KEY POINTS
- This single-centre retrospective study evaluated 46 lung tumours in 32 patients treated with computed tomography-guided interstitial high-dose-rate brachytherapy.
- Patients had medically inoperable primary lung cancer or pulmonary metastases. 63% of lesions were central, and the planning target volume was identical to the gross tumour volume without an additional margin.
- A single fraction was delivered with a median prescription dose of 20 Gy. Median target D95 was 20.6 Gy, while the median dose to 10% of the target was 117 Gy.
- Two-year local tumour control was 81% and remained 81% through the maximum follow-up of 62 months.
- Pneumonitis was grade 1 in 57%, grade 2 in 9% and grade 3 in 7% of treatments. No grade 4 pneumonitis was reported.
- Pneumothorax occurred after 33% of procedures and required drainage after 15%. Partial or complete atelectasis occurred after 22% and 2%, respectively.
- Early ground-glass opacity and spotted consolidation were followed by dense or streaky consolidation and progressive retraction. Increasing fibrosis during the second year was observed in 77% of cases.
CLINICAL TAKEAWAY
Mass-like consolidation and increasing retraction are expected after single-fraction interstitial lung brachytherapy and should not automatically be interpreted as recurrence. The evidence is limited by the small, heterogeneous cohort and lack of systematic pathological confirmation of suspicious imaging changes.