tel.: +1-905-525-9140, ext. 22172; fax: +1-905-522-7681.
Edward Yu
- London Regional Cancer Centre, London, ON, Canada
Conrad Falkson
- Cancer Centre of Southeastern Ontario at Kingston General Hospital, Kingston, ON, Canada
Adam E. Haynes
- Cancer Care Ontario's Program in Evidence-based Care, McMaster University, Hamilton, ON, Canada
Denise Stys-Norman
- Cancer Care Ontario's Program in Evidence-based Care, McMaster University, Hamilton, ON, Canada
William K. Evans
- Juravinski Cancer Centre at Hamilton Health Sciences and McMaster University, Hamilton, ON, Canada
Lung Cancer Disease Site Group of Cancer Care Ontario's Program in Evidence-based Care
- Cancer Care Ontario's Program in Evidence-based Care, McMaster University, Hamilton, ON, Canada
- See the Program in Evidence-based Care section of Cancer Care Ontario's Web site (http://www.cancercare.on.ca/) for a list of current Disease Site Group members.

Received 27 March 2006; received in revised form 16 May 2006; accepted 30 May 2006.

Abstract

Purpose

This review addresses the role of high-dose-rate endobronchial brachytherapy (HDREB) for symptom palliation in patients with non–small-cell lung cancer.

Methods and materials

Relevant trials were identified through a systematic search of the literature.

Results

Twenty-nine trials were eligible. Six randomized trials involved HDREB alone or with external beam radiation therapy (EBR) or laser therapy. Median and 1-year survival ranged from 4 to 10 months and from 11% to 38%, respectively. Symptoms controlled by HDREB were dyspnea, cough, chest pain, and hemoptysis. Fatal hemoptysis ranged from 7% to 22%. Better overall symptom palliation and fewer retreatments were required in previously untreated patients using EBR alone or EBR with HDREB.

Conclusions

EBR alone is more effective than HDREB for symptom palliation in previously untreated patients with endobronchial non–small-cell lung cancer. HDREB with EBR seems to provide better symptom relief than EBR alone. HDREB is recommended for symptomatic patients with recurrent endobronchial obstruction previously treated by EBR, providing it is technically feasible.

Keywords: Non–small-cell lung cancer, High-dose-rate brachytherapy, Radiation therapy, External beam, Systematic review