Lung Resection for a Non-small Cell
Carcinoma (Stage IV) with a Permanent Intracavitary Brachytherapy 125I
Fanta J.1, Lang O.2, Vlachová A.3, Votruba J.4, Kára J.5
1 Chirurgická klinika 3. LF UK a FNKV, přednosta doc. MUDr. J. Fanta, DrSc. 2 Klinika nukleární medicíny 3. LF UK a FNKV, primář MUDr. O. Lang 3 II. interní klinika 3. LF UK a FNKV, přednosta prof. MUDr. M. Anděl, CSc. 4 Nemocnice Na Homolce, plicní oddělení, vedoucí MUDr. J. Votruba 5 Oblastní nemocnice Mladá Boleslav, a.s., Klaudiánova nemocnice, Kosmonosy, TRN oddělení, primář MUDr. J. Kára |
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Summary:
In November 2005, the authors used the lung resection method in combination with peroperative brachytherapy125 for
a non-small cell carcinoma, for the first time. The patient had an adenocarcinoma of the right lung T2N2M0, stage IIIA. During
the procedure, the team diagnosed advanced stage of the process, the tumor originated in the hilus region of the middle lobe
with a metastatic spread into the superior and inferior lobe. Distant unilateral lymphonodes were infiltrated simultaneously. The
histological examination confirmed the diagnosis of T2N2M1, however, the original classification was re-assessed and changed
to stage IV. Pneumonectomy with lymphadenectomy of all of the macroscopically detectable lymphonodes was completed.
The lymphatic drainage sites in the upper and lower mediastinum were covered by seeds of a permanent gama emitter 125I
with a total dose of 100 Gy. The patient recovered with no complications and was discharged on the day 8. He was included in
the study and will be followed on a regular basis. On the authors’ opinion, the method of the lung resection with peroperative
permanent brachytherapy has a potential for decreasing the tumor relaps rates, eventually, for improving the patients survival
rates and their quality of life. The authors will continue their applied research of this serious problematics, aiming to confirm
or refuse the stated hypothesis.
Key words:
peroperative brachytherapy – carcinoma of the lung – 125I
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