Certain patients with a diagnosis of lung cancer may be candidates for Endobroncial High Dose Rate (HDR) Brachytherapy.   

Endobroncial HDR requires implantation of a small intraluminal catheter through the patient’s nose into the lung adjacent to the area where the tumor is located. This catheter is placed by a pulmonologist in a surgical suite while the patient is under sedation. It is inserted on the day of the procedure and generally takes no more than 20 minutes to insert. 

Once the catheter is in place, the patient, still under sedation, will be transferred to the radiation department, and a CT scan will be performed under the supervision of a radiation oncologist. That scan generally will take about 15 minutes to complete. Upon the completion of the CT scan, the patient will be transferred to a special radiation suite where they will remain sedated and monitored by a team of specially trained registered nurses. During this time, the radiation oncologist reviews the images from the CT scan and develops a treatment plan. This plan generally takes about 30 minutes to complete.

Once the treatment plan is complete, a special machine called a high dose rate afterloader holding a small, radioactive source will be wheeled up next to the patient. A catheter will be hooked into the machine, with the other end attached to the intraluminal catheter that is in the patient’s lung. Once attached, the radioactive source will be sent out of the afterloader machine, through the catheters, and will be stopped at the end of the catheter that is in the patient’s lung, adjacent to the area where the tumor is located. This radioactive source will be held in position for about 10-15 minutes to treat the tumor. The patient should not experience any pain during the treatment. Once complete, the radioactive source will be retracted back through the catheters into the afterloader machine.  The catheters are then disconnected and the intraluminal catheter is removed from the patient’s lung. Removal of the catheter generally takes less than one minute. The patient will continue to be monitored for a period of time until the sedation has completely worn off, usually about 20-30 minutes, and then allowed to leave. That completes one treatment course.