PREDICTIVE FACTORS FOR LATE TOXICITY AFTER ENDOBRONCHIAL BRACHYTHERAPY: A MULTIVARIATE ANALYSIS

摘要: Abstract Purpose: To determine the predictive factors associated with hemoptysis and radiation bronchitis after endobronchial brachytherapy by univariate multivariate analyses Methods Materials: One hundred forty-nine patients underwent were divided into three therapeutic groups: group 1: treated palliative intent ( n = 47); 2: curative (small tumors without mediastinal or general dissemination: 73); 3: also receiving external irradiation 29). twelve had previously received irradiation. Brachytherapy was delivered a dose per fraction ranging from 4 to 7 Gy prescription point between 0.5 1.5 cm, usually 1 cm source center. Two six fractions according clinical situation. The influence of following variables on incidence studied: age, sex, Karnofsky score, group, histologic type, endoscopic tumor length, fraction, total dose, beam (brachytherapy plus dose), volumes 100% 200% isodoses, 14 isodoses. Results: We observed 11 hemoptyses (7.4%), 10 lethal. All but one occurred in progressive disease. significantly analysis: p 0.009) length 0.004). No technical seem be implicated occurrence hemoptysis. Only remained model 0.02). Radiation 13 cases (8.7%). By analysis, good score 0.02), treatment location trachea main stem bronchus 0.002) this complication. incriminated: 0.04) isodose volume only retained statistical significance 0.009). Conclusion: Hemoptysis is most likely due disease progression, bleeding being facilitated brachytherapy. Some rare could direct complication itself, particularly when are located upper lobes. In contrast, more frequently controlled disease, influenced (dose treated). Technical improvements should increase ratio.