Merdan FAYDA, Ahmet ILGAZLI, Görkem AKSU, Zeliha ARSLAN, Ayşegül YILDIRIM

Argon plazma koagülasyonu sonrası üç boyutlu endobronşiyal brakiterapi

Endobronşiyal brakiterapinin bilgisayarlı tomografi (BT) eşliğinde üç boyutlu planlanması, akciğer kanseri olan hastalarda dozun doğru bölgeye uygulanmasında yardımcı olabilmektedir. Bu makalede, daha önce kemoterapi ve eksternal radyoterapi uygulanmış, hemoptizi, ses kısıklığı, nefes darlığı yakınmaları ile başvuran T3N3 k üçük h ücreli d ışı a kciğer k anserli 6 0 yaşında bir erkek hasta sunuldu. İlk bronkoskopide sol üst ve alt lob girişini tama yakın tıkayan endobronşiyal lezyonda hemoraji oluşması üzerine argon lazer ile koagülasyon sağlandı. Bilgisayarlı tomografi eşliğinde üç boyutlu planlama ile üç fraksiyonda 5Gy/hafta yüksek doz hızlı endobronşiyal brakiterapi uygulanan hastanın atelektazisi açıldı ve hemoptizi ve solunum yakınmalarında düzelme sağlandı.

The three dimensional endobronchial brachytherapy after the argon plasma coagulation

Three dimensional (3D) endobronchial brachytherapy planning with computed tomography (CT) guidance may help the accurate localization of the target where the prescription dose was administered in patients with lung cancer. In this article, we present a 60-year-old male case of T3N3 non-small cell lung cancer patient who was previously treated with chemotherapy and external beam radiotherapy and was admitted with the complaints of hemoptysis, hoarseness and dyspnea. In his first bronchoscopy, argon laser coagulation was used due to massive hemorrhage of endobronchial lesion obstructed almost totally the left upper and lower lobes. The 3-fraction of 5Gy/week high dose rate endobronchial brachytherapy was applied with CT guided 3 dimensional planning and the atelectasis was opened, while hemoptysis and dyspnea were improved.

PDF

___

1. Gollins SW, Burt PA, Barber PV, Stout R. High dose rate intraluminal radiotherapy for carcinoma of the bronchus: outcome of treatment of 406 patients. Radiother Oncol 1994;33:31-40.
2. Speiser BL, Spratling L. Remote afterloading brachytherapy for the local control of endobronchial carcinoma. Int J Radiat Oncol Biol Phys 1993;25:579-87.
3. Ozkok S, Karakoyun-Celik O, Goksel T, Mogulkoc N, Yalman D, Gok G, et al. High dose rate endobronchial brachytherapy in the management of lung cancer: response and toxicity evaluation in 158 patients. Lung Cancer 2008;62:326-33.
4. Anacak Y, Mogulkoc N, Ozkok S, Goksel T, Haydaroglu A, Bayindir U. High dose rate endobronchial brachytherapy in combination with external beam radiotherapy for stage III non-small cell lung cancer. Lung Cancer 2001;34:253-9.
5. Beder S. Endobronşiyal tedavi yöntemleri. T Klin Tıp Bilimleri 1995;15:437-42
6. Senan S, Lagerwaard FJ, de Pan C, Sipkema D, Burgers SA, Murrer LH. A CT-assisted method of dosimetry in brachytherapy of lung cancer. Rotterdam Oncological Thoracic Study Group. Radiother Oncol 2000;55:75-80.
7. Langendijk JA, Tjwa MK, de Jong JM, ten Velde GP, Wouters EF. Massive haemoptysis after radiotherapy in inoperable non-small cell lung carcinoma: is endobronchial brachytherapy really a risk factor? Radiother Oncol 1998;49:175-83.
8. Pérol M, Caliandro R, Pommier P, Malet C, Montbarbon X, Carrie C, et al. Curative irradiation of limited endobronchial carcinomas with high-dose rate brachytherapy. Results of a pilot study. Chest 1997;111:1417-23.