Bronchoscopic brachytherapy

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Abstract
Increasing lung cancer mortality has created renewed interest in the bronchoscopic use of isotopes for palliation of recurrent airway carcinomas. In the first part of this paper we report our clinical experience with iodine-125 implantation for treatment of endobronchial carcinomas in 18 patients followed until death. Symptoms of cough, hemoptysis, and dyspnea were most effectively relieved with tumors limited to the bronchial lumen. Contraindications to this procedure include extensive extrabronchial tumors causing airway compression and severe debility. In the second part of this paper the development of a new isotope delivery system designed to overcome technical difficulties experienced in the treatment of some patients with interstitial iodine 125 is described. An isotope capsule was constructed to permit insertion and removal by means of a fiberoptic bronchoscope. This device was successfully tested in animals and is now approved for clinical trials. It represents a unique, new modality for treatment of superficial, multifocal, and less-advanced recurrent bronchogenic carcinomas.