Intraluminal irradiation in bronchogenic carcinoma.

Endobronchial tumors present a difficult therapeutic problem. Most often these patients have primary lung cancer and present with endobronchial disease following a definitive course of surgery and/or irradiation. The most common methods of treatment include transbronchial excision of tumor or laser coagulation. The improvement obtained from these procedures is usually limited to 2 or 3 months, and repeated treatments become more difficult and less effective. A number of brachytherapy radiation techniques have been developed to deliver localized radiation in higher doses without exceeding surrounding normal tissue tolerance. Intraluminal radiation with brachytherapy techniques consists of implantation of radioactive pellets into the tumor through a rigid or flexible bronchoscope or the use of afterloading removable implants with remote afterloading techniques. These procedures can be combined with laser therapy to obtain effective palliation and long-term tumor control. Initial results appear promising.