Endobronchial brachytherapy—A novel approach for the management of airway amyloidosis

Assaf Moore, Mordechai R. Kramer, David Silvern, Osnat Shtraichman, Aaron M. Allen

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Airway amyloidosis is an uncommon condition and may have variable clinical course. There is no proven systemic therapy, and the management mainly relies on local invasive treatments. Several reports have found external beam radiotherapy to produce durable responses. The optimal dose and fractionation has not been determined. Endobronchial brachytherapy (EBB) has never been reported to affect this disease. Methods: The study includes a retrospective chart review of all patients with airway amyloidosis treated with EBB at the Davidoff Cancer Center. Data include symptoms, radiotherapy method and dose, treatment outcomes, and toxicities. Results: Three patients were included. Patients were either symptomatic with extensive airway involvement or have undergone multiple local procedures with rapid recurrence of the amyloid deposits. Two patients had upper and 1 patient had lower airway involvement. Two were treated with external beam radiotherapy and EBB and 1 was treated with EBB only. All patients achieved rapid improvement of symptoms with visible improvement in followup bronchoscopies. EBB doses ranged from 7.5 to 10 Gy. Of the seven lesions treated with EBB, only one lesion recurred 6 months from treatment. No major toxicities were reported. Conclusions: EBB is effective and safe for the management of airway amyloidosis and can offer long-term control. This is the first report of EBB for this indication. EBB should be further explored as means of minimizing the irradiated lung volume.

Original languageEnglish
Pages (from-to)966-972
Number of pages7
JournalBrachytherapy
Volume17
Issue number6
DOIs
StatePublished - 1 Nov 2018

Keywords

  • Airway amyloidosis
  • Endobronchial brachytherapy
  • Radiotherapy

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