Diathermy resection and radioactive gold grains for palliation of obstruction due to recurrence of bronchial carcinoma after external irradiation.

During 1985-7 15 patients previously treated by external radiotherapy for inoperable carcinoma of the lower trachea and major bronchi underwent endobronchial insertion of radioactive gold grains as a palliative procedure for relief of symptoms. Four patients had undergone three or more endobronchial laser treatments before being referred. Under general anaesthesia diathermy was used to resect obstructing tumour before the insertion of the gold grains into the tumour and the compressed endobronchial wall. Four patients died within one month. The remaining 11 patients were symptomatically and objectively improved when assessed at one month. Both collapsed lungs and three out of six collapsed lobes had re-expanded. Fourteen of the 15 patients died within 13 months (median survival 2.5 months); one patient with recurrent symptoms after 10 months underwent a further implantation and is alive after two years.