Endobronchial brachytherapy provides excellent long-term control of recurrent granulation tissue after tracheal stenosis

Aaron M. Allen*, Nader Abdelrahman, David Silvern, Eyal Fenig, Oren Fruchter, Mordechai R. Kramer

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Purpose: To review the experience of using endobronchial brachytherapy (EBB) as a treatment for recurrent tracheal granulation tissue. Methods and Materials: Patients referred for EBB at the Rabin Medical Center for benign stenosis were reviewed with institutional review board approval. Patients underwent bronchoscopic resection of granulation tissue followed by insertion of self-expanding metallic stents. After stenting, repeat laser resection was done at least 1 week before brachytherapy. After CT simulation, patients had three-dimensional brachytherapy treatment planning. A single 10-Gy dose was prescribed to 1.0cm from the source and treatment was delivered using high-dose-rate afterloader with 192Ir source. Patients were followedup with bronchoscopy every 3 months after the completion of therapy. Results: From November 2001 to January 2009, 29 patients were treated with EBB to prevent granulation tissue reformation. Median age was 70 years and 55% of patients were male. Ninety percent of patients were treated to the trachea and the remaining patients had stenoses in the main stem bronchi. The primary cause of stenosis was prolonged mechanical ventilation (76%). The median time from stent placement to brachytherapy was 69 days. Median active length of treatment was 7. cm. With a median followup of 36 months, 66% (19 of 29) of patients remained free of granulation tissue. Forty-eight percent of patients have died, with all except 1 patient dying of their underlying condition. A single patient experienced death from tracheoesophageal fistula. Conclusion: EBB is an effective and safe treatment to prevent recurrent granulation tissue formation after endobronchial resection and should be considered in patients who are unable to undergo surgical resection.

Original languageEnglish
Pages (from-to)322-326
Number of pages5
Issue number4
StatePublished - Jul 2012


  • Brachytherapy
  • Bronchoscopy
  • Tracheal stenosis


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