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Japanese Journal of Clinical Oncology Advance Access published online on August 22, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn077
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© The Author (2008). Published by Oxford University Press. All rights reserved

Long-term Observation of 64 Patients with Roentgenographically Occult Lung Cancer Treated with External Irradiation and Intraluminal Irradiation Using Low-dose-rate Iridium

Nobukazu Fuwa1, Takeshi Kodaira2, Hiroyuki Tachibana2, Tatsuya Nakamura1, Natsuo Tomita2 and Takashi Daimon3

1 Department of Radiation Oncology, Southern Tohoku Proton Center, Fukushima
2 Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya
3 Division of Drug Evaluation and Informatics, Graduate School of Pharmaceutical Sciences, University of Shizuoka, Shizuoka, Japan

For reprints and all correspondence: Nobukazu Fuwa, 7-115, Hachiyamada, 963-8563 Koriyama, Japan. E-mail: nobufuwa{at}nifty.com

Received July 9, 2008; accepted July 17, 2008

Objective: Therapeutic results of intraluminal irradiation were analyzed in 64 patients with roentgenographically occult lung cancer (ROLC).

Methods: The subjects were 64 patients who underwent intraluminal irradiation between 1987 and 2003. Radiotherapy was performed by combining external irradiation with intraluminal irradiation using low-dose-rate iridium (four 370-MBq wires) through a catheter with a spacer. The doses of radiation were 0–70 Gy (median value 46 Gy) by external irradiation and 10–60 Gy (median value 29.3 Gy) by intraluminal irradiation.

Results: The therapeutic effect was CR in 63 patients and PR in 1 patient, and local recurrence was observed in a PR case and in seven of the 63 patients who showed CR. The 5-year overall and relapse-free survival rates were 56 (95% CI, 43–69%) and 55% (95% CI, 43–68%), respectively. Fatal pulmonary hemorrhage was observed in one case.

Conclusions: Considering the facts that ROLC often occurs as multiple cancers and that many patients with ROLC have reduced lung function, radiation therapy by a combination of intraluminal and external irradiation may replace surgery as the first choice for the treatment of this disease.

Key Words: roentgenographically occult lung cancer • intraluminal irradiation • external irradiation • iridium thin wire


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