After they have received initial radiation therapy, additional external beam radiotherapy is usually contraindicated because of the risk of damage to normal structures. However, additional treatment modalities to manage the endobronchial disease may be beneficial. Managing incurable endobronchial cancer can provide important palliation to patients suffering from endobronchial obstruction. These modalities can be used individually or can be used in combination. Brachytherapy Brachytherapy is a means of delivering endobronchial radiation therapy with minimal additional injury to lung parenchyma.
Fluoroscopy provides additional confirmation of catheter position.
The catheter is then taped in place, and the patient is transferred to a lead-lined room. 192Ir pellets are then placed in the catheter by the radiotherapist. Typically a dose of 3000 cGy at 0.5 cm is used. Depending on the activity of the source, the catheter is usually in place for 12 to 24 hr. Coughing is suppressed with low dose codeine.