125I brachytherapy in the palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments

Abstract

PurposeThis study sought to assess the safety and effect of 125I seed implantation for palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments.Materials and Methods89 patients with painful bone metastases secondary to lung cancer were consented and enrolled in this study from June 2013 to May 2015. All patients had failed or refused conventional treatments underwent percutaneous CT-guided 125I seed implantation. The Brief Pain Inventory (BPI) was used to measure pain intensity prior to treatment (T0), 2, 4, 6, 8 and 12 weeks (T2, T4, T6, T8 and T12) after treatment in a 24-hour period. Analgesic, quality of life (QOL) scores and complications were also recorded. Four patients were excluded as they were lost to follow-up or had incomplete data.Results85 patients with 126 bone metastases from lung cancer were treated. There were significantly lower scores after treatment in the visual analog scale (VAS) and analgesic. The VAS scores for worst pain was 6.3±1.8 at T0. At T2, T4, T6, T8 and T12, the score in a 24-hour period decreased to 4.9±1.2 (P<0.01), 3.7±1.3 (P<0.01), 3.4±1.2 (P<0.01), 2.6±0.9 (P<0.01), and 1.4±0.8 (P<0.01) respectively. Comparison of QOL scores showed improvements including sleep, appetite, spiritual state, and fatigue at T2, T4, T6, T8 and T12 when compared to T0. No serious complications or massive bleeding were observed.Conclusions125I brachytherapy is a safe and effective method for palliation of painful bone metastases from lung cancer after failure or rejection of conventional treatments.

Analysis of curative effect of I 125 implantation combined with radiofrequency ablation in treating bone metastases

“…In this study, I 125 radioactive particle implantation combined with radiofrequency ablation was applied to treat BM, and the results showed that the analgesic effective rate was 76.7%. Furthermore, the patients’ mobility and quality of life were significantly improved, exhibiting statistical difference than group CON, consistent with the clinical treatment results of Rosenthal and Xiang [7] , [10] who applied I 125 particle implantation alone to treat BM and reduce the patients’ pain caused by invasive surgery. The median onset time of analgesia was 3.5 days, significantly earlier than Group CON.…”

“…During killing tumors, the mechanical and biological functions of the diseased limbs can be reserved, and the inactivated tumor segment can be fully used for reconstruction, thus reducing the complications in traditional surgical treatments. Over the past 20 years, cryoablation, radiofrequency ablation, and radioactive particle implantation have made great progresses in treating BM [7] , [8] , [9] , [10] , [11] . Goetz, reports the radiofrequency ablation treatment of cancerous pain patients with bone metastases, can relieve pain and improve the quality of life, the worst pain in 95% of patients can alleviate at least two points [12] .…”

Radiofrequency ablation versus 125I-seed brachytherapy for painful metastases involving the bone

“…This could be due to the operators’ consideration for injury to the spinal cord and major nerve during RFA, because of which they may have preferred 125 I-seed implantation. The success of 125 I-seed brachytherapy for a tumour depends on the precise placement of radioactive seeds [ 21 , 22 ]. The American Brachytherapy Society's “dual 90” principle stated that the cure for cancer required 90% of the tumour volume to obtain 90% of the prescription dose [ 23 ].…”

¹²⁵I seed brachytherapy versus external beam radiation therapy for the palliation of painful bone metastases of lung cancer after one cycle of chemotherapy progression

“…In our previous study, we have shown that 125 I brachytherapy, a new indication of iodine brachytherapy, was a safe and effective method for palliation of painful bone metastases secondary to lung cancer. 12 Patients had significantly lower scores in the pain visual analog scale (VAS) after treatment with 125 I brachytherapy. The QOL of patients was also obviously improved.…”