125I Brachytherapy in Locally Advanced Nonsmall Cell Lung Cancer After Progression of Concurrent Radiochemotherapy

Abstract

To investigate the safety and effectiveness of computed tomography (CT)-guided 125I seed implantation for locally advanced nonsmall cell lung cancer (NSCLC) after progression of concurrent radiochemotherapy (CCRT).We reviewed 78 locally advanced NSCLC patients who had each one cycle of first-line CCRT but had progressive disease identified from January 2006 to February 2015 at our institution. A total of 37 patients with 44 lesions received CT-guided percutaneous 125I seed implantation and second-line chemotherapy (group A), while 41 with 41 lesions received second-line chemotherapy (group B).Patients in group A and B received a total of 37 and 41 first cycle of CCRT treatment. The median follow-up was 19 (range 3–36) months. After the second treatment, the total response rate (RR) in tumor response accounted for 63.6% in group A, which was significantly higher than that of group B (41.5%) (P = 0.033). The median progression-free survival time (PFST) was 8.00 ± 1.09 months and 5.00 ± 0.64 months in groups A and B (P = 0.011). The 1-, 2-, and 3-year overall survival (OS) rates for group A were 56.8%, 16.2%, and 2.7%, respectively. For group B, OS rates were 36.6%, 9.8%, and 2.4%, respectively. The median OS time was 14.00 ± 1.82 months and 10.00 ± 1.37 months for groups A and B, respectively (P = 0.059). Similar toxicity reactions were found in both groups. Tumor-related clinical symptoms were significantly reduced and the patients’ quality of life was obviously improved.CT-guided 125I seed implantation proved to be potentially beneficial in treating localized advanced NSCLC; it achieved good local control rates and relieved clinical symptoms without increasing side effects.

Clinical efficacy and prognostic factors of CT-guided 125I brachytherapy for the palliative treatment of retroperitoneal metastatic lymph nodes

“…Previous studies don't further explore the factors that can affect clinical efficacy and survival of 125 I brachytherapy [15][16][17][18][19]. Therefore, the main purpose of our study was to explore the potential factors that could influence the clinical efficacy of 125 I brachytherapy.…”

“…The dose within PTV should achieve 95% of the prescribed dose (Vl00 > 95%). According to our previous research experience, the prescription dose was 120 (110-140) Gy [15,19,21]. Fused lymph nodes means multiple lymph nodes (2-5) merge into one large lymph node.…”

“…Low-dose radiation from the radioactive seeds then continuously emit β or γ-rays to kill or inhibit the growth of tumor cells. One of the advantages of brachytherapy is that radiation exposure is localized, thereby preventing off-target radiation damage to adjacent normal tissues [15]. As a result, brachytherapy is often used in patients with tumors in complex locations, or in patients who cannot tolerate traditional radiotherapy [16][17][18].…”

Endobronchial Ultrasound-Guided Iodine-125 Radioactive Seed Implantation as a Novel Therapy for Mediastinal Tumors

“…I n recent years, with the development of nuclear medicine and the treatment planning system (TPS) for iodine-125 ( 125 I), the advent of interstitial implant brachytherapy has been widely used in various malignant solid tumors, such as prostate cancer, pancreatic cancer, liver cancer, peripheral lung cancer, cancers of the head and neck, and other malignant tumors, and this has been proven to exhibit significant efficacy. [1][2][3][4][5][6][7][8][9] To date, the treatment of 125 I seed implantation has been mostly guided by computed tomography (CT). However, CT-guided percutaneous 125 I implantation remains limited for mediastinal lymph node metastasis and lung cancer due to the distance of the tumor from the skin, high risk of pneumothorax, and massive hemorrhage.…”

CT-Guided 125 I Brachytherapy in the Treatment of Distant Metastases in the Oral Cavity and Maxillofacial Region

“…In recent years, a new modality, 125 I brachytherapy, has been accepted as a useful and minimally invasive interventional modality, because it achieves higher local tumor control and fewer complications [12,13]. Many studies have evaluated 125 I brachytherapy have a good curative effect in pancreatic cancer, liver cancer, lung cancer, prostate cancer, and gynecological and brain malignancies [14].…”