Endobronchial brachytherapy for symptom palliation in non-small cell lung cancer--analysis of symptom response, endoscopic improvement and quality of life.

AIMS: Endobronchial brachytherapy (EBBT) is a useful modality for the palliation of endobronchial symptoms in advanced non-small cell lung cancer (NSCLC). We report our experience with a special emphasis on duration of symptom palliation and the impact on quality of life (QOL). MATERIALS AND METHODS: The records of 95 previously untreated patients with locally advanced NSCLC were treated with palliative radiation using EBBT with or without palliative external radiation (XRT) were analysed. Eighty patients received EBBT and palliative XRT. EBBT was delivered in two sessions of EBBT 8Gy each or a single session of 10Gy. Fifteen patients received EBBT alone to 15Gy in a single session. Symptomatic response rates, duration of symptom palliation, obstruction scores and complications were assessed and compared. Quality of life outcomes, measured using the EORTC QLQ C30 and LC13 questionnaires, were analysed. RESULTS: The overall symptomatic response rates were 93% for dyspnea, 81% for cough, 97% for haemoptysis and 91% for obstructive pneumonia. The median time to symptom relapse was 4-8 months for all symptoms, and the median time to symptom progression was 6-11 months. Quality of life showed significant improvement in symptom scores, functional scales and overall QOL. Complication rates were low. Only one patient died of fatal haemoptysis. CONCLUSION: EBBT is thus a safe and effective palliative tool in advanced non-small cell lung cancer, with a relatively long duration of symptom palliation and a considerable improvement in the quality of life. There is significant reduction of endobronchial obstruction.