A PROPOSAL FOR GUIDELINES FOR HIGH DOSE RATE ENDOBRONCHIAL BRANCHYTHERAPY

To proceed with endobronchial brachytherapy with high dose rate Ir-192 safely, we have proposed a standard method of treatment. Since 1997, the Dokiya group of cancer research, entrusted by the Ministry of Health and Welfare, studied this topic. By investigating the results of a questionnaire given to domestic institutions, guidelines for a treatment protocol were proposed as follows. A. External beam radiotherapy of 40 Gy for 4 weeks and endobronchial brachytherapy with three fractions of 6 Gy for patients with roentgenographically occult lung cancer. B. External beam radiotherapy of 60 Gy for 6 weeks and endobronchial brachytherapy with two or three fractions of 6 Gy for patients with lung cancer, with the intent of elimination of the tumor. C. Endobronchial brachytherapy with one fraction of 10 Gy to patients for palliative intent. At the time of treatment, an applicator should be used of which the source transfer tube is contained in the center of the lumen. The reference dose points are 10 mm from the source axis for the trachea and main bronchus, 5 mm from the source axis for the lobar bronchus, segmental, and sub-segmental bronchus.